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 study investigates the influence of silver oxide (Ag2O) concentration on the optical characteristics of phosphate bioactive glasses (PBGs). PBGs have emerged as promising alternatives to conventional silicate glasses in the medical field due to their excellent bioactivity and chemical resistance. Samples with varying Ag2O concentrations (0, 0.25, 0.5, and 0.75g) were sintered at 780°C for 2 hrs in an electric furnace. The samples were subjected to Fourier transfer infrared spectroscopy (FTIR), ultraviolet-visible (UV-Vis) spectroscopy, and photoluminescence (PL) tests to assess their functional groups and optical properties. By analyzing the FTIR spectrum of phosphate bioactive glass containing different amounts of Ag2O, it is
... Show MoreBackground: Obesity is becoming the healthcare epidemic world wide.Obesity is associated with reduced life expectancy, increased morbidity and mortality, and greater healthcare costs.Bariatric surgery is the only effective treatment for morbid obesity and is gaining increasing popularity. There has been a steady rise in the numbers and types of bariatric operations done worldwide in recent years butnon of prove to be ideal .Animal studies and use of animal models are significant element in the evolution of medical knowledge and the use of animals as a model for bariatric surgery is of importance to study the mechanisms of these operationsa and also help to develop new technique in management of obesity.Objectives:Study of effects of slee
... Show MorePortland cement concrete is the most commonly used construction material in the world for decades. However, the searches in concrete technology are remaining growing to meet particular properties related to its strength, durability, and sustainability issue. Thus, several types of concrete have been developed to enhance concrete performance. Most of the modern concrete types have to contain supplementary cementitious materials (SCMs) as a partial replacement of cement. These materials are either by-products of waste such as fly ash, slag, rice husk ash, and silica fume or from a geological resource like natural pozzolans and metakaolin (MK). Ideally, the utilization of SCMs will enhance the concrete performance, minimize
... Show MoreObjectives: To assess the woman satisfaction with nursing care during labor.
Methodology: A descriptive analytic study about conducted for a purposive (non probability) sample of one hundred labor women interview validity and reliability of questionnaire are determined through panel of experts and pilot study. Descriptive and inferential statistical procedures were used to analyze the data, which collected by using interview technique.
Results: The study sample indicated that in general the women were satisfied in nursing care that provided during labor.
Recommendations: The study recommended educational tra
... Show MoreBackground: Study looking into cardiovascular disorders (CVD) medicines or analgesics cost-saving activities during dispensing process is lacking.
Aim: To determine differences in factors and costs associated with refused CVD medicines or analgesics during dispensing process
Method: This study was approved by Medical Research and Ethics Committee (MREC) (Registration number: NMRR-20-177-53153(IIR)). Participants receiving CVD medicines or analgesics during dispensing process were recruited via convenience sampling technique between February and March 2020 at the Specialist Pharmacy Department of Jerantut Hospital, Malaysia. Refusal to medications and its reasons were asked based on the questionnaire developed by the resea
... Show MoreThe aim of the present work to study the effect of changing velocity (Reynold's number) on oxygen cathodic polarization using brass rotating cylinder electrode in 0.1, 0.3 and 0.5N NaCl solutions (PH = 7) at temperatures 40, 50 and 600 C. Cathodic polarization experiments were conducted as a function of electrode rotational speed and concentration.
A new modified differential evolution algorithm DE-BEA, is proposed to improve the reliability of the standard DE/current-to-rand/1/bin by implementing a new mutation scheme inspired by the bacterial evolutionary algorithm (BEA). The crossover and the selection schemes of the DE method are also modified to fit the new DE-BEA mechanism. The new scheme diversifies the population by applying to all the individuals a segment based scheme that generates multiple copies (clones) from each individual one-by-one and applies the BEA segment-wise mechanism. These new steps are embedded in the DE/current-to-rand/bin scheme. The performance of the new algorithm has been compared with several DE variants over eighteen benchmark functions including sever
... Show MoreSemiconductor-based metal oxide gas detector of five mixed from zinc chloride Z and tin chloride S salts Z:S ratio 0, 25, 50, 75 and 100% were fabricated on glass substrate by a spray pyrolysis technique. With thickness were about 0.2 ±0.05 μm using water soluble as precursors at a glass substrate temperature 500 ºC±5, 0.05 M, and their gas sensing properties toward CH4, LPG and H2S gas at different concentration (10, 100, 1000 ppm) in air were investigated at room temperature which related with the petroleum refining industry.
Furthermore structural and morphology properties were scrutinize. Results shows that the mixing ratio affect the composition of formative oxides were (ZnO, Zn2SnO4, Zn2SnO4+ZnSnO3, ZnSnO3, SnO2) ratios ment