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 research seeks to identify the dimensions of creative thinking and its impact on the re-engineering of hotel service operations by analyzing the correlation and impact between research variables as well as comparing the research sample The importance of the research comes from the need to motivate managers the importance of creative thinking among workers in the researched hotels because it is an essential part in the re-engineering of hotel services. To achieve this a questionnaire was designed containing (33) items that include the independent research variables (creative thinking) and the accredited (re-engineering the hotel service) and distributed to a sample of (50) individuals represented by (Commissioner Director, Dep
... Show MoreInvestment in high education is considered to be most important factors of production which the return an individual and social than economic returns found by searching the growing problem of unemployment, especially among youth graduates, where the unemployment rate in 2010 (50%) of these high rates have led to increased migration of scientific minds graduate recently, "to search for job opportunities outside Iraq for not hiring functions and this is in vain" clear "in the human and financial resources lead to structural imbalances in the Iraqi economy. When calculating the correlation coefficient between the graduates and the unemployment rate where it reached (0.21) emerged from the results of
... Show MoreThe aim of this research is to construct a cognitive behavior program based on the theory of Meichenbaum in reducing the emotional sensitivity among Intermediate school students. To achieve the aims of the research, two hypotheses were formulated and the experimental design with equal groups was chosen. The population of research and its sample are determined. The test of negative emotional sensitivity, which is constructed by the researcher, was adopted. The test contains (20) items proved validity and reliability as a reliable test by presenting it to a group of arbitrators and experts in education and psychology. An educational program is constructed based on the theory of Meichenbaum. The test was applied to a sample of (60) second i
... Show MoreThe research aims to study the basic concepts of the underwriting policy with its various indicators. The researcher studies the underwriting policy with its various indicators (sex, health status, age of the insured, insurance amount, The method of acceptance, payment method, and duration of insurance) where each of these indicators constitute an important factor in the productivity of life insurance policies, where the productivity of life insurance policies face many difficulties because insurance is a service and not a tangible material commodity and its benefits and not current. Therefore, the life insurance company needs to use a prudent underwriting policy so as not to endanger its financial position due to the expansion of the un
... Show MoreBackground: Chronic periodontitis is a bacterial infection that result in bone destruction associated with the increasing level of salivary tumor necrosis alpha and interleukin6 that affect Mother-infant bonding status. The aim of the present study was to assess the relationship between the Mother-infant bonding status in mothers with chronic periodontitis in relation to Salivary Tumor necrosis factor alpha and Salivary Interleukin6. Materials and Methods: The selected sample consisted of mothers with chronic periodontitis compared with mothers with healthy periodontium in postpartum period, their age ranged between 30-40 years. Both groups were subjected to postpartum Bonding Questionnaire (PBQ). Periodontal health status was assessed f
... Show MoreBackground: Blood group system and the ability to taste phenylthiocarbamide (PTC) are the most studied traits in human genetics which have been extensively used in describing genetic variations among human populations around the world that may had an effect on dental caries. The aims of present study were to investigate the caries experience among students with different bitter taste threshold in relation to blood type. Materials and Methods: The sample of present study includes dental students female aged19-21 years. The diagnosis of dental caries was done according to the criteria of Manjia et al, 1989 recording decayed lesion by severity (D1-4) MFS. Furthermore, bitter taste sensitivity was measured according to PTC (phenylthiocarbamid
... Show MoreBackground: Appreciation of the crucial role of risk factors in the development of coronary artery disease (CAD) is one of the most significant advances in the understanding of this important disease. Extensive epidemiological research has established cigarette smoking, diabetes, hyperlipidemia, and hypertension as independent risk factors for CADObjective: To determine the prevalence of the 4 conventional risk factors(cigarette smoking, diabetes, hyperlipidemia, and hypertension) among patients with CAD and to determine the correlation of Thrombolysis in Myocardial Infarction (TIMI) risk score with the extent of coronary artery disease (CAD) in patients with unstable angina /non ST elevation myocardial infarction (UA/NSTEMI).Methods: We
... Show MoreThe research aims to verify that there is an influence between innovative marketing and the organization's reputation by brand mediation.
The research problem is that the Oil Marketing Company (SOMO) needs innovative, unconventional methods in marketing its products and improving its reputation by adopting a solid brand that adds value to the product.
The importance of the research: The importance of the research is highlighted as it deals with essential variables in business organizations that help increase customer loyalty by adopting a distinctive brand.
The research started from four main hypotheses to explore correlations and influence between researc
... Show MoreLe Petit Prince est apparu en 1943 vers la fin de la vie de son auteur. La mondialité qu'a gagnée ce récit le rend un des livres les plus lus et les plus vendus dans le monde. Cette popularité en fait un des classiques de la littérature française.
En effet la littérature française a un impact profond et direct sur la vie intellectuelle et littéraire dans le monde arabe. La circulation des œuvres littéraires écrites en français a bien influencé les lecteurs arabes soit en langue française soit traduites en arabe. Cette réalité est identique lorsqu'on parle de la réception du Petit Prince ; l'œuvre la plus connue dans le monde entier dès son apparition officielle.
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