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.
تعد الرماية واحدة من الألعاب التي يقاس مستوى الانجاز فيها بالأرقام إذ ارتفعت الأرقام المسجلة بالنسبة لسلاح المسدس الهوائي حتى وصلت عند بعض الأبطال العالميين إلى الانجاز النهائي ، وقد لجأ المدربون إلى مختلف الطرق التدريبية, وان ضعف الثبات والتركيز هما اللذان يقودان إلى هبوط مستوى الانجاز في الرماية ، ولتحقيق التركيز والثبات المطلوبين أثناء الرمي يجب التدريب على مطاولة حمل السلاح التي تعد من أصعب تدريبات الر
... Show MoreThe main objective of this study is to measure the Impact of global financial crisis on some indicators of the Saudi Arabia's economy using the Mendel-Fleming model, the importance of the study applied by focusing on the theme of general equilibrium in the face of fluctuations in the global economy. Study used a descriptive approach and the methodology of econometrics to construct the model. Study used Eviews Program for data analysis. The Data was collected from the Saudi Arabian Monetary Agency, for the period (1997-2014).Stationery of the variables was checked by Augmented Dickey-Fuller (ADF) and Phillips Perron (PP) unit roots tests. And also the co-integration
... Show MoreThe aim of the research is to know the level of time management application and its impact on the performance of the job, a survey search in the general company for communication and information technology and provide recommendations that help employees to optimize the use of time and improve performance, which is an important element in controlling the various functions of the company. In order to achieve the objectives of the research, the questionnaire was based on two main variables and distributed to a random sample of (44) employees in the company out of (308) employees, thus the proportion of the sample (14%). After collecting the samples from the sample, there are (6) incomplete forms that have been retri
... Show MoreEvery researcher must say that the world in continually progress toward the best and that
the Arab and Islamic civilization had produced much of systems and virtuous educational
practices which raised from Islamic heritage. This nation was not isolated from external
world, but it was made a clear active for promote the banner of other nations which entered
under her influence to promote Islamic banner and Muslims. Consequently also Muslims are
affected and influenced, this resulted a clear impact in the civilization and educational
ideology especially in the contemporary teaching methods.
To avoid the negative effects due to inflexibility of the domestic production inresponse to the increase in government consumption expenditure leads to more imports to meet the increase in domestic demand resulting from the increase in government consumption expenditure. Since the Iraqi economy economy yield unilateral depends on oil revenues to finance spending, and the fact government consumer spending is a progressive high flexibility the increase in overall revenues, while being a regressive flexibility is very low in the event of reduced public revenues, and therefore lead to a deficit in the current account position. And that caused the deficit for imbalance are the disruption of the
... Show MoreThe research aims to reveal the impact of media policy in Iraqi media outlets on the level of objectivity in these outlets. A study from the communicators’ point of view where the researcher used a survey method on the communicators in media outlets to reveal the extent of media policies knowledge as well as the pressures exerted by this policy on communicators in media outlets. It also reveals the extent of their commitment to objectivity, neutrality in dealing with information and the way used to transfer it.
The research sample included (179) respondents from communicators in a range of Media outlets such as (Press, Radio, and Television), The researcher was careful with the diversity of the sample, and
The importance of the study lies in highlighting the role of smartwatches as a modern tool for analyzing training load based on functional indicators, such as heart rate and calorie consumption. This allows coaches to monitor individual players’ responses during different training periods, helping to improve physical performance efficiency and reduce the risk of overload-induced fatigue. The study aimed to analyze calorie consumption at different heart rate levels between the special preparation and competition periods for youth football players, with the goal of determining the effect of physiological adaptation on energy efficiency. To achieve this objective, the researcher adopted the descriptive method due to its suitability f
... Show MoreThe first flow injection spectrophotometric method is characterized by its speed and sensitivity which have been developed for the determination of promethazine-HCl in pure and pharmaceutical preparation. It is based on the in situ detection of colored cationic radicals formed via oxidation of the drug with sodium persulphate to pinkish-red species and the same species was determined by using homemade Ayah 3SX3-3D solar flow injection photometer. Optimum conditions were obtained by using the high intensive green light emitted diode as a source. Linear dynamic range for the absorbance versus promethazine-HCl concentration was 0-7 mmol.L-1, with the correlation coefficient (r) was 0.9904 while the percentage linearity (r2%) was 98.09%. the L.
... Show MoreBackground: Implant stability is considered one of the most important factors affecting healing and successful osseointegration of dental implants. The aims of the study were to measure the implant stability quotient (ISQ) values during the healing period and to determine the factors that affect implant stability. Materials and methods: Thirty patients enrolled in the study (17 female, 13 male). They received 44 Implantium® Dental Implants located as the following: 22 implants in maxillary jaw, 22 implants in mandibular jaw from them 17 implants in anterior segment and 27 in posterior segment. The bone density determined using interactive CT scan and classified according to the Misch bone density classification (29 implants in (D3), 15 i
... Show MoreAmino and fatty acids in the liver tissue of Uromastyx aegyptius microlepis during the periods of hibernation (December) and activity (May) were estimate by a high performance liquid chromatography, liver of a lizard during the activity and hibernation seasons, contained 18 amino acids, which include, 10 essential amino acids and 8 non-essential amino acids, and the liver in the male lizard contained five fatty acids during each season, the concentration rates of all the amino acids during the activity season were higher than their counterparts during the hibernation season, the total concentrations of essential and non-essential amino acids during the activity season were 19434.8 µg/ml, which was greater than the total concentrations leve
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