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.
The current research aims to know the extent of the impact of performance evaluation in its dimensions as an explanatory variable in the behavioural and attitudinal work outputs with its dimensions as a response variable in order to reach appropriate solutions through which the University of Fallujah seeks to achieve its goal in the process of diagnosing the axes of strength and to benefit from them in the process of strengthening the status and sobriety of the academic position of the professor and the researcher relied on The descriptive and analytical approach in carrying out this study, and data was collected from university professors, including leaders, heads of departments and divisions, who numbered (97) teachers. And fie
... Show MoreIntroduction: In recent decades, the endovascular treatment of cerebral arteriovenous malformations (AVMs) has advanced. However, it still carries risks of unanticipated complications. Coil migration is a reported complication of aneurysmal coiling procedures. Herein, we report a case of early intraprocedural coil migration during pressure cooker technique embolization of right thalamic AVM, discussing the management and potential explanations. The literature showed no report of coil migration after the pressure cooker technique in the form of coil-augmented Onyx injection technique (CAIT). Case description: An otherwise healthy 26-year-old female suddenly developed a severe headache with no loss of consciousness. Computed tomograp
... Show Moreلقد تسبب انتشار الإرهاب في العالم وكذلك الحروب الأهلية والصراعات في أوائل القرن الحادي والعشرين في جميع أنحاء العالم في الكثير من الأضرار وخلفت ضحايا جسيمة. أدت الهجمات الإرهابية على النساء، مثل اختطاف بوكو حرام لأكثر من 270 تلميذة في نيجيريا وتقارير عن انتشار الاغتصاب والاعتداء الجنسي في المناطق التي مزقتها الحرب، إلى إنتاج العديد من العروض المسرحية في الولايات المتحدة التي تصور خواص الجناة وكذلك الضحا
... Show MoreThe goal of this study is to build an application that can be used in difficult cases and sudden circumstances during the pandemic and post-disaster state, which can be the development of digital risk management and mitigating the difficult impact of the epidemic through the improvement of IT and IoT that can be fine by finding initial solutions and make the world like a digital city that could be managed by the network. We provide this study to gain an overview of reasons for delayed and exceeded costs in a select of thirty Iraqi case projects by controlling the time and cost. The drivers of delay have been investigated in multiple countries/contexts. however, there is little country data available under the conditions that have ch
... Show MoreThis article investigates the relationship between foot angle and jump stability, focusing on minimizing injury risk. Here are the key points: Importance: Understanding foot angle is crucial for improving jump stability, athletic performance, and reducing jump-related injuries like ankle sprains. Ideal Foot Angle: Research suggests a forward foot angle of around 15 degrees might be ideal for many people during jumps. This angle distributes forces evenly across the foot, lowers the center of gravity, and provides more surface area for pushing off the ground. Factors Affecting Ideal Angle: The optimal angle can vary depending on the type of jump (vertical vs. long jump), fitness level, and personal preference. Incorrect Foot Angles: Landing w
... Show MoreOften there is no well drilling without problems. The solution lies in managing and evaluating these problems and developing strategies to manage and scale them. Non-productive time (NPT) is one of the main causes of delayed drilling operations. Many events or possibilities can lead to a halt in drilling operations or a marginal decrease in the advancement of drilling, this is called (NPT). Reducing NPT has an important impact on the total expenditure, time and cost are considered one of the most important success factors in the oil industry. In other words, steps must be taken to investigate and eliminate loss of time, that is, unproductive time in the drilling rig in order to save time and cost and reduce wasted time. The data of
... Show MoreCommunity pharmacists faced more complex challenges in meeting patients’ medication needs during the pandemic than previously reported in the literature. Objectives To explore the perception and abilities of community pharmacists in managing patients’ needs in terms of medication dispensing during the pandemic, and to examine its effect on improving the patients’ situations. Materials and Methods A cross-sectional study design, validated by 30 experts, was conducted using an electronic survey (Google Form) to assess the effect of the dispensing practice of Iraqi community pharmacists on the patient’s clinical outcomes during the pandemic. The survey was distributed on professional pharmacist’s social media platforms from December
... Show MorePurpose: aims the study to show How to be can to enhance measurement management by incorporating a risk-based approach and the six sigma method into a more thorough assessment of metrological performance. Theoretical framework: Recent literature has recorded good results in analyzing the impact of Six Sigma and risk management on the energy sector (Barrera García et al., 2022) (D'Emilia et al. 2015). However, this research came to validate and emphasize the most comprehensive assessment of metrological performance by integrating Risk management based approach and Six Sigma analysis. Design/methodology/approach: This study was conducted in Iraqi petroleum refining companies. System quality is measured in terms of sigmas, and t
... Show MoreThe aim of this study is to get practical evidence from the Egyptian business environment The Impact of Audit Committees Effectiveness and External Audit Quality on Timeliness of annual Financial Report. Design and methodology: The study based on the content analysis technique to examine the annual reports of a sample of (30) companies listed on the Egyptian Stock Exchange (EGX100) during the period (2016-2019) with a total of (120) respondents. To test the research hypotheses, the results of the study indicate that there is a negative significant impact of audit committees on timeliness of annual financial report. Moreover, while there is a negative impact on the quality of the external audit on the timing of issuing the annual
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This research aims to examine the correlation and the influence of Authentic Leadership on the contextual performance as a dependent variable, in the departments and Division of the iraqi Ministry of Foreign Affairs To try out with a number of recommendations that contribute to raising the level of contextual performance in the Ministry. Starting from the importance of research in public organizations and its Role in society, the researcher adopted the descriptive analytical approach in accomplishing this research, The 99 people responded exclusively comprehensively, based on questionnaire that is include 28-item, using interviews and field observations as
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