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.
Purpose – The main purpose of this research is to highlight the main role of strategic leadership skills for top managements in accessing to effective management in accordance with the (VUCA Prime) methodology in (VUCA) environment as Miniature virtual environment, which refers to (Volatility), (Uncertainty), (Complexity), and (Ambiguity).
methodology – To achieve the research objective, this study selected the quantitative approach in research design, Questionnaire was used as the main instrument for data collection, the sample comprised the opinion poll (106) individual who functions as a head department. (Structural equation modelling by (Smart Pls3)
... Show MoreBackground: One of the most common complications of dentures is its ability to fracture, so the aim of this study was to reinforce the high impact denture base with carbon nanotubes in different concentrations to improve the mechanical and physical properties of the denture base. Materials and methods: Three concentrations of carbon nanotubes was used 0.5%, 1%, 1.5% in a pilot study to see the best values regarding transverse strength, impact, hardness and roughness test, 1 wt% was the best concentration, so new samples for control group and 1wt% carbon nanotubes and the previous tests were of course repeated. Results: There was a significant increase in impact strength and transverse strength when we add carbon nanotubes in 1wt%, compared
... Show MoreThe internet is a basic source of information for many specialities and uses. Such information includes sensitive data whose retrieval has been one of the basic functions of the internet. In order to protect the information from falling into the hands of an intruder, a VPN has been established. Through VPN, data privacy and security can be provided. Two main technologies of VPN are to be discussed; IPSec and Open VPN. The complexity of IPSec makes the OpenVPN the best due to the latter’s portability and flexibility to use in many operating systems. In the LAN, VPN can be implemented through Open VPN to establish a double privacy layer(privacy inside privacy). The specific subnet will be used in this paper. The key and certificate will
... Show MoreTwitter is becoming an increasingly popular platform used by financial analysts to monitor and forecast financial markets. In this paper we investigate the impact of the sentiments expressed in Twitter on the subsequent market movement, specifically the bitcoin exchange rate. This study is divided into two phases, the first phase is sentiment analysis, and the second phase is correlation and regression. We analyzed tweets associated with the Bitcoin in order to determine if the user’s sentiment contained within those tweets reflects the exchange rate of the currency. The sentiment of users over a 2-month period is classified as having a positive or negative sentiment of the digital currency using the proposed CNN-LSTM
... Show MoreThe depreciation of the Iraqi dinar against the US dollar, reaching low levels and causing disruptions in the local markets, has had detrimental effects on individuals and companies, particularly those with limited income and the poor. The local currency approached around 1600 dinars per dollar, after the official exchange rate had stabilized at around 1450 dinars per US dollar. This depreciation in the value of the Iraqi dinar can be attributed to financial speculation among currency traders, which directly affected exchange rates and illicit dollar smuggling operations. Bank transfers are also important alongside financial transactions, especially in light of current economic developments in the 21st century. To prevent currency s
... Show MoreThe research problem lies in the fundamental questions that revolve around the role of each of the tools of promotion, namely advertising, personal sale, public relations, sales promotion, and direct marketing in achieving leadership for business organizations. Research to know the role of promoting the service in the researched company and whether the promotion of the service is qualified to lead the researched company to leadership, and for this purpose formulated research hypotheses of three hypotheses, the first hypothesis says that there is a significant impact relationship between promotion and entrepreneurship. The second hypothesis aimed to determine the role played by promotion in the researched company to achieve unique
... Show MorePraise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
And after:
Muslim scholars have fought in the extent of regard to these interests, each according to his opinion and according to his evaluation, and his consideration of this interest, but it remains important that the legislation in them needs more precaution and caution against the predominance of passions, because the passions often decorate spoilers so they see an interest, so practical application must To realize the spirit of Islamic Sharia in its entirety of its rulings, and the preponderance between the interests and evils that prevail in our societies, which c
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