Background: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a left pure posteriorly directed PCoA aneurysm. In the surgery, through the left pterional approach, all intraoperative steps were carried out. Additional steps were performed as well. Three additional intraoperative steps were contemplated because a pure posteriorly directed PCoA aneurysm is not well appreciated and is often hidden behind the supra cliniold internal carotid artery (ICA). First, the extension of Sylvian fissure dissection to include the distal part and the proximal. Second, temporal pole mobilization is performed by cutting small anterior temporal veins. Third, a brain retractor is placed on the temporal lobe to gently tract the superficial part of the lobe. All these steps widened the surgical corridor to ensure the aneurysm's safe clipping. Conclusion: Surgical clipping is influenced by the aneurysmal dome projection. In a ruptured pure posteriorly directed PCoA aneurysm, further intraoperative steps may facilitate complete access and safe clipping of the aneurysm.
Toxoplasmosis is a parasitic infection that triggers immune cells to produce cytokines and inflammatory mediators that are responsible for abnormal or aborted immune responses. This study highlights the evaluation of the Dectin-1 receptor and cytokine IL-37 in the serum of 80 patients who had miscarried in the first trimester and were infected with toxoplasmosis, as well as 40 pregnant women in the first trimester who had a successful pregnancy (control groups). The serum was first screened for the T. gondii IgM and IgG antibodies by an enzyme-linked immunosorbent assay (ELISA) and then the serum levels of IL-37 and Dectin-1 were determined. The results showed that the serum level of Dectin-1 was significantly increased in anti-
... Show MoreThe Role of the Deubiquitylase MYSM1 During Alphavirus Infection Amer Nubgan The members of the genus Alphavirus are positive-sense RNA viruses and it is one of two within the family Togaviridae. Most alphaviruses are predominantly transmitted to susceptible vertebrates by a mosquito vector. Alphavirus disease in humans can be severely debilitating, and depending on the particular viral species, infection may result in encephalitis and possibly life threatening symptoms. Chikungunya virus (CHIKV) is the aetiological agent represents a substantial health burden to affected populations, with clinical symptoms that include severe joint and muscle pain, rashes, and fever, as well as prolonged periods of disability in some patients. In recent
... Show MoreMagnetosphere is a region of space surrounding Earth magnetic field, the formation of magnetosphere depends on many parameters such as; surface magnetic field of the planet, an ionized plasma stream (solar wind) and the ionization of the planetary upper atmosphere (ionosphere). The main objective of this research is to find the behavior of Earth's magnetosphere radius (Rmp) with respect to the effect of solar wind kinetic energy density (Usw), Earth surface magnetic field (Bo), and the electron density (Ne) of Earth's ionosphere for three years 2016, 2017 and 2018. Also the study provides the effect of solar activity for the same period during strong geomagnetic storms on the behavior of Rmp. F
... Show MorePurpose: The aim of this study was to gain insight into causes of time delays and cost overruns in a selection of thirty case projects in Iraq. Delay factors have been studied in many countries/contexts, but not much data exists from countries under the conditions characterizing Iraq during the last 10-15 years.Design/methodology/approach: A case study approach was adopted, with thirty construction projects selected from the Baghdad region, of different types and sizes. For the case of the study, the participants in the projects provided data about the projects through the data collection tool distributed through the questionnaire directed to them. Statistical data analysis was used to build statistical relationships between time and cost d
... Show MoreIn recent years, the attention of researchers, governments and international non-governmental organizations has focused on the aggressive practices adopted by companies with the aim of evading the tax burden or from paying the tax obligations imposed on them by law, as the results of these practices are negatively affected by tax revenues. And that companies are part of the society in which they work, and they have rights and obligations, including paying taxes. The research community is the Iraqi private shareholding companies, and the research sample was 4 companies within the private sector and in the field and finance - banking, insurance, industrial and service, which are Ashur Bank, Al-Ahlia Insurance Company, Baghdad Soft
... Show MoreThe aim of the research is to test the effect of outsourcing human resources activities (independent variable) with its dimensions (outsourcing of staffing, outsourcing of training and development, outsourcing of wages and compensation, outsourcing of human resources information systems) on organizational winning (dependent variable) with its dimensions (the culture of winning, successful organizational change, continuous improvement, and adoption of risk). The research problem was the questions posed by the researcher, the most important of which is the extent to which the research sample realizes the importance of applying outsourcing to human resources activities and its role in organizational vi
... Show MoreIn recent years, the attention of researchers, governments and international non-governmental organizations has focused on the aggressive practices adopted by companies with the aim of evading the tax burden or from paying the tax obligations imposed on them by law, as the results of these practices are negatively affected by tax revenues. And that companies are part of the society in which they work, and they have rights and obligations, including paying taxes. The research community is the Iraqi private shareholding companies, and the research sample was 4 companies within the private sector and in the field and finance - banking, insurance, industrial and service, which are Ashur Bank, Al-Ahlia Insurance Company, Baghdad Soft
... Show MoreObjectives: To assess nurses-midwives' knowledge about pain management during labor before and after implementation of educational program and to determine the effectiveness of educational program on nurses-midwives' knowledge about pain management during labor in Baghdad Maternity Hospitals.
Methodology: A quasi-experimental design has been conducted during the period of (February 27th 2019 through 2nd June 2019) on non-probability sample (purposive) consists of (44 Nurses/midwives') who are work in delivery room, the sample was exposed to pretest, educational program, posttest. The study was conducted in three Directories, (Baghdad Teaching Hospital) at medical city health
... Show MoreLaryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea
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