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.
Specialized banks provide their banking activities to their customers at interest rates that are determined according to the approved bank policy, which is almost similar to most or most banks. To satisfy the financial desires of customers and at the same time it is a source of the bank's profits, However, these banks have been introduced to new services that they provide with the funds of the Central Bank initiative launched at the beginning of (2016) to address the economic stagnation that befell the country due to the (financial security) crisis that the country faced in 2014. To put forward initiatives amounting to nearly (15) trillion dinars, which were put forward through private commercial and Islamic banks and specialized
... Show MoreThe first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He
Borders Search: Search by students is determined by th
... Show MoreThe research discusses two variables are important, orientation marketing and quality of service, and that the purpose of the research is to see whether the telecom companies applied orientation marketing or not and to what extent is keen to apply it to suit the Iraqi environment as it has been applied research in kork Telecom company and Asia Cell Telecom are sectors service job in the business sector in Iraq, The information was obtained through the design of the questionnaire compatible runway Likert, and distribution (92) questionnaire, which (50) for the company Korek Telecom and (42) of the Asia-Cell, research population sample included a number of staff in the departments and units in the two companies, it has been support
... Show MoreBackground: The main drawback of soft lining materials was that they debonded from the denture base after a certain period of usage. Therefore, the purpose of this research was to determine the impact of oxygen and argon plasma treatment on the shear bonding strength of soft liners to two different kinds of denture base materials: conventional acrylic resin and high impact acrylic resin. Materials and Methods: Heat cure conventional and high impact acrylic blocks (40 for each group) were prepared. A soft liner connected the final test specimen of two blocks of each acrylic material. Shear bond strength (SBS) was assessed using universal testing machine. Additional blocks were also prepared for analyzing Vickers microhardness, contact ang
... Show MoreObjective: To assess the impact of a social support for pregnant women upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of a social support on their pregnancy outcomes. The study was conducted from (22 \ September \ 2020 to 15 \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labor wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the positive pregnancy outcome
... Show MoreThe present study aims to reveal the extent of the influence of the acquired organizational immune through its dimensions (organizational vaccination, organizational learning, organizational memory, and benchmarking) in the application of knowledge management strategies in its two dimensions (codification strategy, personalization strategy) as well as clarifying that influential relationship between the study variables Because of its importance in reducing resistance to change by responding to the requirements of the environment. A set of main and sub-hypotheses emerged from the study, which was formulated in view of the hypothesis scheme of the study, and i
... Show MoreThe results of previous scientific studies showed that knowledge is something and application is something else, that's why teachers' preparation programs focused, in the present time, on special standards for knowledge and performance, i.e., who has knowledge is not necessary able to apply it in his life or in his field of work, which led to the existence of a gap between knowledge and application. Based on that, those interested in (teachers' preparation) reconsidered their work evaluation, thus the concept of competency appeared at the end of the sixties of the past century to address the negative in teachers' preparation.
The following contains a number of competency features in teachers' preparation programs:
Teachers' effec
In subterranean coal seam gas (CSG) reservoirs, massive amounts of small-sized coal fines are released during the production and development stages, especially during hydraulic fracturing stimulation. These coal fines inevitably cause mechanical pump failure and permeability damage due to aggregation and subsequent pore-throat blockage. This aggregation behavior is thus of key importance in CSG production and needs to be minimized. Consequently, such coal fines dispersions need to be stabilized, which can be achieved by the formulation of improved fracturing fluids. Here, we thus systematically investigated the effectiveness of two additives (ethanol, 0.5 wt % and SDBS, 0.001 and 0.01 wt %) on dispersion stability for a wide range of condit
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