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 concept of the order sum graph associated with a finite group based on the order of the group and order of group elements is introduced. Some of the properties and characteristics such as size, chromatic number, domination number, diameter, circumference, independence number, clique number, vertex connectivity, spectra, and Laplacian spectra of the order sum graph are determined. Characterizations of the order sum graph to be complete, perfect, etc. are also obtained.
We used to think of grammar as the bones of the language and vocabulary as the flesh to be added given that language consisted largely of life generated chunks of lexis. This “skeleton image” has been proverbially used to refer to that central feature of lexis named collocation- an idea that for the first 15 years of language study and analysis gave a moment‟s thought to English classroom material and methodology.
The work of John Sinclair, Dave Willis, Ron Carter, Michael McCarthy, Michael Lewis, and many others have all contributed to the way teachers today approach the area of lexis and what it means in the teaching/learning process of the language. This also seems to have incorporated lexical ideas into the teaching mechanis
An energy and exergy thermodynamic analysis using EES program was done for a domestic refrigerator working with R-134a using vapor compression refrigeration cycle. The analysis deals with the system component, i.e. compressor, condenser, evaporator and the expansion device. The analysis depends on the entropy generation minimization approach to improve the refrigerator performance by exploring the optimum design points. These design points were derived from three different theories governing the entropy generation minimization using exergy analyzing method. These theories were first applied to find the optimum balance between the hot inner condenser area and the cold inner evaporator area of the refrigerator and between
... Show MoreThis paper generalizes and improves the results of Margenstren, by proving that the number of -practical numbers which is defined by has a lower bound in terms of . This bound is more sharper than Mangenstern bound when Further general results are given for the existence of -practical numbers, by proving that the interval contains a -practical for all
In this paper, various aspects of smart grids are described. These aspects include the components of smart grids, the detailed functions of the smart energy meters within the smart grids and their effects on increasing the awareness, the advantages and disadvantages of smart grids, and the requirements of utilizing smart grids. To put some light on the difference between smart grids and traditional utility grids, some aspects of the traditional utility grids are covered in this paper as well.
Evaluating treatment effect on interferon-alpha in female patients with systemic lupus erythematosus: a case-control study
Background Parkinson’s disease (PD) is currently the fastest-growing neurological disorder in the world. Patients with PD face numerous challenges in managing their chronic condition, particularly in countries with scarce healthcare infrastructure. Objective This qualitative study aimed to delve into neurologists’ perspectives on challenges and gaps in the Iraqi healthcare system that influence the management of PD, as well as strategies to mitigate these obstacles. Method Semi-structured interviews were conducted with neurologists from five different Iraqi provinces, working in both hospitals and private neurology clinics, between November 2024 and January 2025. A thematic analysis approach was employed to identify the main challenge
... Show MoreBackground: COVID-19 is an ongoing disease that caused, and still causes, many challenges for humanity. In fact, COVID-19 death cases reached more than 4.5 million by the end of August 2021, although an improvement in the medical treatments and pharmaceutical protocols was obtained, and many vaccines were released. Objective: To, statistically, analyze the data of COVID-19 patients at Alshifaa Healthcare Center (Baghdad, Iraq). Methods: In this work, a statistical analysis was conducted on data included the total number, positive cases, and negative cases of people tested for COVID-19 at the Alshifaa Healthcare Center/Baghdad for the period 1 September – 31 December 2020. The number of people who got the test was 1080, where 424 w
... Show MoreMedication safety is an important part of the comprehensive patient safety term. Medication safety is gaining more attention as the World Health Organization set the goal of decreasing medication harm by (50%) for the next 5 years when launching the third global challenge. Studying medication safety in the risk groups such as young ages, children are crucial to learn more about the effect of medicines in this risk group since they are not included in the clinical trials. Adverse drug reaction is defined as any harm resulted from the drug itself during medical process journey, while medication errors are any harm resulted from the treatment process rather than the drug or it is the result of the failure in a step of the treatment process
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