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.
Smoking has multiple effects on sex hormone , some of which are associated with important clinical implication .The present study was undertaken to investigate the biochemical changes of sex hormones associated with long standing cigarette smoking in 40 heavy smokers comparing with non- smoker and to correlate it with BMI for each .The sex hormones levels were determined by RIA technique . Atomic absorption technique was used to measure the zinc levels. The serum testosterone and estrogen levels of non – smoker group were 17.775ng\ml and 38.65ng\ml at p< 0.05, respectively .While the serum testosterone and estrogen levels of smoker group were 17.615n
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This research revolves around the probing of those whom Ibn Hajar said, "He has a vision", its significance, and the ruling on the connection and transmission to it. The number of narrators reached fifty-one (51) narrators, among whom it was said, “He has a vision, whether it is definite or possibly. Some of them had a vision and companionship.”They are eleven (11) narrators, And among them were those who had visions and had no company, and their number was twenty-one (21) narrators, and among them were those who had no vision and nor company, and their number is nineteen (19) narrators.
As a result , whoever said about him “has a vision” and has companions, his hadith is connected, even i
The study aims at investigating the quality of internal auditing and its impact on nature, timing, and procedures of external audit, based on international auditing standards, in particular ISA (610). The standard ISA (610) requires the external auditors to assess independence, the scope of internal audit unit, competence, and due professional care of internal auditors as indicators that reflect the quality of internal audit performance before deciding to rely on internal auditors.
The sample of this study consisted of external auditors in Iraqi Solidary Companies for Auditing. A questionnaire was distributed to them via e-mail
... Show More In this research study, I tried to trace the epic effect to learn how it was understood and how it was used. Following the descriptive and analytical approach in the research, the first chapter dealt with a presentation of the methodological framework of the problem, the goal, the limits of the research, the importance and the need for it and the definition of terms, as well as the theoretical framework which consisted of two topics, including the impact of the epic theater on the world theater and the second the effect of the epic theater on the Arab theater, This came by tracing the epic impact on the world stage of the Greeks, the Middle Ages, the Renaissance, and the Arab theater of the twentieth century.
As for the second
Biodiesel production from microalgae depends on the biomass and lipid production. Both biomass and lipid accumulation is controlled by several factors. The effect of various culture media (BG11, BBM, and Urea), nutrients stress [nitrogen (N), phosphorous (P), magnesium (Mg) and carbonate (CO3)] and gamma (γ) radiation on the growth and lipid accumulation of Dictyochloropsis splendida were investigated. The highest biomass and lipid yield of D. splendida were achieved on BG11 medium. Cultivation of D. splendida in a medium containing 3000 mg L−1 N, or 160 mg L−1 P, or 113 mg L−1 Mg, or 20 mg L-1 CO3, led to enhanced growth rate. While u
... Show MoreThe research aims to verifying the tax exemptions granted in accordance with the Iraqi tax legislations, showing their suitability for basic tax rules, and identifying their role to reduce the tax evasion phenomenon and the negative effects resulting therefrom, which arerepresented by a decrease in the proceeds of tax revenue and therefore leadings to a reduction of public revenues of the state. Also, the research tries to identify the ways to reduce cases of tax evasion due to their reflection positively on the public budgetof the state. The data of the research was collected through two models of questionnaires distributed to a sample of taxpayers from some professions and a sample of the tax administration staff. The research has reac
... Show MoreBrucella melitensis isolates were obtained from human infections , and milk which obtained from aborted sheep at Mosul city vicinity . One isolate from each source was used in carrying out this study. Brucella liquid culture was added to sheep milk at 2.5 % for treatments . To first treatment 2 % of yoghurt starter ( Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus salivarius subsp. thermophilus ( 1: 1 ) ) . Second treatment was carried out without addition of yoghurt starter but the pH was lowered using lactic acid in pattern similar to first treatment . Third treatment was similar to the first treatment but contained buffer to alleviate the reduction in pH , which reduced to 6.1 in comparison to 4.9 of the first treatment .
... Show MoreThis study aimed at recognizing the impact of empowerment of human resources strategy on enhancing the financial performance in working banks in Jordan, the axes of the strategy were: informative sharing, free and independence, working teams, and organizational power. To achieve the objective of the study, a questionnaire is designed and distributed on the sample of the study, which represented 60 employees of Banks. After analyzing the data by using SPSS, the study resulted that there is positive impact of empowerment of human resources strategy on enhancing the financial performance in working banks in Jordan. It suggested that the working banks in Jordan should establish database, and to create working teams.
... Show MoreThe research aims to achieve a set of objectives, the most important of which is to educate the management of companies operating in the private sector about the advantages and risks of using creative accounting practices, as on the one hand they serve the interests of the company and improve its image, and on the other hand it exposes it to the risks of non-compliance with tax laws and legislation or the risks of default and bankruptcy as a result of exploiting gaps and flexibility in the application Accounting standards, and in line with the objectives and through the research problem that was formulated in the form of a question (Are their creative accounting practices that are reflected in the honesty and fairness of financia
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