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.
The purpose behind this paper is to discuss nanoparticles effect, porous media, radiation and heat source/sink parameter on hyperbolic tangent nanofluid of peristaltic flow in a channel type that is asymmetric. Under a long wavelength and the approaches of low Reynolds number, the governing nanofluid equations are first formulated and then simplified. Associated nonlinear differential equations will be obtained after making these approximations. Then the concentration of nanoparticle exact solution, temperature distribution, stream function, and pressure gradient will be calculated. Eventually, the obtained results will be illustrated graphically via MATHEMATICA software.
The technology in continuous and quick development, that reflects in all parts of our life and interred both scientific and practical fields. Marketing is one of them, a customer’s way to deal with choosing and demanding the product deferent from the traditional way. Some of the buying processes are electronic now, therefore the current research is identifying the digital channels that entered the world of marketing and influenced the activities and types that fall under this name and how it affects in positioning strategy, which is how to install the product or brand in the mind of the customer and was dimensions (brand identity, brand personality, brand communication, brand awareness, brand image), The researcher took t
... Show MoreThe aim of the research is to determine the impact of profit management practices on the quality of profits through the use of flexibility in determining accounting methods and practices profit information is one of the most important information that concerns current users in general and observing users in particular. Some corporations managements manipulate the results of the company's profit or loss (income statement) and financial position statement with multiple reasons, including capital market motivations to raise their share prices in the stock market and attract investors, and on the other hand the motives of funding and borrowing loans, and the use of the flexibility in accounting policies and estimates to change the in
... Show MoreDoxycycline hyclate is an antibiotic drug with a broad‐spectrum activity against a variety of gram‐positive and gram‐negative bacteria and is frequently used as a pharmacological agent and as an effector molecule in an inducible gene expression system. A sensitive, reliable and fast spectrophotometric method for the determination of doxycycline hyclate in pure and pharmaceutical formulations has been developed using flow injection analysis (FIA) and batch procedures. The proposed method is based on the reaction between the chromogenic reagent (V4+) and doxycycline hyclate in a neutral medium, resulting in the formation of a yellow compound that shows maximum absorbance at 3
Background: During Ramadan, Muslims fast throughout daylight hours. There is a direct link between fasting and increasing incidence of infections. Antibiotic usage for treatment of infections should be based on accurate diagnosis, with the correct dose and dosing regimen for the shortest period to avoid bacterial resistance. This study aimed to evaluate the practices of physicians in prescribing suitable antibiotics for fasting patients and the compliance of the patients in using such antibiotics at regular intervals. Materials and methods: An observational study was carried out during the middle 10 days of Ramadan 2014 in two pharmacies at Baghdad. A total of 34 prescriptions (Rx) for adults who suffered from infections were examined. For
... Show MoreAfter the fall of the Soviet Union, a number of Eastern Bloc countries and Soviet republics have witnessed political transition. However, Turkmenistan, as one of the former Soviet republics, succeeded to preserve the authoritarian nature of the former Soviet regime. This study seeks to answer a number of research questions, the most prominent of which are: How were the political elite in Turkmenistan able to preserve the legacy of the Soviet policy based on centralization of power and individual rule?. The study reaches a set of conclusions, the most important of which are:
1-The roots of the tyranny in Turkmenistan are du to internal and external structural factors. The most important of which are: the former Soviet policies of m
... Show MoreA new scheme of plasma-mediated thermal coupling has been implemented which yields the temporal distributions of the thermal flux which reaches the metal surface, from which the spatial and temporal temperature profiles can be calculated. The model has shown that the temperature of evaporating surface is determined by the balance between the absorbed power and the rate of energy loss due to evaporation. When the laser power intensity range is 107 to108 W/cm2 the temperature of vapor could increase beyond the critical temperature of plasma ignition, i.e. plasma will be ignited above the metal surface. The plasma density has been analyzed at different values of vapor temperature and pressure using Boltzmann’s code for calculation of elec
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