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 new definition of a graph called Pure graph of a ring denote Pur(R) was presented , where the vertices of the graph represent the elements of R such that there is an edge between the two vertices ???? and ???? if and only if ????=???????? ???????? ????=????????, denoted by pur(R) . In this work we studied some new properties of pur(R) finally we defined the complement of pur(R) and studied some of it is properties
We describe the use of on-chip buckled-dome Fabry–Perot microcavities as pressure sensing elements. These cavities, fabricated by a controlled thin-film buckling process, are inherently sealed and support stable optical modes (finesse
We report on the experimental and theoretical characterization of elliptically shaped Fabry–Perot microcavities fabricated through a controlled thin-film buckling process. Due to the highly astigmatic nature of the buckled mirrors, the cavity modes are well described as elliptical Hermite–Gaussian beams. In addition to lifting the typical degeneracy of higher-order transverse spatial modes, the cavities exhibit large polarization-mode splitting greater than 25 GHz in the 1550 nm wavelength range. This large, controllable, and highly predictable birefringence makes these cavities of interest for emerging applications in cavity quantum optics that rely on non-degenerate polarization modes.
Background: Posterior urethral rupture remains
one of the most difficult and controversial injuries
to treat and its management still controversial.
Aim: To assess the effect of primary
realignment of posterior urethral rupture.
Methods: in this study, 20 patients (mean age
24.7 years, range 12 to 39 years) were admitted to
al-kindey teaching hospital, Baghdad, Iraq, with
complete posterior urethral rupture associated with
fractured pelvis following trauma (3 cases of fall
from high, 17 cases of road traffic accidents). All
the patients were operated upon at the day of
accident to establish the alignment of the posterior
urethra on a Foley's catheter with bladder drainage
by suprapubic catheter.
AIM: To analyse our experiences in the management of traumatic retroperitoneal hematoma (RPH), highlighting the various challenges faced and to report on the outcome of these patients. METHODS: From May 2014 to May 2017, all patients with traumatic RPH who underwent surgical treatment were retrospectively analysed. The kind of injury, intraoperative findings, sites of hematoma, postoperative morbidity and the overall outcomes were recorded. RESULTS: Ninety-six patients; 53 with blunt trauma and 43 with penetrating injury, were included in this study. The centre-medial hematoma was observed in 24 (25%) patients, lateral hematoma in 46 (47.9%) patients, pelvic hematoma in 19 (19.8%) patients, and multiple zone hematomas in
... Show MoreBackground: the condition of hallux valgus is considered as the most common deformities affecting females more than males, characteristically manifested as lateral deviation of the big toe and widening of first and second inter -metatarsal angle with a deformity of second toe in some severe cases. Objective: to make a radiological and clinical assessment of two surgical methods of osteotomy used in treatment of hallux valgu and to compare between them: first one is the distal dome osteotomy, and second one is a distal wedge metatarsal osteotomy. Patients and methods: a total of 36 feet of 28 patients suffer from hallux valgus, with mean age of 50.3 years were included in this study, followed for 6- 30 months ( mean follow-up of 8.8 months).
... Show MoreThis study investigated the impact of lime stabilization on the fate and transformation of AgNPs. It also evaluated the changes in the population and diversity of the five most relevant bacterial phyla in soil after applying lime-stabilized sludge containing AgNPs. The study was performed by spiking an environmentally relevant concentration of AgNPs (2 mg AgNPs/g TS) in sludge, applying lime stabilization to increase pH to above 12 for two hours, and applying lime-treated sludge to soil samples. Transmission electron microscopy (TEM) and energy-dispersive X-ray spectroscopy (EDS) were used to investigate the morphological and compositional changes of AgNPs during lime stabilization. After the application of lime stabilized sludge to
... Show MoreAbstract Background: Dne of the key component of nasal tipplasty is effecter control of naral tip projection. Several cartilage grafts have been decreased for this purpose each had its own advantage and disadvantage. Aim: To evaluate using of double teostrut graft for controlling of tip projection. Patients and Methods: A total number of 170 patients were subjected to primary and secondary rhino plaster between January 2020 to January 2023. Those patients had double Teostrut banner graft for support of their nasal tip and maintaining tip projection after operation. Results: The follow period was ranging between 6-12 months. The shape of the nose was evaluating by patents vernal analogues scale. The average score for patients satisfaction wa
... Show MoreRudimentary non-communicating functional uterine horn with unicornuate uterus, originating from anomalous embryological development of one Mullerian duct, is prone to different complications either at the gynecological or obstetrical level such as chronic pelvic pain, hematometra, subfertility and decreased quality of life. This unique case report presents a 14-year-old female with a history of severe chronic pelvic pain. She was diagnosed with Familial Mediterranean Fever (FMF) and had an appendectomy for suspected appendicitis within the symptoms’ interval. Ultrasound showed a right 5*6 cm right complex cystic mass assuming ovarian in place. She underwent a suspected endometrioma cystectomy operation and was diagnosed with left unico
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