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 study has tackled three important variables on the strategic and organizational level, that are : (Administrative skill, strategic Entrepreneurship and organizational flexibility). Through the statistical analysis is, the research hers have sought to identify the relation among them. The study has been applied on a sample of (44) private banks in Iraq. A questionnaire, which has been designed according to a number of international standards, has been used. It's made of (29) items that cover the three variables to test their hypotheses. A number of statistical tools have been used A number of conclusion have been reached and recommendations have also been suggested.
The new Hexadentate complexes type [M(H3L3)]K were prepared from the condensation reaction of Diphenylmonoxime and KOH with (Mn(II), Co(II), Ni(II), Cu(II), Zn(II), and Hg(II)) in methanol with 3:1 ligand : metal ratio to give a series of new complexes of the general formula [M(H3L3)]K (where: M(II) = Mn ,Co ,N ,Cu ,Zn and Hg).All compounds have been Characterized by spectroscopic methods [I.R, U.v-Vis, atomic absorption and microanalysis (C.H.N) along with conductivity measurements. The stability constant K and Gibbs free energy ∆G were calculated for [Co (H3L3)] K, [Ni (H3L3)] K and [Cu (H3L3)] K and complexes using spectrophotometer method. The obtained values indicate that these complexes stable in their solution. From the above data
... Show MoreThe health care provided by health institutions and all kinds suffers from many problems, and since the health services provided are related to human life, it is necessary to shed light on this activity and identify the causes of these problems. This research aims to Definition of health institutions (hospitals) Performance audit of these institutions according to the latest indicators, which are the standards of health accreditation for hospitals, specifically the basic standards issued by the Health Care Accreditation Council (HCAC) to reach the level of performance and Knowledge of Constraints that lead to in an acceptable manner consistent with the approved standards. In theoretical and practical study, a number of conclusions were r
... Show MoreThe new 4-[(7-chloro-2,1,3-benzoxadiazole)azo]-4,5-diphenyl imidazole (L) have been synthesized and characterized by micro elemental and thermal analyses as well as 1H.NMR, FT-IR, and UV-Vis spectroscopic techniques. (L) acts as a ligand coordinating with some metal ionsV(IV), Fe(III), Co(II), Ni(II), Cu(II), and Zn(II). Structures of the new compounds were characterized by elemental and thermal analyses as well as FT-IR and UV-Vis Spectra. The magnetic properties and electrical conductivities of metal complexes were also determined. Study of the nature of the complexes formed in ethanol following the mole ratio method.. The work also include a theoretical treatment of the formed complexes in the gas phase, this was done using the (hyperch
... Show MoreThe aim of the research is to assess the practice of tax administration to diminish the strategic direction of (proactive, analytical, defensive, response) and the nature of its relationship to organizational excellence represented by (leadership, strategic planning, focus on taxpayers, information and analysis and knowledge management, focus on operations, focus on forces. The questionnaire was adopted as a main tool in collecting data and information from the sample members of the General Authority for Taxes (110) who are in the site (m. Second Division Manager, Ms The statistical program (SPSS) was used to calculate (mean, standard deviation, difference coefficient, correlation coefficient, t-test). The research reached a number
... Show MoreThe research aims to enhance the level of evaluation of the performance of banking transactions control policies and procedures. The research is based on the following hypothesis: efficient transactions control policies and procedures contribute enhancing financial reporting, by assessing non-application gap of those policies and procedures in a manner that helps to prevent, discover, and correct material misstatements. The researchers designed an examination list that includes the control policies and procedures related to the transactions, as a guide to the bank audit program prepared by the Federal Financial Supervision Bureau. The research methodology is
... Show MoreChronic Kidney Disease (CKD) is a public health problem and many studies support the link between kidney dysfunction and cardiovascular events. Aldosterone has been shown for decades that a plasma aldosterone concentration is elevated in CKD. Whilst, Osteoprotegerin (OPG), after its capacity to protect bone, also osteoprotegerin is elevated in patients with chronic kidney disease (CKD), where it could predict the deterioration of kidney function, cardiovascular, vascular events and all-cause mortality. On the other hand, fibroblast growth factors (FGFs), in patients with CKD, its levels seem to increase progressively as kidney function worsens. The aim of the present study is to assess the correlations between serum osteoprotegerin
... Show MoreAn abstract is a brief summary of a research article, thesis, Schiff base ligand (L) was prepared by the reaction of 4-aminantipyrine with o-phenylenediamine, the prepared ligand characterized by Micro elemental Analysis, FT. IR, UV-Vis, and 1H,13C-NMR spectroscopy.complexes of Mn(II), Co(II), Ni(II), Cu(II) and Hg(II) with Schiff base and 1,10-phenanthroline (Phen) have been investigated in aqueous ethanol with (1:1:1) (M:L:Phen). The prepared complexes were characterized using flame atomic absorption, (C. H. N) Analysis, FT. IR and UV-Vis spectroscopic methods as well as magnetic susceptibility and conductivity measurements. From the obtained data the octahedral structure was suggested for all complexes. The biological screening effects o
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