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.
This study aims to impact statement played by banking governance according to the decisions of the Basel Committee in achieving the strategic objectives of the banks, But order to achieve the this goal has been the adoption of two hypotheses in addition to the two main hypotheses as sub answered preliminary The study seeks to verify their health and two (no correlation relationship and impact between Banking governance and achieve strategic objectives), has been tested hypotheses. Study has reached
... Show MoreBackground: fixed orthodontic appliances deleterious influence on gingival health is well documented. Association between weight status and gingival health is presented in many studies. This study aimed to evaluate how early the impact of fixed orthodontic therapy on patients` gingival health, and if there are differences of that impact among different weight status groups. Materials and Methods: Sample consisted of 54 patients (25 males, 29 females; age limits are 16 -18 years) going under the course of treatment with fixed orthodontic appliance. Patients were categorized according to their Body Mass Index (BMI) into 3 weight status groups considering WHO charts in 2007 (underweight, normal weight, overweight and obese), then determinat
... Show MoreOne of the most important problems that would continuously face the Higher education organizations is how to improve the service level presented by them, and how this can lead to increase demand for services of this organizations.As this issue has exhausted many organizations pushed some of them to withdraw from the market Because of weaknesses in their services. Here lies the importance of this matter to be given more attention in order to maintain the organization competitive position. According to that, The selection of the research title (The Impact of Quality on the Level of the University Service Request) which seeks to measure the impact of service quality on the level of demand, At a time when world&
... Show MoreMonetary policy is an important part of the economic policy to influence the monetary aspect of stabilization, for this reason the research will seek to clarify the extent of the impact of monetary policy in achieving monetary stability in Iraq during the chosen research period, because the Iraqi economy suffers from monetary instability due to political and security turmoil, Therefore, an effective and effective monetary policy is required in terms of reducing inflationary pressures to reach the required monetary stability, in order to create the appropriate monetary environment for the work of the economic and productive sectors. Thus, the research adopted a basic hypothesis that monetary policy in Iraq has a clear impact on achieving mon
... Show MoreThe current research aims to diagnose the nature of the relation between dynamic capabilities as an independent variable and competitive advantage as a respondent variable, and identify the role of each of them in achieving the required performance of the organizations and adapt to the rapid environmental changes. The research was applied to the Iraqi Cement State Company one of the formations of the Iraqi Ministry of Industry and Minerals, and based on the importance of the subject matter of the research and the importance of the research sample and company of inquiry, The researcher adopted the descriptive analytical method in completing his research. The sample of the research was Intention
... Show MoreBackground: Postoperative nausea and vomiting (PONV) are one of the most common complaints following laparoscopic cholecystectomy.
Objective: This study was designed to compare the effects of dexamethasone, metoclopramide, and their combination on preventing PONV in patients undergoing laparoscopic cholecystectomy.
Methods: A total of 135 patients enrolled in the study. American Society of Anesthesiologists (ASA) physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to group A administered 8mg iv dexamethasone, group B received metoclopramide 10 mg, group C received combination of 8mg de
... Show Moreالخلفية: إن سمية الدواء والآثار الجانبية للعلاج الكيميائي تؤثر سلبا على مرضى سرطان الثدي. الأهداف: لتقييم فعالية التدخلات الصيدلانية في تحسين معرفة مرضى سرطان الثدي ومواقفهم وممارساتهم فيما يتعلق بالعلاج الكيميائي لسرطان الثدي.
Background: Developing Goalkeeper’s performance is imperative to defence the goal. As the Football match’s nature needs implementning the skill with strength, and speed. so, the Goalkeeper demands special physical abilities that enabling him the ball blocking skill masterly. Objetive: The study aimed to identify the effect of developing some special physical abilities on the goalkeeper’s performance level while blocking executed balls from the penalty mark in football using plyometric training. Methodology: The experimental approach (continuous training that divided into two phases: General preparation, and Special preparation stage) was adopted for one experimental group by pre/post-measurements. The research sample was delib
... Show More