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.
Crime is one of the most severe challenges facing States, and strives to find preventive measures, reduce its seriousness, and prevent them; due to developments, crimes have increased, and emerging new patterns of crimes, there is an urgent need to prevent crimes and reduce their effects. Modernizing its punitive system and diverting it to correctional rehabilitative justice to redress the prejudice caused by the crime and rehabilitate the convicted person by using alternative measures to short-term imprisonment. This research emphasizes alternative sanctions' value to minimizing short-term imprisonment penalties and their impact on societal security through several goals like, the negative consequences, justifications, and alternatives
... Show MoreApplying a well-performing heat exchanger is an efficient way to fortify the relatively low thermal response of phase-change materials (PCMs), which have broad application prospects in the fields of thermal management and energy storage. In this study, an improved PCM melting and solidification in corrugated (zigzag) plate heat exchanger are numerically examined compared with smooth (flat) plate heat exchanger in both horizontal and vertical positions. The effects of the channel width (0.5 W, W, and 2 W) and the airflow temperature (318 K, 323 K, and 328 K) are exclusively studied and reported. The results reveal the much better performance of the horizontal corrugated configuration compared with the smooth channel during both melti
... Show MoreThe objective that the researcher seeks to achieve through this research is to clarify the relationship between strategic management accounting techniques and the reliability of financial statements, and to measure the impact of these techniques as an independent variable with its three dimensions, which are: activities-based cost, target cost, and benchmarking on the reliability of financial statements as a dependent variable. To achieve this objective, the researcher did the following: First: Determine the research problem through the following question: Do strategic management accounting techniques affect the reliability of financial statements in industrial companies listed on the Palestine Exchange? Second: Making the analytical des
... Show MoreThe purpose of this study is to examine the effect of human resource diversity management practices on achieving entrepreneurship in Jordanian public universities. To achieve the aims of the study, a well-designed questionnaire was used for collecting data. The population of the study was (7433) faculty members (including different ranks such as professors, associate professors, assistant professors and lecturers) in Jordanian public universities. The study sample was selected through the use of a random sample, the questionnaire is distributed to a sample (of 400 with the percentage of 5%) selected by using a random sampling (350) copies of the questionnaire were collected, reaching about (87.5%) out of the sum total of the dist
... Show MoreThe interest in pre-service teacher training has become influential in teaching English as a foreign language, and the purpose of this training course is to prepare qualified teachers to teach effectively through the application of this technique by undergraduate students. This research aims to find out the effect of using the seven principles of good practice as a teaching technique on the fourth stage student-teachers’ performance at the College of Education for Women/University of Baghdad, during the academic year 2017-2018. The sample includes (60) students selected according to the stratified sampling method. The observational checklist used by the department to assess the student teachers’ performance during the practicum perio
... Show MoreToxoplasmosis is a parasitic infection that triggers immune cells to produce cytokines and inflammatory mediators that are responsible for abnormal or aborted immune responses. This study highlights the evaluation of the Dectin-1 receptor and cytokine IL-37 in the serum of 80 patients who had miscarried in the first trimester and were infected with toxoplasmosis, as well as 40 pregnant women in the first trimester who had a successful pregnancy (control groups). The serum was first screened for the T. gondii IgM and IgG antibodies by an enzyme-linked immunosorbent assay (ELISA) and then the serum levels of IL-37 and Dectin-1 were determined. The results showed that the serum level of Dectin-1 was significantly increased in anti-
... Show MoreThe Role of the Deubiquitylase MYSM1 During Alphavirus Infection Amer Nubgan The members of the genus Alphavirus are positive-sense RNA viruses and it is one of two within the family Togaviridae. Most alphaviruses are predominantly transmitted to susceptible vertebrates by a mosquito vector. Alphavirus disease in humans can be severely debilitating, and depending on the particular viral species, infection may result in encephalitis and possibly life threatening symptoms. Chikungunya virus (CHIKV) is the aetiological agent represents a substantial health burden to affected populations, with clinical symptoms that include severe joint and muscle pain, rashes, and fever, as well as prolonged periods of disability in some patients. In recent
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