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.
Countries have faced the challenges of high levels of public debt and seek to define the optimum limits to reduce risks to which the financial system can be exposed and its impact on the economy as a whole. Hence the importance of research in studying the impact of internal and external public debt components on indicators of stability of the financial system for the period 2005-2017 for the purpose of knowing the extent of the financial stability indicators response to the high level of the public debt from its optimum ratio, as the aim of the research is to estimate and analyze the dynamic relationship of short and long term between the components of public debt and indicators of financial stability using the (ARDL) model that
... Show MoreThe significant shift in the Fine Arts, who led the avant-garde movements and creative which appeared in the modern, specifically in the mid-nineteenth century and early twentieth century era path, embodied in a clear show of new aesthetic value rejects traditional methods put in shape and color qualities She described the movements subjectivity or no formal, was intended to determine the direct function of expression and speech language in the visual arts away from the representation and simulation of reality was accompanied by the appearance of those fine movements directed towards a global approach to design carries features and clear in its organizations formalism of the most important move away from the symmetry and the adoption of
... Show MoreThe influx of Arab Qahtani and Nizari tribes continued to the countries of Baluchistan and the Levant in pre-Islamic times until the Levant became open to the Arab-Islamic tide during the first century AH. The Islamic Orient until the early Islamic Arab Army reached the western borders of China. What we will see in the folds of the search.
Unlike fault diagnosis approaches based on the direct analysis of current and voltage signals, this paper proposes a diagnosis of induction motor faults through monitoring the variations in motor's parameters when it is subjected to an open circuit or short circuit faults. These parameters include stator and rotor resistances, self-inductances, and mutual inductance. The genetic algorithm and the trust-region method are used for the estimation process. Simulation results confirm the efficiency of both the genetic algorithm and the trust-region method in estimating the motor parameters; however, better performance in terms of estimation time is obtained when the trust-region method is adopted. The results also show the po
... Show MoreThe research problem stems from the suffering of organizations from the weakness of their organizing aspect and the weak influence of the leadership on the subordinates and their dispersion. Organizations today are in rapid development and therefore work relations are not dominated by the humanitarian aspect and the first goal has become productivity. The research aims to identify the influence of servant leadership and its dimensions as an independent variable on the effectiveness of work teams as an approved variable and their importance increases when these organizations are service organizations, and how their influence increases when this leadership is the servant leadership and its dimensions in the Health Depa
... Show MoreEmpirical research in the disciplines of art and design has started to escalate and gather consideration within the academic community over the past few decades. However, still, graphic design tends to be a topic extremely under-researched by scholarly persons. Profound research in the field of graphic design extends far beyond the works produced by the designer himself (Khoury, 2009, p.844). In order to develop a clear insight, one needs to delve deep into the subcategories that the diverse field of graphic design is comprised of, including illustration, typography, interaction design, branding and even the impact of notable, eminent institutes from around the world that have taken the budding artists for quite a long time (Walke
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A descriptive study, which was using an assessment approach, was conducted for the
determination of the impact of rheumatoid arthritis and osteoarthritis patient’s functional disability
upon their life style. The study was carried out at the Rheumatology and outpatients clinics of ALKarama
Teaching Hospital, Baghdad Teaching Hospital AL-Kindey Teaching Hospital and Specialized
surgeries Teaching Hospital for the period of October 15th 2003 through May 13th 2004 in Baghdad
City. A purposive (non-probability) sample of (245) arthritis patients which was comprised (111)
rheumatoid arthritis patients and (134) osteoarthritis patients, was selected out of the early stated
settings. The questionnaire was comprised of
This study focused on extracting the outer membrane nanovesicles (OMVs) from Escherichia coli BE2 (EC- OMVs) by ultracentrifugation, and the yield was 2.3mg/ml. This was followed by purification with gel filtration chromatography using Sephadex G-150, which was 2mg/ml. The morphology and size of purified EC-OMVs were confirmed by transmission electron microscopy (TEM) at 40-200 nm. The nature of functional groups in the vesicle vesicle was determined by Fourier transforms infrared spectroscopy (FT-IR) analysis. The antitumor activity of EC-OMVs was conducted in vitro by MTT assay in human ovarian (OV33) cancer cell line at 24,48 and 96hrs. The cytotoxicity test showed high susceptibility to the vesicles in ovarian compared to normal
... Show MoreSimple, cheap, sensitive, and accurate kinetic- spectrophotometric method has been developed for the determination of naringenin in pure and supplements formulations. The method is based on the formation of Prussian blue. The product dye exhibits a maximum absorbance at 707 nm. The calibration graph of naringenin was linear over the range 0.3 to 10 µg ml-1 for the fixed time method (at 15 min) with a correlation coefficient (r) and percentage linearity (r2%) were of 0.9995 and 99.90 %, respectively, while the limit of detection LOD was 0.041 µg ml-1. The method was successfully applied for the determination of naringenin in supplements with satisfac
... Show MoreThis approach was developed to achieve an accurate, fast, economic and sensitivity to estimation of diphenhydramine Hydrochloride. The dye that produced via reaction between diphenhydramine HCl with thymol blue in acidic medium pH ≈ 4.0. The ion pair method include an optimization study to formed yellowcolored that extraction by liquid – liquid method. The product separated of complexes by using by chloroform solution measured spectrophotometry at 400 nm. The analysis data at optimum conditions showed that linearity concentration in a range of calibration curve 1.0 – 50 μg /mL, limit of detectionand limit of quantification 0.0786 and 0.2358 μg/mL respectively. The molar absorptivity and Sandell’s sensitivity were 1.8 × 10 -4 L/mo
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