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: Coronary artery disease (CAD) is a major contributor to morbidity and mortality worldwide. Early-onset CAD, also known as PCAD, is a severe form of CAD associated with high mortality and a poor prognosis. Early diagnosis is crucial to reducing complications. While hsCRP is an established biomarker for CAD, kalirin is a potential novel biomarker due to its role in promoting smooth muscle proliferation and endothelial dysfunction. Objective: To evaluate the relationship between serum kalirin and hsCRP levels with the presence and severity of PCAD and to compare the diagnostic value of both biomarkers. Method: The study recruited 92 participants into two groups: the PCAD group (46) included patients with confirmed CAD by an
... Show MoreThe problem of research was the lack of research that dealt with issue of the job design approach that is more suitable for knowledge work, therefore, the research aims to determine the impact of job enrichment, and knowledge capitalon strategic success, starting from the hypothesis that there significant impact of job enrichment and knowledge capital on strategic success, to achieve this goal the researchers from the theoretical literature and related studies conclude to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted job enrichment as independent variable while knowledge capital plays two roles, the first as an independent variable and the second as an intermediate
... Show MoreThe optimum design is characterized by structural concrete components that can sustain loads well beyond the yielding stage. This is often accomplished by a fulfilled ductility index, which is greatly influenced by the arrangement of the shear reinforcement. The current study investigates the impact of the shear reinforcement arrangement on the structural response of the deep beams using a variety of parameters, including the type of shear reinforcement, the number of lacing bars, and the lacing arrangement pattern. It was found that lacing reinforcement, as opposed to vertical stirrups, enhanced the overall structural response of deep beams, as evidenced by test results showing increases in ultimate loads, yielding, and cracking of
... Show MoreDynamic Thermal Management (DTM) emerged as a solution to address the reliability challenges with thermal hotspots and unbalanced temperatures. DTM efficiency is highly affected by the accuracy of the temperature information presented to the DTM manager. This work aims to investigate the effect of inaccuracy caused by the deep sub-micron (DSM) noise during the transmission of temperature information to the manager on DTM efficiency. A simulation framework has been developed and results show up to 38% DTM performance degradation and 18% unattended cycles in emergency temperature under DSM noise. The finding highlights the importance of further research in providing reliable on-chip data transmission in DTM application.
The optimum design is characterized by structural concrete components that can sustain loads well beyond the yielding stage. This is often accomplished by a fulfilled ductility index, which is greatly influenced by the arrangement of the shear reinforcement. The current study investigates the impact of the shear reinforcement arrangement on the structural response of the deep beams using a variety of parameters, including the type of shear reinforcement, the number of lacing bars, and the lacing arrangement pattern. It was found that lacing reinforcement, as opposed to vertical stirrups, enhanced the overall structural response of deep beams, as evidenced by test results showing increases in ultimate loads, yielding, and cracking of
... Show MoreBackground: The posterior slope of the articular eminence of completely edentulous patients compared to patients with maintained occlusion shows significant flattening. This study aimed to correlate between the flattening of the posterior slope of the articular eminence, with dental status, age, genders, on both sides using computed tomography. Materials and Methods: The sample of the present study was a total of 117 Iraqi subjects, who admitted to the maxillofacial department at Al-Sadr Teaching Hospital in Al-Najaf city. The examination was performed on CT scanner; the eminence inclination was measured in two methods using sagittal section. Results: Clinically, the inclination of articular eminence was higher in edentulous subjects than i
... Show MoreThe general assumption of linear variation of earth pressures with depth on retaining structures is still controversial; investigations are yet required to determine those distributions of the passive earth pressure (PEP) accurately and deduce the corresponding centroid location. In particular, for rigid retaining walls, the calculation of PEP is strongly dependent on the type of wall movement. This paper presents a numerical analysis for studying the influence of wall movement on the PEP distribution on a rigid retaining wall and the passive earth thrust location. The numerical predictions are remarkably similar to existing experimental works as recorded on scaled test models and ful
This research was based on two pillars. The first is a comparison between of research done and the result of a particular variable of research indebendently in the united state, and second, knowledge and determine the effect of managers practices on the contributions of personnel. The manager and staff are considered to be the most important elements in the organization and all of them have a duty towards the others which governed by the relationship rules of procedure of the ministry researched, on the one hand and the interests of the organization and hence employees , whether executives or employees within management formations that the availability of an acceptable level of good pract
... Show MoreThe scarcity of irrigation water requires procedures of specific. One of these procedures is the implementation of the rationing system (a period of the irrigation followed by a period of the dry). This system can have an impact on the properties of irrigation channels. Therefore, the study of rationing system for irrigation channels is important in both water resources and civil engineering, especially if they are constructed with gypseous soil. In order to assess the rationing system on gypseous canals stabilized with a specific ratio of cement, practical experiments were conducted to detect the effect of wetting and drying cycles on the physical and hydraulic behavior of this soil and calculation of some properties of soil such a
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