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 current study performs an explicit nonlinear finite element simulation to predict temperature distribution and consequent stresses during the friction stir welding (FSW) of AA 7075-T651 alloy. The ABAQUS® finite element software was used to model and analyze the process steps that involve plunging, dwelling, and traverse stages. Techniques such as Arbitrary Lagrangian–Eulerian (ALE) formulation, adaptive meshing, and computational feature of mass scaling were utilized to simulate sequence events during the friction stir welding process. The contact between the welding tool and workpiece was modelled through applying Coulomb’s friction model with a nonlinear friction coefficient value. Also, the model considered the effect of nonlin
... Show MoreAPFS Mohammed, 2014
The Battle of Kadesh is replete with many military arrangements that reflect the tremendous development of war preparations in the thirteenth century BC; where the expressive pictures the Egyptians left on some of the walls of their temples show the tremendous ability to organize and divide the forces and the great development that affected the war machine. Furthermore, the text accompanied these pictures reveal some news about that battle, which is considered one of the most important wars in the ancient world. Thus, the importance of the study lies in the fact that it examines one of the most important battles of the ancient Near East, the results of which had great repercussions on the region. This is because it is the most abundant B
... Show MoreThe impact of a proposal for the curriculum dictated by some of the barriers to the development of motor skillsA. M. D. Huda Ibrahim RezoukiM. M. Susan Salim DawoodIs the childhood of the most important and most fertile stage of basic education because of their significant impact in building a base on which the stated origin of sound in the early stages older age because the baby at this stage be very vulnerability to environmental factors different surroundings in which to leave their mark on his life in the stages of life other.The Gymnastics of sports long-term training, which begins between the ages very early relative to the rest of other games to reach the stage of the tournament from the age of 13-17 years almost to the women, this a
... Show MoreThis study is considered to be the first on this sector of Tigris River after 2003, to evaluate the effect of Tharthar Arm on the composition and diversity of Copepoda in Tigris River. Six sampling sites were selected; two on the Tharthar Arm and four sites along the Tigris River, one before the confluence as a control site and the others downstream the confluence; thirty-five copepod taxa were recorded, 34 taxa in the Tigris River and 25 taxa in the Tharthar Arm.
The highest density of Copepoda was in site 2 at Tharthar Arm was 265584.2 Ind./m3 lead to an increasing in Copepoda density in Tigris River from 63878.2 Ind./m3 in site 1 before the confluence to 127198.3 Ind./m3 in site 4 immediately downstream the confluence. Also, the me
Due to the increasing interest in the quality of auditing by writers, researchers and regulators of the auditing profession. The matter necessitated a statement of the extent to which the auditor practices professional skepticism, because of its significant impact in discovering errors and material misrepresentations contained in the financial statements in order to give the financial community confidence in them and the success of the audit process. The research aims to clarify the concept and importance of the practice of professional skepticism and its effect on the quality of the auditor's performance in Iraq. To achieve the research objectives, the two re
... Show MoreBackground: Women sexuality is basic right and it plays a major role in women's Health aspects. Up is one of the factors that lead to sexual dysfunction while the incidence of it is rising as UP severity being more. Objectives: To assess the impact of different degrees of uterine prolapse on sexual function of women at teaching hospitals in AL-Hilla City. Methodology: A descriptive analytical study was conducted from 1ST Feb to 10th Jun /2014 to assess the impact of different degrees of uterine prolapse on sexual function for women who attend to consultant clinic at teaching hospitals in AL-Hilla City
دُرِست العوامل المؤثرة في عدد ساعات تجهيز الكهرباء في مدينة بغداد، وتكونت عينة الدراسة من (365) مشاهدة يومية لعام 2018، وتمثلت بستة متغيرات استعملت في الدراسة. كان الهدف الرئيس هو دراسة العلاقة بين هذه المتغيرات، وتقدير تأثيرات المتغيرات التنبؤية في المتغير التابع (عدد ساعات تجهيز الكهرباء في مدينة بغداد). ولتحقيق ذلك استعملت نمذجة المعادلات الهيكلية/ تحليل المسار وبرنامج AMOS
... Show MoreBackground: Psoriasis is an immune-mediated inflammatory disease with unknown aetiology that may be associated with the defect in proliferation and differentiation of the keratinocytes related to inflammatory cell infiltration. According to published reports, it is universal in occurrence; its prevalence in different populations varies from 0.1% to 11.8%. Receiving Apremilast resulted in a strong reduction in interleukin 17 and interleukin 23, as well as reduced expression of other inflammatory cytokines and improvement of psoriatic lesions. Objectives: This study aimed to assess the impact of Apremilast on levels of IL-17, IL-23, and lipids in obese psoriatic patients. Methods: Thirty obese patients with psoriasis were included in
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