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: Pain due to muscular cramp during hemodialysis is one of the most common problems experienced by patient undergoing hemodialysis, and is associated with poor outcomes of patients. The main aim of this study was to comparing the effects of lavender oil and olive oil massage on Pain due to muscular cramp during hemodialysis.
Methods: In this random clinical trial, 60 hemodialysis patients were enrolled randomly and allocated to two groups with 30 members in Lordegan and Brojen hospitals, Shahrekord, Iran. The intervention included flora massage on the lower leg muscles so that the first group received olive oil massage (10 drops) and the second group received lavender oil massage (10 dr
... Show MoreLaryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea
... Show MoreBackground: One common undesirable side effect of orthodontic treatment with fixed appliances is the development of incipient caries lesions around brackets, particularly in patients with poor oral hygiene. Different methods have been used to prevent demineralization; the recent effort to improve the resistance against the demineralization is by the application of lasers. Materials and method: Thirty human premolars extracted for orthodontic purposes were used to test the effect of two energy level of ER-YAG laser on enamel resistance to demineralization. The brackets were bonded on the teeth and all the labial surface excluding 2 mm area gingival to the brackets were painted with acid resistance varnish. Three groups were generated. The fi
... Show MoreObjectives: To assess nurses-midwives' knowledge about pain management during labor before and after implementation of educational program and to determine the effectiveness of educational program on nurses-midwives' knowledge about pain management during labor in Baghdad Maternity Hospitals.
Methodology: A quasi-experimental design has been conducted during the period of (February 27th 2019 through 2nd June 2019) on non-probability sample (purposive) consists of (44 Nurses/midwives') who are work in delivery room, the sample was exposed to pretest, educational program, posttest. The study was conducted in three Directories, (Baghdad Teaching Hospital) at medical city health
... 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 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 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 MoreMan has a great role in the development of society in all fields, and therefore the human thought played a great role in its continuous pursuit and insight into the social classes that differ in their privileges, which makes the members of society not reconcile because of that disparity that is not based on human principles, so one class exploits another, and this is what stopped me Rather, it prompted me to choose the topic (class and its impact on society) in order to show the impact of classes on each other negatively and positively, so I work to avoid the first with the recommendations I put forward and offer guidance, and strengthen the second, and after this topic of necessity in a place because of the imbalance and promise of appr
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