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.
Background: Wounds are any disruption to the normal anatomic structure of tissue which leads to the loss of epithelial continuity with or without a loss of underlying connective tissue, as well as the anatomic and functional integrity of the living tissue . Wound healing is a complex process with overlapping phases haemostasis, inflammation, proliferation and maturation/matrix Remodeling. Each phase of wound healing requires different management strategies, and inappropriate treatment can delay wound healing. The aim of wound treatment is a rapid wound closure and re-establish tissue function,chia seeds oil are widely used herbal medicines because of their anti-inflammatory and antioxidant capacity as they considerd agood source of polyunsa
... Show MoreThe improvement of the mechanical soil characteristics of jet grouting technique is very attractive. The jet grouted soil cement columns in soft is a complicated issue because it depends on a number of factors such as, soil nature, mixture, influence among soil and grouting materials, jetting force of nozzle, jet grouting and water flow rate, rotation and lifting speed. This paper discusses the estimation of shear strength parameters of soil-cement column (soilcrete) in soft clayey soil based on the relationships between the unconfined compressive and split tensile strength for the soilcrete and the effect of the jet grouting and water pressure in the values of cohesion and internal f
Purpose: To evaluate the effect of intravitreal Aflibercept injection on wet AMD both functionally and anatomically after loading doses. The secondary aim is to evaluate the effect of risk factors including (gender, age, smoking, hypertension, and diabetes meatus) on the patient’s response. Study Design: Interventional case series. Place and Duration of Study: Al-Haitham Eyes Teaching Hospital in Baghdad, Iraq, from November 2021 and September 2022. Methods: Fifty eyes of 47 patients with treatment naïve wet AMD were selected through convenient sampling. Data were collected for age, gender, smoking, and chronic disease. Clinical examination, best corrected visual acuity (BCVA), optical coherence tomography angiography
... Show MoreThis study attempts to test the interactive role played by organizational agility in enhancing the effect of organizational anomie on the behavior of planned human resources. The study of organizational anomie has increased because of the moral and legal pressures facing the organization by the external environment within its framework. To adapt to all external developments faced by these organizations, the behavior of human resources planned reflects the ability of individuals to control their behavior in different situations and situations that face them in the work.
The problem of the research indicates that there is a clear lack of understanding of what is meant by the variables studied in the sample
... Show MoreThe rubber ropes exercises affected muscle groups, which in turn affects the corners of the conditions of the body before and over the barrier where affected the time passed. To change the angle of the approaching and payment impact on passing each times the barrier 1-5. That passed over the barrier 1and gate 5 impacts on the nature of the achievement, where time has become less. Find the values of cruise missiles and other phases and stages of pitch angle other categories which it enshrines stood as compelling rejection men's 110m hurdles. Find the value of the instant messaging distances between different barriers and stages. Studies by adding rubber sling barriers race categories, measurement of kinematic variables. Emphasis on the devel
... Show MoreThis research discusses one of the most important means of reducing corruption in public sector companies and government departments, a relationship of cooperation and coordination between the external auditor and internal auditor, in the light of ISA (610), the recommendations of the International Organization of Supreme Audit Institutions (INTOSAI) and the National Strategy to combat corruption. The research was based on two assumptions: the first was weak relationship of cooperation and coordination between the external auditor and internal auditor leads to weakne
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الحمد لله رب العالمين، وأفضل السلام وأتم التسليم على سيدنا محمد، وعلى آله وصحبه، أجمعين، وعلى من تبعهم بإحسان إلى يوم الدين، أما بعد.
فإن مسألة التعارض بين الرواية، والفتوى، من المسائل المشهورة عند الأصوليين والفقهاء،وهي من مباحث السنة عند الأصوليين، والتي تبنى عليها مسائل متعددة، وهي من أسباب اختلاف الفقهاء، فإذا ما روى أحد الرواة حديثاً معيناً، ثم عمل بخلاف ما روى، فللعل
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The problem of the study is the main question (Can tourism planning address the phenomenon of unemployment in Iraq ?) , And the importance of the study in the fact that the tourism sector can become an effective development alternative in many countries, especially Iraq, as tourism contributes to diversify sources of income and stimulate other economic sectors , We know how important Iraq's qualifications are in the field of tourism and what it can generate on the public treasury, To confirm the current study on the need to pay attention to tourism planning for its role in providing employment opportunities that reduce the unemployment rate in the future.
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