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.
A multistep synthesis was established for the preparation of a new vanillic acid-1, 2, 4-1triazole-3-thiol conjugate (
Irrigation has significant role in endodontic treatment, many types of antimicrobial irrigation solutions have been used, but due to the ineffectiveness, safety concerns and side effects of this irrigation, the herbal alternatives for endodontic irrigants might be beneficial. Objectives This study compared the in vitro effectiveness of tea tree oil and clove oil as possible irrigants in endodontics against Enterococcus faecalis in comparison with 3% Sodium hypochlorite. Materials and Methods E. faecalis was isolated from patients in need for endodontic treatment; VITEK was employed for E. faecalis isolate conformation. Muller Hinton agar was prepared with 100μl of freshly prepared suspension of E.faecalis. Wells of 6mm diameter and 4mm dep
... Show MoreEuropean Chemical Bulletin (ISSN 2063-5346) is a peer-reviewed journal that publishes original research papers, short communications, and review articles in all areas of chemistry. European Chemical Bulletin has eight sections, namely
This study showed the basic features of corporate tax in Iraq by showing what was in the Income Tax Law in force .The study aims of this to indicate the role of tax corprates in tax revenue and then the possibility of strengthening the revenue of this tax as an important source of local funding sources in the form that is with him reduce dependence on oil revenues to finance the general budget in Iraq, the risks and the study found a number of conclusions from the most important: that the corporate tax comes in the introduction to the components of the income tax structure in terms of relative importance and formed a revenue source of prime The gross proceeds of the income tax in Iraq, where it contributed to more than a quarter of that
... Show MoreThe new ligand [N1,N4-bis((1H-benzo[d]Glyoxalin-2-yl)carbamothioyl)Butanedi amide] (NCB) derived from Butanedioyl diisothiocyanate with 2-aminobenz imidazole was used to prepare a chain of new metal complexes of Cr(III), Mn(II), Co(II), Ni(II), Cu(II), Pd(II), Ag(I), Cd(II) by general formula [M(NCB)]Xn ,Where M= Cr(III), n=3, X=Cl; Mn(II), Co(II), Ni(II), Cu(II), Pd(II), Cd(II) ,n=2 , X=Cl; Ag(I), n=1, X=NO3. Characterized compounds on the basis of 1H, 13CNMR (for (NCB), FT-IR and U.V spectrum, melting point, molar conduct, %C, %H, %N and %S, the percentage of the metal in complexes %M, Magnetic susceptibility, thermal studies (TGA),while its corrosion inhibition for mild steel in Ca(OH)2 solution is studied by weight loss. These measureme
... Show MoreThe aim of the research is to diagnose and analyze the gap between the actual reality and the application of the eighth requirement (operation) in the National Insurance Company in accordance with the international standard specification for the quality management system (ISO 9001:2015), which is related to the planning, implementation and control of operations, which would raise the level of performance of employees and be reflected in the provision of An appropriate service for the faithful, as the reality of the condition of the requirement was studied by identifying the strengths and weaknesses of the system to diagnose the gap and find ways to address it. A workshop was held with company officials, through which questions were raise
... Show MoreThe effect of cognitive trips via the Internet (web quest) accompanying practical lessons in learning some basic handball skills for female students