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.
In diabetes, impaired wound healing and other tissue abnormalities are considered major concerns. Many factorsaffect the time and quality of wound healing. One of the purposes of medical sciences is wound healing in a short time withreduced side effects. The herbal products are more precious in both prophylaxis as well as curative in delayed diabetic woundhealing activity when compared to synthetic drugs.A wide range of evidence has shown that capers plant possesses differentbiological effects, including antioxidant, anticancer and antibacterial effects. Phytochemical analysis shows thatC. spinosahashigh quantities of bioactive constituents, including polyphenolic compounds, which are responsible for its health-promotingeffects. The healing
... Show MoreThis research investigated the effect of adding two groups of reinforcement materials, including bioactive materials Hydroxyapatite (HA) and halloysite nanoclay and bioinert materials Alumina (AL2O3) and Zirconia (ZrO2), each of them with various weight ratios (1,2,3,4 &5)% to the polymer matrix PMMA. The best ratios were selected, and then a hybrid was preparing Composite red from the best ratios from each group. Thermal properties, including thermal conductivity and Thermomechanical Analysis (TMA) technology, have been studied. The results showed that adding 3% Hydroxyapatite (HA) and 5% halloysite nanoclay to the polymethacrylate (PMMA) mer leads to an increase in thermal conductivity. It was also found from the Thermomechanical Analysis
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The tax is one of the elements of the general revenues of the state and contributes to covering its expenses. Taxes are imposed in most countries of the world. The tax proceeds depend on a set of factors that contribute either positively or negatively to the tax share by increasing or decreasing it. Therefore, the research aims to demonstrate the role of the tax examiner's procedures in achieving the validity of the taxable base and its reflection on the tax proceeds, as well as reviewing the tax examiner's procedures related to the tax return process. Examination and tax audit of the financial statements, as well as presenting the financial statements to an independent and i
... Show MoreThose interested in the educational process and lesson management sought to invest the information experience with industrial intelligence and technology because of its importance in increasing the effectiveness of lesson management and developing the creative capabilities of the teacher in directing and managing his lesson. Field research for sports educational institutions that are interested in managing the lesson and preparing mathematical teaching cadres is an important issue and necessary means for identifying the most important phenomena that accompany the process of managing the educational process, as the teacher's success in providing the appropriate conditions to provide rich and influencing experiences in managing and directing
... Show MoreATAW Eqbal Abdul Ameer'. Shifaa Jameel Ibrahim?, HISTORY Of MEDICINE, 2023
Aromaticity, antiaromaticity and chemical bonding in the ground (S0), first singlet excited (S1) and lowest triplet (T1) electronic states of disulfur dinitride, S2N2, were investigated by analysing the isotropic magnetic shielding, σiso(r), in the space surrounding the molecule for each electronic state. The σiso(r) values were calculated by state-optimized CASSCF/cc-pVTZ wave functions with 22 electrons in 16 orbitals constructed from gauge-including atomic orbitals (GIAOs). The S1 and T1 electronic states were confirmed as 11Au and 13B3u, respectively, through linear response CC3/aug-cc-pVTZ calculations of the vertical excitation energies for eight singlet (S1–S8) and eight triplet (T1–T8) electronic states. The aromaticities of S
... Show MoreThrough research and research in the creative composition in the poetry of Zafer-Alhaddad it turned out to be superior in its systems, especially that he chose a linguistic and verbal texture accompanied by a cultural dictionary full of creativity and beauty helped this culture arrangement reflects the poetically wonderful and beautiful custom led to the harmony of colors and bodies painted by the poet brush the creative artist evaluates the metaphorical and metaphorical relations that would explain the poets idea, most of which were inspired by the wonderful spirit of nature, its beautiful landscapes and bright colors, especially that we do not forget the beautiful colors and the aesthetic touch that created a fascinating musical intera
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