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 research aims to determine the impact of Human Resources Accounting (HRA) on employee’s performance. The research’s problem was embodied in the lack of interest in HRA, which was reflected on the performance of employees in the Ministry of Education; the research adopted the descriptive-analytical approach, and the research community included the directors of departments and people at the headquarters of the Ministry of Education. The sample size was (224) individuals from the total community of 533. The questionnaire was adopted as the main tool for collecting data and information, as well as the interviews that were conducted by the researcher. In order to analyze t
... Show MoreThe research stems from its goal of identifying the impact of visual management on the strategic acceleration of business organizations and the state of this effect through the knowledge embedding in the Iraqi oil companies. The oil sector was tested, represented by (3) oil companies, and a sample of (151) individuals who participated in activating the visual management, distributed in higher management levels. The research relied on the descriptiveanalytical approach and the questionnaire was a main tool for collecting data and information. The results showed that visual management positively affects strategic acceleration. Moreover, This effect is amplified by the mediating role played by Embedding Knowledge.
This study seeks to shed light on the aspects of visual pollution and its impact on the aesthetics of the town of Al-Eizariya known to suffer from the phenomenon. In order to identify the real causes of the problem which develops in various forms and patterns, threatening not only the aesthetic appearance of the towns, but also causes the emergence of new problems and phenomena that will have negative repercussions on the population. The researcher uses the analytical descriptive method to analyze the phenomenon of visual pollution in terms of reality, development, manifestations and spread and uses photos which document the visual pollution and its impact on the aesthetics of the known. The study concluded the existence of a strong rela
... Show MoreA cumulative review with a systematic approach aimed to provide a comparison of studies’ investigating the possible impact of the active form of vitamin D3, calcitriol (CTL), on the tooth movement caused by orthodontic forces (OTM) by evaluating the quality of evidence, based on collating current data from animal model studies, in vivo cell culture studies, and human clinical trials. Methods: A strict systematic review protocol was applied following the application of the International Prospective Register of Systematic Reviews (PROSPERO). A structured search strategy, including main keywords, was defined during detailed search with the application of electronic database systems: Medline/Pubmed, EMBASE, Scopus, Web of Science, and
... Show MoreBackground: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled i
... Show MoreKurdistan power system is expanded along years ago. The electrical power is transmitted through long transmission lines. The main problem of transmission lines is active and reactive power losses. It is important to solve this issue, unless, the most of electrical energy will lost over transmission system. In this study, High Voltage Direct Current links/bipolar connection were connected in a power system to reduce the power losses. The 132kV, 50 Hz, 36 buses Kurdistan power system is used as a study case. The load flow analysis was implemented by using ETAP.16 program in which Newton-Raphson method for three cases. The results show that the losses are reduced after inserted HVDC links.
This study sought to give a general picture of the organizations and formations of the ground forces of the Abbasid army in its first era, in preparation and armament and continuous development of the mechanisms to help maintain the moral and spiritual morale in the fighting.
Therefore, the caliphs' interest in building the army, organizing it, arming it, choosing competent leaders, and providing them with various weapons in terms of production and storage, as well as taking care of fortifying the cities and gaps in determination and determination, and embarked on construction and restoration, where amazing speed and acted according to the circumstances. During the first Abbasid era, there were significant developments in the military
The aim of this study is to shed light on the importance of biofuels as an alternative to conventional energy, in addition to the importance of preserving agricultural crops, which are the main source of this fuel, to maintain food security, especially in developing countries. The increase in global oil prices, in addition to the fear of global warming, are among the main factors that draw the world’s attention to searching for alternative sources of traditional energy, which are sustainable on the one hand, and on the other hand reduce carbon emissions. Therefore, the volume of global investment in renewable energy in general, and in liquid biofuels and biomass in particular, has increased. Global fears emerged that the excessive convers
... Show MoreThe aim of this study is to shed light on the importance of biofuels as an alternative to conventional energy, in addition to the importance of preserving agricultural crops, which are the main source of this fuel, to maintain food security, especially in developing countries. The increase in global oil prices, in addition to the fear of global warming, are among the main factors that draw the world’s attention to searching for alternative sources of traditional energy, which are sustainable on the one hand, and on the other hand reduce carbon emissions. Therefore, the volume of global investment in renewable energy in general, and in liquid biofuels and biomass in particular, has increased. Global fears emerged that the excessive
... Show MoreThis study aims to highlight the role of strategic leadership in adopting the intelligent organization model. The study was conducted on 7 economic organizations in Algeria. The study population consisted of 354 leaders, of whom a random sample of 176 leaders (managers, department heads, division heads, engineers) was selected. The researcher used a questionnaire as the main tool of the study. Statistical analysis and hypothesis testing were conducted using SEM (Structural Equation Modeling) with the aid of SPSS.v26 and AMOS.v24 software. The study concluded with a set of results, most notably: there is a statistically significant direct positive effect between strategic leadership and building intelligent organizations at a significance le
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