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.
Competitive advantage is a substantial strategic objective for organizations. It requires high levels in the quality of products and services provided to customers, continuous improvement of costing , care for creativity and innovative employees, and speed unique to the marketing and financial engineering, and business re-engineering processes. The situation in this area, requires actors to attract and develop human resources, including help in proper implementation of the strategic tasks that targeted by those institutions. According to the opinions and viewpoints of management scholars, the competitive advantage resource is the most important issue for organizations in the third millennium, which can be a
... Show MoreThere is no adopt in the importance of the optical communications in scientific civil and military applications because of it’s simplicity in manufacturing and it's low cost. The method of optical communication depends upon bearing the light beam the translated informations by a method called the light modulation. This method depends upon changing some light properties as frequency, amplitude and pulse duration according to the translating informations. The changes in the first two properties are concerned optically with the analog modulation while the third one concern at most with digital modulation. All past methods are expensive with low efficiency and needs electrical or magnetic fields. In this technique the source of voice used
... Show MoreCarbazone Derivatives (CD) (semicarbazone, semithiocarbasone) are produced by the condensation reaction between a aldehyde (or ketone) with a carbazide derivatives (semicarbazide, semithiocarbazide). CD and their metal complexes existent a wide range of implementation that stretch from their ply in the medicinal and pharmaceutical area because of their major significant pharmacological characteristic such as anti-fungal,anti-bacterial, anti-cancer, anti-human immunodeficiency virus, anti-inflammation, anti-neoplastic,inhibition corrosion, antioxidation, antiradical. This paper reviews the definition, importance and various applications of carbazone derivatives with transitional meta
Bee keping projects is one of the most important agricltural investment projects because it generate profit in a short period . In addition to the multiplicity of products and other benefits . Research aimed at study the feasibility of two projects one hand in the origin of the Al – Mashrok since 2006 , kicking off with ten hives , and the scond proposal , kicking of 100 hives using the criteria of the world bank . Results showed that the bee keeping projects is economically feasible, whether small or large .. Even when the analysis of the sensitivity of the project to changes which may occur in the price of output and resources by reducing costs and increasing revenues by 10% it remains economically viable .
... Show MoreWar as a human phenomenon, has its own literature. Poetry is a major genre in this literature. This paper is an attempt to investigate and analyse some stylistic features in two selected, English and Arabic, war poems. These poems share the same theme.Both promote the principle of sacrificing one’s own life for the sake of homeland. This paper limits itself to analyse, thecontent words, tenses, semantic grouping of vocabulary and foregrounding in the two poems. The areas of analysis show great similarities in distributing the general content words (nouns, verbs, adjectives, and adverbs). In the analysis of the semantic areas of each content word, these poems reveal some similarities and some differences in their frequency rates.
... Show MoreThis study explores the semiotic aspects of American slang, specifically focusing on the phenomenon of reduplicative expressions in informal speech. Despite the extensive research on American slang, limited attention has been given to the cultural and mythical meanings embedded within reduplicative expressions. To address this gap, the study investigates how these expressions convey denotative, connotative, and mythical meanings within casual American discourse. The objectives of the study include: 1. To what extent does Barthes’ semiotic model hold potential for application in this study? 2. How are reduplicative slang expressions widely used in everyday American life? 3. To what extent do qualitative and quantitative methods hav
... Show MoreThis study includes a detailed morphological description of Cosmina baghdadensis sp. nov.
from Iraq.
Many characters are used in identification especially chaetotaxy and male genetalia.
Locality, host plant, and data of collection were given.
Background: Maxillary sinusitis can arise after sinus floor elevation surgery and should be treated immediately to prevent further complications which included dental implants failure, graft lost, and oro-antral fistula. This is the first systematic review to assess the incidence, causes, and treatment of sinusitis after sinus lift surgery. Materials and methods: An electronic search included MEDLINE (PUBMED) data base site was carried out for articles involving development of sinusitis after sinus lift surgery from September 1997 up to April, 8, 2017. The search was done and reviewed by two independent authors. Results: The total results of electronic search were (182) abstracts and articles, the extracted articles which involved develo
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