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.
Art education is one among the fundamental subjects for elementary school students, because it contributes to assembling learners’ personalities and developing their technical skills. For this reason, this research comes, which aims to understand the effect of the task groups’ strategy in developing the performance of elementary school students in art education. to realize the goal of the research, the researcher put the subsequent hypotheses:
-There is not any statistically significant difference at the amount (5%) between the typical many students between the experimental group that studied consistent with the strategy of task groups and therefore the control group that studied in keeping with the same old method that they obt
The impact of digital transformation on the relationship between commercial bank customers’ empowerment and competitive advantage
Aim: This abstract aims to highlight the critical nature of climate change as a pressing challenge facing humanity in the 21st century. It underscores the severe consequences it poses to essential facets of human existence, including water and energy resources, agricultural production, and the broader environmental systems. Method: The abstract primarily utilizes a descriptive approach to emphasize the impact of climate change on the Middle East, particularly the Arab region. It relies on a review of existing knowledge and data related to climate change and its effects on ecosystems and drought patterns. Results: The abstract outlines the direct and indirect repercussions of climate change on human life and the environment. It draws atten
... Show MoreBackground: Psoriasis is an immune-mediated inflammatory disease with unknown aetiology that may be associated with the defect in proliferation and differentiation of the keratinocytes related to inflammatory cell infiltration. According to published reports, it is universal in occurrence; its prevalence in different populations varies from 0.1% to 11.8%. Receiving Apremilast resulted in a strong reduction in interleukin 17 and interleukin 23, as well as reduced expression of other inflammatory cytokines and improvement of psoriatic lesions. Objectives: This study aimed to assess the impact of Apremilast on levels of IL-17, IL-23, and lipids in obese psoriatic patients. Methods: Thirty obese patients with psoriasis were included in
... Show MoreDue to the increasing interest in the quality of auditing by writers, researchers and regulators of the auditing profession. The matter necessitated a statement of the extent to which the auditor practices professional skepticism, because of its significant impact in discovering errors and material misrepresentations contained in the financial statements in order to give the financial community confidence in them and the success of the audit process. The research aims to clarify the concept and importance of the practice of professional skepticism and its effect on the quality of the auditor's performance in Iraq. To achieve the research objectives, the two re
... Show MoreThis study is considered to be the first on this sector of Tigris River after 2003, to evaluate the effect of Tharthar Arm on the composition and diversity of Copepoda in Tigris River. Six sampling sites were selected; two on the Tharthar Arm and four sites along the Tigris River, one before the confluence as a control site and the others downstream the confluence; thirty-five copepod taxa were recorded, 34 taxa in the Tigris River and 25 taxa in the Tharthar Arm.
The highest density of Copepoda was in site 2 at Tharthar Arm was 265584.2 Ind./m3 lead to an increasing in Copepoda density in Tigris River from 63878.2 Ind./m3 in site 1 before the confluence to 127198.3 Ind./m3 in site 4 immediately downstream the confluence. Also, the me
دُرِست العوامل المؤثرة في عدد ساعات تجهيز الكهرباء في مدينة بغداد، وتكونت عينة الدراسة من (365) مشاهدة يومية لعام 2018، وتمثلت بستة متغيرات استعملت في الدراسة. كان الهدف الرئيس هو دراسة العلاقة بين هذه المتغيرات، وتقدير تأثيرات المتغيرات التنبؤية في المتغير التابع (عدد ساعات تجهيز الكهرباء في مدينة بغداد). ولتحقيق ذلك استعملت نمذجة المعادلات الهيكلية/ تحليل المسار وبرنامج AMOS
... Show MoreBackground: Women sexuality is basic right and it plays a major role in women's Health aspects. Up is one of the factors that lead to sexual dysfunction while the incidence of it is rising as UP severity being more. Objectives: To assess the impact of different degrees of uterine prolapse on sexual function of women at teaching hospitals in AL-Hilla City. Methodology: A descriptive analytical study was conducted from 1ST Feb to 10th Jun /2014 to assess the impact of different degrees of uterine prolapse on sexual function for women who attend to consultant clinic at teaching hospitals in AL-Hilla City
Systems on Chips (SoCs) architecture complexity is result of integrating a large numbers of cores in a single chip. The approaches should address the systems particular challenges such as reliability, performance, and power constraints. Monitoring became a necessary part for testing, debugging and performance evaluations of SoCs at run time, as On-chip monitoring is employed to provide environmental information, such as temperature, voltage, and error data. Real-time system validation is done by exploiting the monitoring to determine the proper operation of a system within the designed parameters. The paper explains the common monitoring operations in SoCs, showing the functionality of thermal, voltage and soft error monitors. The different
... Show MoreThe research included studying the effect of different plowing depths (10,20and30) cm and three angles of the disc harrows (18,20and25) when they were combined in one compound machine consisting of a triple plow and disc harrows tied within one structure. Draft force, fuel consumption, practical productivity, and resistance to soil penetration. The results indicated that the plowing depth and disc angle had a significant effect on all studied parameters. The results showed that when the plowing depth increased and the disc angle increased, leads to increased pull force ratio, fuel consumption, resistance to soil penetration, and reduce the machine practical productivity.