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.
أدى التغير السريع في البيئة الخارجية للمنظمة إلى ظهور حالة من التنافس الشديد مما زاد تخوف الشركات من فقدان الحصة السوقية والخسارة . مما حدا بالمنظمات إلى الاهتمام بوجود مدير يحمل صفات وخصائص قيادية لما فيه من ميزات في تنظيم الإنتاج ومقابلة الطلب وتقليل التكاليف وتطوير الأداء للحصول على ميزة تنافسية تحافظ او تزيد من حصتها السوقية وإرباحها .
تسعى الدراسة الى تحديد عدد من الاهداف كان اهمها معرفة الع
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The objective of this study, is to attempt to explain the reality of the Structural Imbalances in the Iraqi Economy during the period of research, by providing a quantitative analysis of the most important types of Imbalances, Which are represented by the disruption in the Productive Structure, the imbalance of the structure of Public Budget, and the imbalance of the Structure of Trade. The problem of the research, is the fact that the economy structure in Iraq has long suffered from an Imbalances in its economic structure, which are represented in the unequal relations between its constituent elements, according to the proportions levels defined by the economic theory.
... Show MoreType 2 daibetes mellitus (T2DM) is a global concern boosted by both population growth and ageing, the majority of affected people are aged between (40- 59 year). The objective of this research was to estimate the impact of age and gender on glycaemic control parameters: Fasting blood glucose (FBC), glycated hemoglobin (HbA1C), insulin, insulin resistance (IR) and insulin sensitivity (IS), renal function parameters: urea, creatinine and oxidative stress parameters: total antioxidant capacity (TAC) and reactive oxygen species (ROS). Eighty-one random samples of T2DM patients (35 men and 46 women) were included in this study, their average age was 52.75±9.63 year. Current study found that FBG, HbA1C and IR were highly significant (P<0.01) inc
... Show MoreThe objective of this paper is, first, study a new collection of sets such as field and we discuss the properties of this collection. Second, introduce a new concepts related to the field such as measure on field, outer measure on field and we obtain some important results deals with these concepts. Third, introduce the concept of null-additive on field as a generalization of the concept of measure on field. Furthermore, we establish new concept related to - field noted by weakly null-additive on field as a generalizations of the concepts of measure on and null-additive. Finally, we introduce the restriction of a set function on field and many of its properties and characterizations are given.
Research includes evaluation of projects implemented and which entered into trial operation period in accordance with the evaluation criteria and of (cost, quality and time) to determine the size deviations gap for the sample of projects during the years of assessment (2011-2012-2013-2014) of each of the three evaluation criteria, and then followed by a calculation the size of the overall gap to the problem based on the research problem to determine deviations from the specific implementation of each project by answering several questions to answer turns out the reasons for these deviations occur.
The importance of research Focus on the evaluation of received projects from contractors executing the projec
... Show MoreThe clinical spectrum of cutaneous leishmaniasis (CL), an intracellular parasitic pathogen, ranges from a single sore healing to chronic crusty lesions with a manifestation of treatment resistance. The complicated interaction between Leishmania bodies and the early immune response, including innate and adaptive mechanisms, determines the evolution of nodules. This study examined the levels of the chemoattractant interleukin 8 (IL-8), pro-inflammatory nitric oxide (NO), and immunoregulatory macrophage inhibitory factor (MIF) in the serum of subjects recently diagnosed with cutaneous leishmaniasis, in parallel with patients being monitored during consecutive sodium stibogluconate (Pentostam) treatment. A total of 161 serum samples of newly di
... Show MoreThe development of new building materials, able of absorbing more energy is an active research area. Engineering Cementitious Composite (ECC) is a class of super-elastic fiberreinforced cement composites characterized by high ductility and tight crack width control. The use of bendable concrete produced from Portland Limestone Cement (PLC) may lead to an interest in new concrete mixes. Impact results of bendable concrete reinforced with steel mesh and polymer fibers will provide data for the use of this concrete in areas subject to impact loading. The experimental part consisted of compressive strength and impact resistance tests along with a result comparison with unreinforced concrete. Concrete samples, with dimensions of 100×
... Show MoreThe research aimed to study the financial markets liquidity and returns of common stocks , Take the research the theoretical concepts associated with each of the liquidity of financial markets and returns of common stocks , As well as the use of mathematical methods in the practical side to measure market liquidity and Stocks Return, the community of research in listed companies in Iraqi stock exchange that have been trading on its stock and number 85 joint-stock company, The research was based to one premise, there is a statistically significant effect for the liquidity of the Iraqi stock exchange on returns of common stocks to traded companies in which , Using th
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