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.
This study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
... Show MoreClinical index is needed to predict the outcome of pregnancy after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) for infertile patients. Growth differentiation factor-8 (GDF-8), also known as myostatin, is one of transforming growth factor-â superfamily localized in antral follicles in normal and PCOS ovaries but its function in female reproductive system is still unknown. Aim of the study is to assess the correlation between levels of GDF8 in follicular fluid (FF) with outcomes of in vitro fertilization (IVF/ICSI) in women with and without PCOS. A prospective case control study was performed enrolling (40) patients with PCOS and (40) non-PCOS women (male infertility) undergoing IVF/ICSI. The collect
... Show MoreThis paper analysed the effect of electronic internal auditing (EIA) based on the Control Objectives for Information and Related Technologies (COBIT) framework. Organisations must implement an up-to-date accounting information system (AIS) capable of meeting their auditing requirements. Electronic audit risk (compliance assessment, control assurance, and risk assessment) is a development by Weidenmier and Ramamoorti (2006) to improve AIS. In order to fulfil the study’s objectives, a questionnaire was prepared and distributed to a sample comprising 120 employees. The employees were financial managers, internal auditors, and workers involved in the company’s information security departments in the General Company for Electricity D
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Although the subject of biofuels industry is linked directly to the energy sector, but has links and numerous indirect effects, in particular effects on the environment and agriculture, this study (opportunities and challenges of biofuels industry and impact on the development of the agricultural sector in developing countries) a modest step to identify the industry in detail and identify the types of products and raw materials entering, then define or limit the positive and negative impacts of this industry in General and for specific products In particular, detailed, and then flip all those effects on the agricultural sector in developing countries can benef
... Show MoreBackground: Celiac disease is an autoimmune chronic disease that affects the human’s intestine and subsequently reflects its effect on the entire body health by retardation the absorption and immune mediated complications cause the involvement of oral health. The present study intended to evaluate the impact of the histopathological disease activity upon dental enamel defects and dental caries.
Subjects and methods: Forty celiac-diseased patients aged 7-11 years were collected from 3 different teaching hospitals in Baghdad classified by means of the histopathological activity of the intestinal disease according to modified Marsh-Ros
... Show MoreForeign direct investment (FDI) is one of the most practical types of foreign investment. FDI contributes to job creation, foreign exchange earnings and national income escalation, improving semi-skill and skilled labor. Based on our knowledge, this paper is the first study attempting to investigate the effect of political stability on the FDI in Turkey using an econometric approach. Achieving this objective, a co-integration analysis was conducted between the FDI and its determinants in the short-run and long-run including “macroeconomic indicators” and “Political Stability (PS)” in Turkey. Using annual data from 1974 to 2017 via Auto-Regressive Distributed Lag (ARDL) model. The results confirm the positive correlation betwe
... Show MoreBackground: Mother-infant bonding is an important psychological step postpartum and disturbed relationship may carry dramatic consequences as a psychological disorder which may affect the periodontal health of the mother. The aim of the present study was to assess the effect of the postpartum Mother-infant bonding on their periodontal condition. Materials and Methods: Mothers in the postpartum period with age range 20-35 years were subjected to postpartum Bonding Questionnaire (PBQ). Periodontal health status was assessed by measuring probing pocket depth and clinical attachment level. Results: The mean values of both probing pocket depth (PPD) and clinical attachment loss (CAL) were higher among disordered mothers than mothers with normal
... Show MoreThis study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
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