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.
Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild sys
... Show MoreThis research was conducted in order to monitor and measure the dimensions of media policy in satellite channels directed from the point of view of the communicator, and this research is classified among the descriptive studies, as the researcher used the survey method to answer the questions that were formulated in light of the research problem represented by the main question: What are the dimensions of media policy in Directed satellite channels? .
To achieve the objectives of the study, the researcher used the following tools:
The questionnaire, in order to survey the attitudes of communicators about the extent to which the media policy during crises reflects on their professional standards. The research community is represente
Abstract
It considers training programs is an important process contributing to provide employees with the skills required to do their jobs efficiently and effectively, so it should be concerned with and the focus of all government our organizations, and perhaps the most important reasons that I was invited to select the subject (evaluation of training programs directed toward the diagnosis of the phenomenon of financial and administrative corruption) It is the importance of those programs working in the regulatory institutions General and the Office of Inspector General of Finance and the Ministry particularly for employees because of their role in the development of their skills and their experience and their beha
... Show MoreWhen the drawdown pressure amounts to a value below the dew point pressure, a minor droplet of condensate is shaped and accumulated in the close area of wellbore. As the accumulation happens, the saturation of the liquid will grow and a reduction in gas relative permeability will happen, therefore it will affect the productivity. Generally, condensate baking problem in gas wells is being deliberated and studied and numerous techniques have been suggested to solve the problem. The studying of condensate banking dynamics is essential to evaluate the productivity and behavior of the wells of the gas fields.
Praise be to Allah , the Lord of Heavens , Who revealed His Scripture in plain Arabic, and prayers and peace be upon the Master of all creatures and the chosen one , Muhammad (PBUH).Pushkin was known as a poet in Russia, the sun of its poetry that set, the father of the Russian literature and the founder of its literary language. When he published his poems, trying to express his inner poetic feelings and creative visions, he presented them with creativity and special touch. The reason behind the selection of Pushkin as the subject of this study is that he was affected by Islam and Arabs. For the purpose of this study, the dissertation has been divided into introduction and three chapters; each chapter includes two topics. In the introdu
... Show MoreA submoduleA of amodule M is said to be strongly pure , if for each finite subset {ai} in A , (equivalently, for each a ?A) there exists ahomomorphism f : M ?A such that f(ai) = ai, ?i(f(a)=a).A module M is said to be strongly F–regular if each submodule of M is strongly pure .The main purpose of this paper is to develop the properties of strongly F–regular modules and study modules with the property that the intersection of any two strongly pure submodules is strongly pure .
The aim of this paper is to study the frames of Argument of normalization with Israel on the websites of the satellite channels directed in the Arabic language (Al-Alam and Al-Hurra Iraq) channels by analyzing the mechanisms of framing an Argument, The way in which we frame an issue largely determines how that issue will be understood and acted upon، The research adopted the survey method applied to the sites of(Al-
Alam and Al-Hurra) channels, at the period 13 Aug. - 12 Nov. 2020, which included (855) news items, (633) for Al-Alam channel website, and (222) for Alhurra Iraq channel website.
The most important results are: The two channels dependence on the Argument Directed, Al-Alam channel focuses on Islamic and Arab attitudes,