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: 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 MoreThis study was aimed to determine the impact of Conocarpus erectus L. compost fertilizer, and some micronutrients on growth and production of potato. This research was conducted at one of the fields of the College of Agricultural Engineering Sciences - University of Baghdad. The experiment was implemented using factorial arrangement (4X3X3) within randomized complete block design with three replicates. Conocarpus fertilizer was represented the first factor with three levels (7.5, 15, 30 ton.ha-1), which symbolized (C2, C3, C4). Chemical fertilizer as recommended dose as a control, which symbolized (C1). The second factor was foliar spraying with three levels of iron (0, 100, 200 mg.L-1), which symbolized (F0, F1, F2). The third fact
... Show MoreThe study aimed to investigate the relationship between empowerment strategies and their impact on the success of enrichment work, it included the dimensions of empowerment strategies (power, knowledge, information, rewards), The dimensions of Job enrichment are (Skill variety, Task identity, Task significance, Autonomy, Feedback). The study was conducted at the headquarters of the Iraqi Oil Ministry in Baghdad and was based on a sample of the leadership of the ministry of managers consisting of 215 people. The data were collected using the questionnaire method based on scientific standards adopted in previous st
... Show MoreThis study seeks to identify the role that the leadership trend plays in the management of health institutions in Iraq and its impact on improving the quality of the health service provided by analyzing some opinions of affiliates working in the Iraqi health sector where a survey list was used as a main tool for collecting primary data, as it was subjected to this analysis ( 60) of the medical staff, of whom (40) are doctors and (20) are affiliated with the rank of assistant physician, and (60) members of the administrative cadre have undergone their various job ranks and administrative specializations (department manager, auditor, observer, accountant, statistician, secretary). Reliance on statistical software (spss) in data ana
... Show MoreThe internationalization of the Libyan crisis and its accompanying militarization of the conflict have played a vital role in hindering to reach a comprehensive political settlement solution in Libya. The increasing international greediness in the Libyan energy resources and the geopolitical importance of the Libyan State led to the involvement of many international and regional powers in this crisis and transformed the Libyan crisis into “proxy war”. Moreover, the Turkish direct military intervention in the Libyan crisis is considered as one of the main constraints facing the international and regional efforts to settle the Libyan crisis as a result of the Turkish insistence on its military existence in Libya to preserve i
... Show MoreThe research tackles the nature of relationship between the Orthodox Church and the state in the Russian Federation. At the beginning of the nineties of the last century, the church had been performed a different role in its relationship with the state, and it had an effect over the internal and foreign policies for the Russian Federation. In political history of Russia, the church’s existence became an evident too much in comparing with the previous historical period, starting with the educational and political system, whether through a symbolic participating roles as what happened in the inauguration ceremony to take over responsibility of the head of state or taking actual roles such as influencing on the process of holding elections d
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The research the impact of the application of some of the production system tools in the specified time, which can be adapted in the service sectors (banking sector) over the improvement and increase the quality of banking services, and highlights the research problem in the low quality of banking services provided to customers because of the reliance on traditional banking systems in the provision of services Because of the lack keep pace with global developments in the banking industry, and the goal of research is to clarify the applicability of the production system in the time specified in the service sector and th
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