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.
This research came with the aim of showing the impact of governance mechanisms on tax avoidance practices, and in light of this, the financial data of the joint stock companies (industrial, service, agricultural, and hotels) listed in the Iraq Stock Exchange amounting to (35) companies were collected during the period (2009-2020). Through the financial reports published on the market website, multiple linear regression analysis was used as a tool to study the relationship between variables, and (Eviews 12) program was used for analysis and hypothesis testing. To achieve the objectives of the research,(administrative ownership, board size, board independence, women's membership) was adopted as an indicator of the dimensions of governance, an
... Show MoreNumerous trace elements, notably metals, are essential for the normal functioning of several biological reactions, especially as enzyme cofactors. Several Trace elements refer to essential micronutrients required in minimal quantities for certain biological functions pertaining to human metabolism, albeit their minimal concentrations in the organism. Nonetheless, our understanding of this topic is considerably restricted, and emerging insights into their metabolic functions necessitate contributions and have implications across various domains, encompassing nutritional chemistry, with a focus on analytical chemistry, biological sciences, medicine, pharmacology, and agricultural sciences.
The 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 aim of this research is to demonstrate the impact of credit risk on the banks of the study sample on the granting of loans and credit facilities, and try to reduce the size of credit risk to banks as a result of granting loans and credit facilities, credit risk is the oldest form of risk in financial markets. Every financial institution takes a degree of risk when it gives loans and credit facilities to companies and customers, It is exposed to financial losses when some borrowers fail to repay their loans as agreed, and at the same time credit facilities are the most profitable operations of the bank as it is the most profitable banking operations than other operations, so it represents the research communit
... 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.
The current research aims to test the impact of the strategy of merger (as an explanatory variable) in human resources management practices (as a response variable), and the importance of the subject being an important topic that mimics the Iraqi environment, where has seen many mergers that have not been addressed by former researchers in the field. In addition, the future prospects carry many mergers, and the problem of research was the lack of understanding among departments in how to manage the integration and deal with it, on the basis of scientific which reflected negatively on the practices of human resources management, and the research was based on two main hypotheses Six sub-hypotheses emerge to explore the correlation
... Show MoreThis 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 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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