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Unilateral absence of the internal carotid artery associated with anterior communicating artery aneurysms: Systematic review and a proposed management algorithm
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Background:

Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associated with Acom aneurysms and provide an illustrative case.

Methods:

We combined our experience of one case of a unilaterally absent ICA associated with an Acom aneurysm with the 33 existing publications on the same subject in the literature, for a total of 40 cases. We provide a detailed systematic literature review of this association of vascular anomalies, exploring different aspects regarding the collateral pathways and how they impact management strategies and propose a management algorithm to deal with such association.

Results:

The mean age was 48.2 ± 16.5 years. The aneurysmal rupture was the most common presentation (75%). Agenesis was observed in 70% of patients, followed by hypoplasia (20%) and, finally, aplasia (10%). Lie Type A was the most common pattern of collaterals (50%), with Types B and D being of almost equal proportions. Most aneurysms were located at the A1-Acom junction contralateral to the anomalous side (Fisher’s Exact test;P= 0.03). One case of temporary clipping was reported in the literature.

Conclusion:

Acom aneurysms in patients with unilateral ICA anomalies, given they are more commonly present contralaterally, could be of acquired etiology, warranting periodic screening in asymptomatic patients. Temporary clipping might be safe in patients with Type D collateral pattern, while those with Types A or B may require intraoperative rupture risk assessment and a tailored management plan to avoid disrupting collateral flow and causing ischemia.

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Publication Date
Thu Sep 30 2021
Journal Name
Iraqi Journal Of Science
Establishment of Lipid Profile Reference Intervals in a Sample Population of Halabja City, Kurdistan Region of Iraq
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     Every laboratory needs to establish its own community-based reference intervals for the achievement of the optimal and true diagnosis in the clinical practice. However, such vital experimentations are not been conducted sufficiently in Halabja city and Kurdistan region of Iraq as a whole. This study is an attempt to introduce for the first time a set of reference intervals of lipid profile variables that are based on the healthy and asymptomatic adult population of Halabja using international standards. The methodology recruited for this purpose is based on the IFCC, CLSI, and WHO’s standards, in which the study population was subjected to strict exclusion criteria for the sake of higher accuracy in the results

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Publication Date
Mon Aug 01 2016
Journal Name
Iosr Journal Of Dental And Medical Sciences
Evaluating the Effect of Showing the Dental Injector to Children on Their Dental Behavior in Relation to the Vital Signs And Maternal Anxiety
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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
The political dimension in the speech of the director, author (Dawoud Abdel Sayed) Citizen film, informant and thief (amodel): احمد جبار عبد الكاظم
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The research addresses the questioning of political loads in a cinematic model from the films of the author (David Abdel Sayed), who has been busy throughout his films in criticizing political power, where he presented protests visions her body the artistic composition of cinematic means of expression through artistic treatments that facilitate the representations of modernity in contemporary cinematic trends, and by this Several contemporary cinematic criticism is an example of a thinker cinematographer who presents his critical thesis on power politics through the composition of the film (material - form - expression). The research consisted of four chapters. The first was a methodological framework that included the research problem o

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Publication Date
Fri Feb 15 2019
Journal Name
Route Educational & Social Science Journal
The effect of the 4-H model on self-regulated learning and life skills for female chemistry students in the second intermediate year
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Publication Date
Tue Dec 15 2020
Journal Name
Al-academy
The aesthetics of the design idea and its communicative role in the graphic achievement: انتصار رسمي موسى-دينا محمد عناد -سحر علي سرحان
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The field of graphic design has witnessed a unique, unique form transformed in its construction and installation and superior to systems through its creation of foundational data for design ideas with functional aesthetics and utilitarianism and effective and moving formulation in light of modern trends and what globalization has brought about in terms of openness to the outside world and the processes of communication and communication with the international community through graphic design. Based on the above, this study marked (Aesthetics of the Design Idea and its Communication Role in the Graphic Outcome) comes to clarify the topic through three chapters, including the first chapter, which was devoted to the research methodology, th

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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The causal relationship between leadership integrity and organizational conflict: An applied research in the State Real Estate Department in the province of Najaf
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This research aims to know the impact of leadership integrity as explanatory variable including its dimensions (courage, asceticism, justice, rationality, and humanity) on organizational conflict as responding variable. This research depended on the descriptive- constructive approach through the responses of a sample of (79) employees from (Real Estate Office of The State) in Al-Najaf province. The analyzing of the study done by using (Smart PLS) program to calculate (R2, t, p). Many results concluded and one of them, there is significant impact correlation of the leadership integrity on organizational conflict. There are many suggestions have been reached depending on the results reached and one of them is the necessity of de

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of business incubators represented by the banking system in financing small and medium enterprises in Iraq for the period 2000-2010
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The process of transformation from the central economy to a free economy requires restructuring the economy according to a new economic philosophy that relies on activating the role of private economic activity in which private and medium-sized institutions occupy an essential axis for their active role in the economies of all countries, especially those countries that have directed towards the market mechanism and sector leadership. The special process of economic development and the role that commercial banks can play in advancing the financing of these projects by establishing specialized business incubators for financing.

What encouraged countries to pay attention to these institutions is the ease of

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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
The Relation between Bacterial and Heavy Metal Water Pollution and Blood Micronuclei as Biomarkers in the Tigris River Fish
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The objective of this study is to evaluate the bacterial count and heavy metal concentration of river water on fish micronuclei. Fish and water samples are carried out in 1 May to 1 June 2013 from Tigris River. A total of fifty three fish sample are studied. The bacteriological quality of water showed that the total viable count is ranged from 150×103 to 352×103 cfu/ml and fecal coliform counts was 1250 cell/100ml during the study period. All the metals (Cu, Hg, Pb, and Zn) are within the normal limit, but Cd was slightly elevated in river water samples. The appearance of micronuclei in red blood cells of all fish species is detect , by recording a larger number of it, in ( Abu Alsomere , Hishne , Bannini Kaber al fam & Karkoor

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Publication Date
Tue Jan 06 2004
Journal Name
Iraqi Journal Of Science
Cluster and factor analyses R and Q mode technique of geochemical and petrological data of the Shalair Metamorphic Rock Group, Shalair Valley area, Northeastern Iraq
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Publication Date
Sat Apr 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Relationship Between the Above-Ground Biomass and the Vegetation Cover Indices at Different Salinity Levels
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Abstract<p>The current study was carried out to find out the relationship between the Above-Ground Biomass and the spectral vegetative indices (Normalized Difference Vegetation Index, Soil Adjusted Vegetation Index, Difference Vegetation Index) (NDVI, SAVI, DVI) for soils with different salinity levels. Al Salamiyat Project was chosen as a study area located at an altitude of 34 m above sea level and within the geographical coordinates (E 44°.09´13.65´´ N 33°.25´ 07.87´´ and E 44°.17´ 46.03´´ N 33°.2l´40.72´´), with a total area of 14265 Dunum. Surface and subsurface soil samples were chosen from the study area and according to the previously defined salinity units, except for th</p> ... Show More
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