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.
Chronic 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 MoreThe developed financial system is essential for increasing economic growth and poverty reduction in the world. The financial development helps in poverty reduction indirectly via intermediate channel which is the economic growth. The financial development enhancing economic development through mobilization of savings and channel them to the most efficient uses with higher economic and social returns. In addition, the economic growth reduces the poverty through two channels. The first is direct by increasing the introduction factors held by poor and improve the situations into the sectors and areas where the poor live. The second is indirect through redistribution the realized incomes from the economic growth as well as the realiz
... Show MoreThe prostaglandins inside inflamed tissues are produced by cyclooxygenase-2 (COX-2), making it an important target for improving anti-inflammatory medications over a long period. Adverse effects have been related to the traditional usage of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of inflammation, mainly centered around gastrointestinal (GI) complications. The current research involves the creation of a virtual library of innovative molecules showing similar drug properties via a structure-based drug design. A library that includes five novel derivatives of Diclofenac was designed. Subsequently, molecular docking through the Glide module and determining the binding free energy implementing the P
... 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 syntheses, characterizations and structures of three novel dichloro(bis{2-[1-(4-methoxyphenyl)-1H-1,2,3-triazol-4-yl-κN3]pyridine-κN})metal(II), [M(L)2Cl2], complexes (metal = Mn, Co and Ni) are presented. In the solid state the molecules are arranged in infinite hydrogen-bonded 3D supramolecular structures, further stabilized by weak intermolecular π…π interactions. The DFT results for all the different spin states and isomers of dichloro(bis{2-[1-phenyl-1H-1,2,3-triazol-4-yl-κN3]pyridine-κN})metal(II) complexes, [M(L1)2Cl2], support experimental measurements, namely that (i) d5 [Mn(L1)2Cl2] is high spin with S = 5/2; (ii) d7 [Co(L1)2Cl2] has a spin state of S = 3/2, (iii) d8 [Ni(L1)2Cl2] has a spin state of S =
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The research aims to diagnose the reality of applying the eighth requirement (operation) of the business continuity management system according to the international standard (ISO 22301: 2019), in the General Tax Authority, which is related to planning, implementing and controlling specific processes and procedures to address risks and opportunities, and the research adopted the checklist of the standard ( ISO 22301: 2019), in obtaining information, to measure the extent of application and documentation, the percentages and the weighted arithmetic mean were relied upon, and the research reached a set of result
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Взгляд на пол как на комплексное социальное отношение означает,что роль женщины в истории следует рассматривать не просто как новый для исторической науки предмет исследования, а как обойденный вниманием ученых вопрос об отношениях между людьми или группами людей.
Женщина играет особую и важную роль в обществе , даже скажут ,что она половина нашего общества ,поэтому она яв
... Show MoreThis study was for searching for Cholera Bacteria serotype which causes epidemiology Cholera in the 2007 in a fast method which contains (Rapid Visual Test) (Crystal V.C.) which was used for the first time in Iraq to diagnosis of Cholera Bacteria & compared with the traditional bacteriology method. The Cholera disease is one of the most dangerous epidemiological diseases which lead to death with a percentage of (50 – 70) % in the severe cases for untreated patients . For this purpose, 100 samples of stool from the patients from a (13) hospitals in Baghdad Governorate in the period from August to the end of December. The Cholera was diagnosis in two methods, 1st method was the fast method using the nitrocellulose which is coated with anti-
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