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.
This research Sought to Determine the Relationship and impact between the tax knowledge in dimensions of the tax compliance costs (monetary costs, time costs, psychic costs) Since the sample included 81 individuals represented by the Executive directors and Financial and Accountant working in the Joint-stock company, A questionnaire was used as a tool for data collection and its analysis. For the purpose of analyzing the research data the statistical package for social science, SPSS. The most important tools used in the statistical analysis are:(standard deviation, and simple linear regression, percentages, arithmetic mean, Cronbach's alpha, F-test, T- Test). The research found a weakness attenti
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This paper represents a study of the effect of the soil type, the drilling parameters and the drilling tool properties on the dynamic vibrational behavior of the drilling rig and its assessment in the drilling system. So first, an experimental drilling rig was designed and constructed to embrace the numerical work.
The experimental work included implementation of the drill-string in different types of soil with different properties according to the difference in the grains size, at different rotational speeds (RPM), and different weights on bit (WOB) (Thrust force), in a way that allows establishing the charts that correlate the vibration acceleration, the rate of penetration (ROP), and the power
... Show MoreRapid development has achieved in treating tumor to stop malignant cell growth and metastasis in the past decade. Numerous researches have emerged to increase potency and efficacy with novel methods for drug delivery. The main objective of this literature review was to illustrate the impact of current new targeting methods to other previous delivering systems to select the most appropriate method in cancer therapy. This review first gave a brief summary of cancer structure and highlighted the main roles of targeting systems. Different types of delivering systems have been addressed in this literature review with focusing on the latest carrier derived from malarial protein. The remarkable advantages and main limitations of the later
... Show MoreThis research aims to measure the impact of applying bank governance mechanisms in reducing the financial risks of banks listed on the Palestine Stock Exchange, and to answer research questions and test hypotheses for the study, researchers adopted the descriptive and analytical approach, and data were collected from the annual financial reports of the banks listed on the Palestine Exchange during the period between (2009-2018), as a time series for the purpose of finding, analyzing and measuring the effect between the study variables during this period by (60) views for each of the study variables, using the statistical analysis program views(9) to enter, process and analyze the data. The results of the study proved that there i
... Show MoreThis research raised the strategic selection factors and dimensions of the quality of higher education and what the nature of their relationship and has been collecting a sample search from the technological University of president scientific departments and administrative and scientific associates and chiefs of branches This research aims at studying factors affecting the strategic selection effects these factors in the quality of higher education and the combination of these factors has been identified as a group of selected dimensions of quality of higher education and study link relationships and affecting factors and strategic selection of (risk, previous strategies, resources, time, considerations and internal trends) and d
... Show MoreIn this research we have tackled the role of Talent management (as a private variable) within (the Talent attraction, the Talent management performance, Talent development and Talent retention) on strategic performance reinforcement ( accredited variable) within its dimensions ( financial perspective, costumer perspective, internal operations perspective and learning and development perspective). The research conducted on sample of some college teachers from two of Sumer's colleges. The research problem represented by the broad organization's competition as well as universities; which led these colleges to investigate it's skillful human staff to meet it's strategic performance.
To meet the aims of
... Show MoreThe effect of water stress induced by using polyethylene glycol (PEG-6000) on germination of seeds and growth of seedlings of Silybum marianum was studied. Two concentrations of PEG were used to get two water stresses (-0.4 & -0.8 bar) as well as the control for comparison. The results showed a significant decrease (P<0.05) in germination ratio compared with the control. The ratio did not slow down to less than 50% which indicates the ability of the seeds to resist water stress to some extent. Also, a significant decrease (P<0.05) in the length of shoot and root was observed compared with the control. This plant showed
... Show MoreThe study aims to measure the level of academic stress in the e-learning environment in three areas, students and their dealing with classmates, dealing with the professor and technical skills, and the nature and content of the curriculum among graduate students in the College of Education at King Khalid University during COVID-19 pandemic. This study was descriptive in nature (survey, comparative). The sample consisted of (512) male and female graduate students in the master's and doctoral programs. The Academic Stress Scale in the E-learning Environment designed by Amer (2021) was used. The results indicated a high level of academic stress among graduate students in the e-learning environment. The study also found that there were stati
... Show MoreThis research aims to demonstrate the impact of the going concern assumption in different accounting applications to provide a realistic look and more accurate result of activity and financial situation, as well as determining the responsibility of the Company's administration in compliance with the going concern assumption during the preparation for their financial statements, and to clarify the concept of integration between internal audit and external audit about going concern assumption, besides its importance and usefulness on the work of both of the internal auditor and the external auditor, as well as on the company under auditing process.This research purports preparing an internal audit program, including a set of auditing actio
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