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 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
... 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 MoreIn this work, two different laser dye solutions were used to host highly-pure silicon nitride nanoparticles as scattering centers to fabricate random gain media. The laser dye was dissolved in three different solvents (ethanol, methanol and acetone) and the final results were obtained for methanol only. The silicon nitride nanoparticles were synthesized by dc reactive magnetron sputtering technique with average particle size of 35 nm. The random gain medium was made as a solid rod with high spectral efficiency and low production cost. Optical emission with narrow linewidth was detected at 532-534 nm as 9 mg of silicon nitride nanoparticles were added to the 10 -5 M dye solution. The FWHM of 0.3 and 3.52 nm was determined for Rhodamine B and
... Show MoreBackground. Implant insertion in regions with poor bone quantity, such as the posterior maxilla, is potentially associated with an increased rate of implant failure. Calcium sulfate can be used as the coating material for commercially pure titanium (CpTi) and as the bone graft material around implants when bound to eggshell powder to enhance the bone quality and quantity of bone defect regions. This study performed a torque removal test to evaluate the effectiveness of eggshell powder as a bone substitute for filling bone defects around CpTi-coated implants coated with nanocrystalline calcium sulfate. Materials and Methods. Eighty screw implant designs were used in the tibiae of 20 white New Zealand rabbits. A total of uncoated 20 s
... Show MoreNew membrane electrodes for determination of ciprofloxacin hydrochloride were prepared depending on ciprofloxacin hydrochloride - phosphotungstic acid (CFH-PT) as an active material and these electrodes were made with three plasticizers: Di-octylphenylphosphonate(DOPH), Di-butyl phosphate (DBP)Tri-n-butyl phosphate(TBP), in PVC matrix. One of the ciprofloxacin electrodes was gave Nernstian slope equal to 57.21 mV/ decade for DOPH membrane with concentration range from 1.5×10-5 to1.0×10-1 M, and detection limit equal to 1.5×10-6 M .Lifetime was 93 days. Non- Nernstian responses equal to 39.40 and 30.70 mV/ decade for membranes DBP, TBP, respectively. These electrodes were gave concentration range from 1.0× 10-5 to 1.0×10-2 and from 4.0
... Show MoreThe current research aims to find out the extent to which students of the Faculty of Education for Pure Sciences\/Ibn al-Haitham have owned laboratory academic skills, the researcher adopted a descriptive research approach to conform to the goal of the research, the research sample the consisted of 140 students from the Department of Chemistry Phase II, The research tool, which consisted of a measure of laboratory academic skills, which consisted of seven skills and consisted of 28 paragraphs (four paragraphs per field), was prepared and the pent-up scale was chosen because the selected sample were university students, and the results showed the ownership of students' skills of laboratory academic skills other than skill The use of the libr
... Show MoreDevelopment of a precise and delicate reaction has been acquired for the determination of vancomycin hydrochloride using batch and cloud point extraction (CPE) methods. The first method is based on the formation of azo dye as a result of diazotized dapsone coupled with vancomycin HCl (VAN) in a basic medium. The sensitivity of this reaction was enhanced by utilizing a nonionic surfactant (Triton X-114) and the cloud point extraction technique (second method). The azo dye formed was extracted into the surfactant-rich phase, dissolved in ethanol and detected at λmax 440 nm spectrophotometrically. The reaction was investigated using both batch and CPE methods (with and without extraction), and a simple comparison between the two
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