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.
Many reports confirm ulcers as an adverse effect of drugs such as nicorandil and aspirin. The exact responsible mechanisms of ulceration have until now not proved. Mucosal ulcers associated with the onset of ulcer are manifested by an increase in proinflammatory cytokine, excessive prostaglandin, and up-regulation of Endothilin-1 level, which directly impacts the release of leptin. These, released locally within mucosal tissues, have played a role in controlling the extent of local inflammatory responses and processes of mucosal repair.
This study was designed to find out the correlation of plasma leptin and prostaglandin levels as a possible mechanism of oral ulcer formation as an adverse effect of nicorandil. The effect of nicorandi
The study aimed at interpreting the role of architectural design quality in in build competitiveness model in accordance with the proposal included the idea of architectural design quality for its removal; interesting design factors of the environment, good design of the spaces, and design aesthetic explanatory variable. The competitiveness dimensions; the level of innovation, stimulate research, and the quality of the company's products, and activating the role of human resources, entrepreneurship, profitability, market share and competitiveness, variable responsive. The study of construction companies in the Ministry of Housing and Construction has taken the Iraqi society for the study. The sample consisted of (48) manage
... Show MoreThis research aims to study the degree to which human resources re-engineering programs contribute to enhancing the morale of employees , as it constitutes re-HR Software Engineering contemporary trend to redesign activities and tasks that can HR do a way that helps their organization to achieve its goals as part of the operating environment including dealing with all activities related variables, and the promotion of workers' morale is one of the selections that have to be addressed so that the senior management helps the organization to invest their human resources best possible way as posing the most valuable and rarest of resources enjoyed by comparison with her competitors.
The research problem has
... Show MoreThe utilization of artificial intelligence techniques has garnered significant interest in recent research due to their pivotal role in enhancing the quality of educational offerings. This study investigated the impact of employing artificial intelligence techniques on improving the quality of educational services, as perceived by students enrolled in the College of Pharmacy at the University of Baghdad. The study sample comprised 379 male and female students. A descriptive-analytical approach was used, with a questionnaire as the primary tool for data collection. The findings indicated that the application of artificial intelligence methods was highly effective, and the educational services provided to students were of exceptional
... Show MoreBackground: Dorsal plication on each side of the penis at the 2 and 10-o’clock positions had been a mainstay for correction of ventral penile curvature. However, because only the 12-o’clock position proved to be a nerve-free zone, dorsal plication at the 12-o’clock position can be advocated.
Objectives: To evaluate tunica albuginea plication with and without neurovascular bundle mobilization in patients with ventral penile curvature. Type of the study: A prospective study.
Methods: A 34 patients with a mean age of (4.8 ± 0.54) years, Who still
The Local and Global Corporations are suffering of managerial and financial corruption phenomena, which leads them to loss and bankruptcy. So, it is necessary to search for tools which help prevent phenomena like this, and one of these tools is (corporate governance) which represent controlling tool that contribute in reducing corruption. this study aims at modifying (corporate governance system)in order to make it suitable with Iraqi government Corporations. the study depend upon main hypothesis which is (the performance level of the strategic perspective of governance system is depending upon work according to the perspective dimensions itself. From the main conclusions:-It is possible to building a strategic perspective
... Show MoreAllowing Iraqi companies to use multiple systems and policies leads to varying levels of disclosure and no high symmetry between report preparers and users, and that the adoption of integrated reporting can reduce information asymmetry. The theoretical side addressed the concepts of these variables, and in the practical side the binary variable (0, 1) was used. To compensate for the value of the independent variable (integrated reporting) based on the Central Bank of Iraq’s classification of banks according to the (CAMLES) index, and the dependent variable (information asymmetry) was measured through two measures (price difference, unusual return), the research community was represented by (5) Banks out of the total of banks li
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