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.
Bac kground: The transfer of the tibialis posterior tendon to the anterior aspect
of the ankle not only replaces the function of the paralyzed muscles, but also
removes the deforming force on the medial aspect of the foot.
Objec t i ves : In this study, we evaluated patients who underwent tibialis
posterior tendon transfer for the treatment of foot drop, and comparison through
interosseous membrane route versus anterior to lower tibia route of tibialis
posterior tendon transfer, with evaluation of the results according to carayon
criteria
Methods: Nine patients with foot drop secondary to different causes treated with
tibialis posterior tendon transfer from January 2011 to January 2012 were
followed up for a
Let R be a commutative ring with identity 1 and M be a unitary left R-module. A submodule N of an R-module M is said to be pure relative to submodule T of M (Simply T-pure) if for each ideal A of R, N?AM=AN+T?(N?AM). In this paper, the properties of the following concepts were studied: Pure essential submodules relative to submodule T of M (Simply T-pure essential),Pure closed submodules relative to submodule T of M (Simply T-pure closed) and relative pure complement submodule relative to submodule T of M (Simply T-pure complement) and T-purely extending. We prove that; Let M be a T-purely extending module and let N be a T-pure submodule of M. If M has the T-PIP, then N is T-purely extending.
Background. Aneurysms of the distal anterior cerebral artery (DACA) are uncommon; they often form near the pericallosal-callosomarginal junction and are typically small. To our knowledge, giant DACA aneurysms developing from the more distant parts of the anterior cerebral artery (ACA), A4-5, have been described only once in the literature. Case description. A 66-year-old gentleman reported with a brief loss of consciousness followed by weakness in his right lower leg. The patient was admitted with a Glasgow Coma Score (GCS) of 15. A computed tomography (CT) scan of the head revealed a left hyperdense mass in the frontal parasagittal supracallosal region. Contrast MRI revealed a heterogeneously enhancing mass measuring 35x30x25 mm. C
... Show MoreBackground. In cases of spontaneous subarachnoid haemorrhage (SAH) with multiple intracranial aneurysms (MIAs) detected on angiography, some radiological clues assist in determining the site of a ruptured aneurysm which is bleeding is quite beneficial for the selection of the best treatment strategy. Case description. We report a case of a 60 years old patient who presented with spontaneous SAH, sellar hematoma, and three different aneurysms detected in angiography. Although the right Posterior communicating artery (PcomA) aneurysms showed Murphy’s teat on angiography intraoperatively, we discovered that the right superior hypophyseal aneurysm (SHA) was the source of the index bleeding. Both aneurysms were clipped successfully. Co
... Show MoreEducation around the world has been negatively affected by the new coronavirus disease (COVID-19) pandemic. Many institutions had to transition to distance learning in compliance with the enforced safety measures. Distance learning might work well for settings with stable internet connections, professional technical teams, and basic implementation of technology in education. In contrast, distance learning faces serious challenges in less fortunate settings with inferior infrastructure. This report aims to shed light on the immediate action steps taken at a leading pharmacy school in Iraq to accommodate for the enforced changes in pharmacy education. The University of Baghdad College of Pharmacy went from less than minimal technology impl
... Show MoreObjective: To assess the impact of anxiety and stress during pregnancy upon neonatal outcome Methodology: A descriptive purposive study was used to assess the impact of anxiety and stress during pregnancy upon neonatal outcome. The study was conducted from (22nd \ September \ 2020 to 15th \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labour wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the n
... Show MoreBackground: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswit
... Show MoreNumerical study of separation control on symmetrical airfoil, four digits (NACA
0012) by using rotating cylinder with double steps on its upper surface based on the computation of Reynolds-average Navier- Stokes equations was carried out to find the optimum configuration of unconventional airfoil for best aerodynamics performance. A model based on collocated Finite Volume Method was developed to solve the governing equations on a body-fitted coordinate system. A revised (k-w) model was proposed as a known turbulence model. This model was adapted to simulate the control effects of rotating cylinder. Numerical solutions were performed for flow around unconventional airfoil with cylinder to main stream velocities ratio in the range
... Show MoreMany studies have evaluated the effect of platelet rich plasma (PRP) in the treatment of non-union fractures but few studies have investigated their effect on the union of femoral neck fractures or their functional outcome in young adults. The aim of this study was to evaluate the union time and functional outcome in young adult patients with femoral neck fracture managed by three cannulated screws injected with PRP and those managed by fixation only. This prospective study included 24 patients diagnosed with femoral neck fractures within 24 hours of presentation. Twelve cases in group A were managed by closed reduction and three cannulated screws fixation injected with PRP; twelve patients in group B were managed only by closed reduction a
... Show MoreThe cinematographer mediates through the means of cinema and television a set of elements complementing each other in the light of developments in various sciences, culture and arts for the purpose of conveying the meaning to the recipient and achieve aesthetic taste. Despite the diversity of cinematographic media with its multiple forms, The researcher started from the principle of definition and knowledge of a technical phenomenon that emerged in the cinematographic medium through the treatment of dramatic events through the solutions of the exit line depends on the narrative of events in one place contributes to attract Mam spectator since this interesting phenomenon in the mediator, there .van question arises the adoption of that vis
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