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 current research studies the aesthetic framework for the dialectical development of the functions of the contemporary theater director in an aesthetic approach to the mechanisms of functional overlap between the dramaturgy and direction functions, and scenography and direction, the detection of the controversial structure of that overlap, and what can be summed up in the following question: (what are the aesthetic approaches of the dialectical development in the function of the contemporary theatre director?). The research is determined by a pivotal aim which is (knowing the aesthetic nature of the dialectical development in
AbstractBackground:Reduced glomeular filtration rate isassociated with increasedmorbidity in patientswith coronary arterydisease.Objectives :To analyze the declining eGFR andmortality risks in a patients with Chronic KidneyDisease and have had Coronary Artery Diseaseincluding risk factors .Patientsand Methods:The study included (160)patientsbetween the ages of 16 and 87years.Glomerular filtration rate was estimated (eGFR)using the Modification of Diet in Renal Diseaseequationand was categorized in the ranges<60 mL· min−1 per 1.73 m2and≥ 60 ml/min/1.73 m2.Baseline risk factors were analyzed by category ofeGFR,.The studied patients in emergencydepartment, were investigatedusing Coxproportional hazard models adjusting for traditiona
... Show MoreMillions of pilgrims and visitors from numerous parts of the world flock to Karbala (one of the most prominent ideological and religious places in central Iraq) each year to visit the holy shrines in Karbala due to their sanctity. Many improvements have been made to the Two Holy Shrines (THS), the Shrines of Imam Husayn and Imam Abbas, and the area between them (ATHS), due to the high temperatures in this region and to improve pedestrian thermal comfort. Studies on improving outdoor thermal comfort in Karbala are scarce. Hence, this research aims to look into historical and current architectural changes and how they affect thermal comfort. On the hottest summer day, the ENVI-met software program was used to simulate the building des
... Show MoreMillions of pilgrims and visitors from numerous parts of the world flock to Karbala (one of the most prominent ideological and religious places in central Iraq) each year to visit the holy shrines in Karbala due to their sanctity. Many improvements have been made to the Two Holy Shrines (THS), the Shrines of Imam Husayn and Imam Abbas, and the area between them (ATHS), due to the high temperatures in this region and to improve pedestrian thermal comfort. Studies on improving outdoor thermal comfort in Karbala are scarce. Hence, this research aims to look into historical and current architectural changes and how they affect thermal comfort. On the hottest summer day, the ENVI-met software program was used to simulate the building des
... Show MoreThis study was designed to highlight the role of Epstein Barr viruses (EBV) as a possible causative effect in multiple sclerosis (MS) through testing the viral load along with both biochemical and immunological parameters in female MS patients. We also aimed at finding the effects of different types of treatment line on the various study aspects. The results of the enzyme-linked immunosorbent assay (ELISA) revealed first an increased level of EBV EBNA1IgG IL-17A (96.13±27.60 pg/ml) in sera of female MS patients (0.05±0.01 U/ml, n=50) compared with the control group (n=40). We confirmed this result using real-time polymerase chain reaction (RT-PCR) which also showed a significantly higher EBV load in MS patients (22.61±12.72 copi
... Show More<p>The current work investigated the combustion efficiency of biodiesel engines under diverse ratios of compression (15.5, 16.5, 17.5, and 18.5) and different biodiesel fuels produced from apricot oil, papaya oil, sunflower oil, and tomato seed oil. The combustion process of the biodiesel fuel inside the engine was simulated utilizing ANSYS Fluent v16 (CFD). On AV1 diesel engines (Kirloskar), numerical simulations were conducted at 1500 rpm. The outcomes of the simulation demonstrated that increasing the compression ratio (CR) led to increased peak temperature and pressures in the combustion chamber, as well as elevated levels of CO<sub>2</sub> and NO mass fractions and decreased CO emission values un
... Show MoreBackground: This study was designed to measure the displacement pattern of posterior palatal seal (pps) area in different forms of the palate and with different impression techniques. Materials and method: This study was used to measure the displacement pattern of (pps)in different palatal shapes by using different impression materials Korrecta wax No.4,Green compound and design of House for pps for each palatal forms by using a 3D Scanner of CAD/CAM and measuring the distance between 2 points in pps area by using Caural Threw. Result: The results show highly significant differences between these techniques and the control group (impression with light body) Conclusion: The physiological impression technique of pps with Korecta wax no.4
... Show More
This research aims to understand complexity management and its impact on the use of the dynamic capabilities of a sample of private colleges. Private colleges are currently facing many crises, changes, unrest and high competitive pressures. Which is sometimes difficult or even impossible to predict. The recruitment of dynamic capabilities is also one of the challenges facing senior management at private colleges to help them survive and survive. Thus, the problem of research was (there is a clear insufficiency of interest in Complexity Management and trying to employ it in improving the dynamic capabilities of Colleges that have been discussed?). A group of private colleges was selected as a
... Show MoreThe UN plans to achieve several development objectives by 2030. These objectives address global warming, a major issue. This method aims to improve sustainable accounting performance (AP). In this circumstance, AI is being applied in various fields, notably in economic, social, and environmental (ESE) domains. This research investigates how sustainable development (SD) influences AI methodologies and AP improvement. The research examined a sample of Iraqi banks listed on the Iraq Stock Exchange from 2014 to 2022. AI was measured by ATM and POS prevalence. A three-dimensional approach examined economic, social, and environmental (ESE) sustainability. Meanwhile, the performance of sustainable accounting was measured through the return on asse
... Show More