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.
Abstract
were determine the problem of current research to answer the question on the consciousness of the Ministry of Agriculture to adopt Staffing strategy and identify the shortcomings as the independent variable, represented by the three dimensions (recruitment , selection, placement) and its impact on high performance, as dependent variable is described in four dimensions (leadership, strategy, structure and processes, culture), in this research were Used analytical descriptive style . This research aims to identify the correlation and impact of Staffing strategy at high-performance in Ministry of Agriculture , To clarify the relationship between
... Show MoreRestoration of degraded lands by adoption of recommended conservation management practices can rehabilitate watersheds and lead to improving soil and water quality. The objective was to evaluate the effects of grass buffers (GBs), biomass crops (BCs), grass waterways (GWWs), agroforestry buffers (ABs), landscape positions, and distance from tree base for AB treatment on soil quality compared with row crop (RC) (corn [
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:
... Show MoreAbstract: E2F6 is a member of the E2F family of transcription factors involved in regulation of a wide variety of genes through both activation and repression. E2F6 has been reported as overexpressed in breast cancers but whether or not this is important for tumor development is unclear. We first checked E2F6 expression in tumor cDNAs and the protein level in a range of breast cancer cell lines. RNA interference-mediated depletion was then used to assess the importance of E2F6 expression in cell lines with regard to cell cycle profile using fluorescence-activated cell sorting and a cell survival assay using (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). The overexpression of E2F6 was confirmed in breast tumor cDNA samp
... Show MoreAn experimental and theoretical analysis was conducted for simulation of open circuit cross flow heat
exchanger dynamics during flow reduction transient in their secondary loops. Finite difference
mathematical model was prepared to cover the heat transfer mechanism between the hot water in the
primary circuit and the cold water in the secondary circuit during transient course. This model takes under
consideration the effect of water heat up in the secondary circuit due to step reduction of its flow on the
physical and thermal properties linked to the parameters that are used for calculation of heat transfer
coefficients on both sides of their tubes. Computer program was prepared for calculation purposes which
cover a
The present work aimed to examine the nature and degree of the cross-correlations among three different ionospheric indices: these are Optimum Working Frequency (OWF), Highest Probable Frequency (HPF), and Best Usable Frequency (BUF). VOCAP and ASASPS models were adopted to determine the datasets of the selected ionospheric indices. The determination was made for different transceiver stations that provide certain HF connection links during the minimum and maximum years of solar cycle 24, 2009 and 2014, respectively. Matlab program was implemented to produce the geodesic parameters for the selected transceiver stations. The determination was made for different path lengths (500, 1000, 1500, and 2000) Km and bearings (0o, 45
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In this research, a study of the behavior and correlation between sunspot number (SSN) and solar flux (F10.7) have been suggested. The annual time of the years (2008-2017) of solar cycle 24 has been adopted to make the investigation in order to get the mutual correlation between (SSN) and (F10.7). The test results of the annual correlation between SSN & F10.7 is simple and can be represented by a linear regression equation. The results of the conducted study showed that there was a good fit between SSN and F10.7 values that have been generated using the suggested mutual correlation equation and the observed data.
Background: Type 2 diabetes mellitus is a condition characterized by an elevation of oxidative stress, which has been implicated in diabetic progression and its vascular complications. Aim: Assessing the impact of gliclazide modified release (MR) versus glimepiride on oxidative stress markers, glycemic indices, lipid profile, and estimated glomerular filtration rate in uncontrolled type 2 diabetic patients on metformin monotherapy. Methods: This was an observational comparative study conducted in Thi-Qar specialized diabetic, endocrine, and metabolism center. Sixty-six patients were randomized into two groups based on the addition of the sulfonylureas (SUs). Group 1 (33 patients) was on gliclazide MR, whereas Group 2 (33 patients)
... Show MoreBackground: 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
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