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 basis of the personality of each individual lies in the early years of his or her life. If the personality of the child has been well organized and if the motives have been fully expressed and effectively directed, the child will have a strong will, happy self-confidence and a strong personality. If there is a failure In the early years, the individual will be unable to meet his responsibilities in life and may be the victim of many psychological disorders. The family is a learning process through which children acquire the customs, traditions, attitudes and values prevailing in their social environment. (Pre-and-after) play and its relationship to parenting methods of (democratic-bullying-overprotection- and neglect), which wi
... Show MoreKp index correlates with the many magnetosphere properties, which are used to measure the level of magnetic activity. In the solar system, the two different planets, Mercury with weak magnetic field and Jupiter with strong magnetic field, are selected for this study to calculate the planet's magnetosphere radius (RMP) which represents the size of magnetosphere compared with solar activity through Kp index, through two types of geomagnetic conditions; quiet and strong for the period (2016-2018). From the results, we found that there are reversible relations between them during strong geomagnetic storms, while there are direct relations during quiet geomagnetic conditions. Also it is found that the
... Show More(Thimma) in Arabic means compact, and immunity. (People of Thimma) are the free non-Muslim people under Muslim rule. This includes Heavenly Religions people, i. e., Christian and Jews).
They have been called (People of Thimma) because they had paid (Jizyah: tribute) so they became safe for their souls, honor, properties at the custody of Muslims.
Islamic law had posed (Jizyah: tribute) upon the Jews and Christians who were living under Muslim rule as a reaction of not embracing Islam Faith against securing their rights and freedom.
Freedoms secured by Islam for the (People of Thimma) had been many, including the right of faith, not coercing them to be Muslim, the right to live, to possess properties, protect and secure them, the
Background: Data on the impact of neonatal and total pediatric admissions volume on neonatal mortality are sparse. Objectives: This study is done to estimate the neonatal mortality in relation to neonatal admissions and to total hospital admissions in Al-Alwyia Pediatric Teaching Hospital through years 2005-2012 Type of the study: A retrospective study.Methods: statistical records of all cases admitted to APTH were studied during 2005-2012.Results: Neonatal mortality decreased to the nadir at last year of study period (2012) and reached 6.1% of neonatal admissions compared to 2005 level which was 9.7 %. Mortality rate among premature and low birth weight (LBW) infants decreased also. The study also reveals that neonatal mortality constit
... Show MoreComputer simulations were carried out to investigate the dependence of the main perturbation parameters (Sun and Moon attractions, solar radiation pressure, atmosphere drag, and geopotential of Earth) on the orbital behavior of satellite. In this simulation, the Cowell method for accelerations technique was adopted, the equation of motion with perturbation was solved by 4th order Runge-Kutta method with step (1/50000) of period to obtain the state vectors for position and velocity. The results of this simulation have been compared with data that available on TLEs (NORD data in two line elements). The results of state vectors for satellites (Cartosat-2B, Gsat-14 an
The Audit evedances represent the reconciliation tools between the Financial data shown on financial statements, and the level of satisfaction level of the Auditor about these statements. According that, the Auditor try to achieve the highest quantity of These evidances, and the most satisfactive of it…, but that will be so hard sometimes, when the internal controlling system is not good, and when the Auditor had some satisfied evidences, but not sharp… So, this research comes to inspect the relation between the quantity, and the level of satisfaction, and argument to prove that evidences gives. This research assumes that getting enough evidences leads to reduce faults, improves the auditing operation, and avoids risks. The research
... Show MoreThe subject of the evolution of fire insurance of the hottest topics accidents, because it falls within the commercial insurance, as its importance is reflected for being a security source and contentment of the insured person and so it is worth pointing out the importance of fire insurance in enterprises and organizations of all kinds, because of the guarantee of its assets from meridian as well as protection from the effects of the fire therefore ensure continuity in the performance of their activities
Abstract
The research aims to determine the role of the efficiency of Human Resources Information System in the effectiveness of Employees Performance Appraisal System in the Ministry of Higher Education and Scientific Research / Center for the ministry, it was touching the researchers need the ministry to devise methods that employ outputs Human Resources Information System in the organization surveyed for the development of methods and levels of process evaluate the performance of its employees, in order to identify the extent of the role played by human resources information system in the process of assessing the performance of employees, we raised the question of the President as follows:
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