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 current research discusses “The impact of the critical factors for the transfer of knowledge on opportunities and strategic success ", the attention have been increased on knowledge transfer and strategic success subjects because on being one of the important and contemporary issues, which have a significant impact on the existence of organizations and its future. The research aims to identify the critical factors for knowledge transfer in private high education environment which enables (the college community surveyed) to achieve strategic success, also the research sought to answer questions related to research problem by testing a number of major and minor hypothes in impact, in order to test the hypotheses I used a fiel
... Show MoreObjective(s): The aim of this study is to compare the impact strength of a heat cured denture-base acrylic resin
reinforced with metal wire and glass fibers.
Methodology: Forty five specimens were prepared from pink heat cure acrylic resin. Specimens were grouped into;
group-I (control group) which consists of 15 specimens with no reinforcement, group-II which consists of 15 specimens
reinforced with metal wire, and group-III consists of 15 specimens reinforced with glass fibers. Specimens were tested
by using charpy impact machine.
Results: The result showed that there was a highly significant difference in impact strength value among the testing
groups at (P < 0.001).
Conclusion: The impact str
... Show MoreVariation orders are an on-going phenomenon in construction and industry projects worldwide, particularly in the province of Sulaimani, where the project's damage from cost and schedule overrun because of variation orders. However, the effect on project costs and time overrun of variation order has yet to be identified. This study evaluates the impact of variation orders on the cost and time off in the Sulaimani governorate. Two hundred twenty-eight projects from various construction sectors built between 2007-2012 were adopted to calculate the contract cost and schedule overruns due to variation orders. Data analysis was applied in the study were descriptive statistics. One-way ANOVA was also applied to determine w
... Show MoreConstruction projects have a special nature and affect them many factors making them exposed to multiple risks as a result of the length of the implementation period and the multiplicity of stages, starting from the decision stage through implementation until the final delivery, which leads to increased uncertainty and the likelihood of risk.
The process of analysis and risk management is one of the effective and productive methods that are used in managing the construction projects for the purpose of increasing the chances of ending the project successfully in terms of cost, time and quality and at the lowest possible problems.
The research aims first to the effective planning for analysis and risk managemen
... Show MoreIn this paper, numerical and experimental studies on the elastic behavior of glass fiber reinforced polymer (GFRP) with stiffeners in the GFRP section's web (to prevent local buckling) are presented. The GFRP profiles were connected to the concrete deck slab by shear connectors. Two full-scale simply supported composite beams (with and without stiffeners) were tested under impact load (three-point load) to assess its structural response. The results proved that the maximum impact force, maximum deflection, damping time, and damping ratio of the composite beam were affected by the GFRP stiffeners. The experimental results indicated that the damping ratio and deflection were diminished compare
... Show MoreThe effect of metal nanoparticles on the anaerobic digestion of sludge and the sludge bacterial community are still not well-understood, and both improvements and inhibitions have been reported. This study investigated the impact of 2, 10, and 30 mg/g TS silver and copper oxide nanoparticles (AgNPs and CuONPs) on the mesophilic anaerobic digestion of sludge and the bacterial community structure. The reactors were monitored for changes in tCOD, sCOD, TS, VS, biogas generation, and cell viability. Also, the relative abundance and taxonomic distribution of the bacterial communities were analyzed at the phylum and genus levels, including the genera involved in anaerobic digestion. Both AgNPs and CuONPs exhibited some inhibition on anaer
... Show MoreThe rapid spread of novel coronavirus disease
(COVID19) throughout the world without available
specific treatment or vaccine necessitates alternative
options to contain the disease. Historically, children
and pregnant women were considered high-risk
population of infectious diseases but rarely have been
spotlighted nowadays in the regular COVID-19
updates, may be due to low global rates of incidence,
morbidity, and mortality. However, complications did
occur in these subjects affected by COVID-19. We
aimed to explore the latest updates of
immunotherapeutic perspectives of COVID-19
patients in general population and some added details
regarding pediatric and obstetrical practice.
Immune system boo
The records of Primary Health Care Centres (Al-Risafa section of Baghdad) were inspected for communicable diseases during the period January-April 2006. There were 8622 recorded cases (the diagnosis was based on a clinical examination and laboratory findings), which were distributed as 4782 (55.5%), 1430 (16.6%), 1604 (18.6%) and 806 (9.3%) for Sadar city, Risafa, A'adhamyiah and Mada'in, respectively. The highest frequency was reported for chicken pox (42.7%), followed by mumps and typhoid fever (20 and 13.7%, respectively), while diphtheria and cholera were not recorded. These three most frequent diseases were further analyzed, and their distribution showed a significant difference (P ? 0.001). April was the month of the highest recorded
... Show MoreBackground: Pregnancy is a stressful state of increased inflammatory activity, and pregnancy – associated hormone changes can influence periodontal tissues, these inflammatory activity lead to production of inflammatory mediators. Interleukin 1 beta (IL-1β) is a potent pro-inflammatory cytokines that is consistently associated with periodontal diseases. This study was designed to determine the periodontal health status and detect the serum level of IL-1β in the healthy pregnant women at first, second and third trimester and compare it with healthy non pregnant women, and determine its correlation with different clinical periodontal parameters. M
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