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.
Illiteracy has spread in the last years, although it was eliminated in the 1980s. The return of illiteracy brings ignorance, illness, backwardness and regression among nations. It has taken many types, mainly alphabetical, scientific and computer illiteracy. Hence, the increasing nature of illiteracy has attracted the attention of governments and societies alike. This may touch the reality of societies starting with their youth unless those, who are in charge, will find workable solutions for the existing problems. The results of the study revealed that there is a real disaster awaiting the next generation after years of stray, and ignorance of the people in charge who are too engaged in getting their privileges to care about this proble
... Show MoreThat the structural changes in the environment, business and finance and the spread of business and the diversity of transactions between economic organizations and breadth of a commercial scale in the world have left their clear on the need to keep up with the accounting for these variables as one of the social sciences affect and are affected by the surrounding environment because of the various economic and social factors, technical, legal and others.
As a result of these variables emerged a new field of accounting called Forensic Accounting, which involves the use of expertise of multiple pour in the end to the accounting profession, where the Forensic Accounting cover a large area of disciplines including strengthening
... Show MoreThe research aims to identify the degree of the availability of knowledge, skill and ability as components of human capital, in addition to stand at the level of strategic agility upon tourism and travel agencies company of Jordan, the impact of human capital on strategic agility has been tested through distribution of a questionnaire on a Randomly Sample from Workers in Jordan tourist Companies of (349),a number of statistics techinces have been used simple liner Regrision and Multiplayer regession, it has shown that the degree of knowledge, ability and skill availability was high, and the same applies on strategic agility components, and shown out that there is a statistically significant impact between human capital and strate
... Show MoreBackground: Mother-infant bonding is an important psychological step postpartum and disturbed relationship may carry dramatic consequences as a psychological disorder which may affect the periodontal health of the mother. The aim of the present study was to assess the effect of the postpartum Mother-infant bonding on their periodontal condition. Materials and Methods: Mothers in the postpartum period with age range 20-35 years were subjected to postpartum Bonding Questionnaire (PBQ). Periodontal health status was assessed by measuring probing pocket depth and clinical attachment level. Results: The mean values of both probing pocket depth (PPD) and clinical attachment loss (CAL) were higher among disordered mothers than mothers with normal
... Show MoreThis paper analysed the effect of electronic internal auditing (EIA) based on the Control Objectives for Information and Related Technologies (COBIT) framework. Organisations must implement an up-to-date accounting information system (AIS) capable of meeting their auditing requirements. Electronic audit risk (compliance assessment, control assurance, and risk assessment) is a development by Weidenmier and Ramamoorti (2006) to improve AIS. In order to fulfil the study’s objectives, a questionnaire was prepared and distributed to a sample comprising 120 employees. The employees were financial managers, internal auditors, and workers involved in the company’s information security departments in the General Company for Electricity D
... Show MoreThis study examines the impact of adopting International Financial Reporting Standards (IFRS) on the value of economic units. Given the global push toward standardization of financial reporting to enhance financial statement transparency, comparability, and reliability, this research seeks to understand the implications of these standards for economic valuation within a region characterized by its unique economic and regulatory challenges. A questionnaire was distributed to 86 Iraqi academics specializing in economics, accounting, and finance to collect their views on the impact of adopting international financial reporting standards. Through careful statistical analysis, the study concluded that applying international financial reporting s
... Show MoreHypothesis Nanofluid flooding has been identified as a promising method for enhanced oil recovery (EOR) and improved Carbon geo-sequestration (CGS). However, it is unclear how nanoparticles (NPs) influence the CO2-brine interfacial tension (γ), which is a key parameter in pore-to reservoirs-scale fluid dynamics, and consequently project success. The effects of pressure, temperature, salinity, and NPs concentration on CO2-silica (hydrophilic or hydrophobic) nanofluid γ was thus systematically investigated to understand the influence of nanofluid flooding on CO2 geo-storage. Experiments Pendant drop method was used to measure CO2/nanofluid γ at carbon storage conditions using high pressure-high temperature optical cell. Findings CO2/nano
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