Background. Aneurysms of the distal anterior cerebral artery (DACA) are uncommon; they often form near the pericallosal-callosomarginal junction and are typically small. To our knowledge, giant DACA aneurysms developing from the more distant parts of the anterior cerebral artery (ACA), A4-5, have been described only once in the literature. Case description. A 66-year-old gentleman reported with a brief loss of consciousness followed by weakness in his right lower leg. The patient was admitted with a Glasgow Coma Score (GCS) of 15. A computed tomography (CT) scan of the head revealed a left hyperdense mass in the frontal parasagittal supracallosal region. Contrast MRI revealed a heterogeneously enhancing mass measuring 35x30x25 mm. CT angiography (CTA) revealed a small saccular aneurysm on the posteromedial aspect of the mass, perpendicular to the vertical plane of the coronal suture, corresponding to the A4-A5 junction of the left ACA. Through a left paramedian craniotomy, a modified anterior interhemispheric approach that was more posterior than the conventional projection was performed. A giant partially thrombosed was found. The aneurysm was resected, and the neck was reconstructed using four clips placed on top of them to enhance the clipping force over any remaining thrombus. The patient recovered as expected and was neurologically intact three months later. Conclusion. Giant distal anterior cerebral artery (DACA) aneurysms found in the A4-A5 segment represent a pathologically uncommon phenomenon. Due to the rarity of giant aneurysms at this location, their reporting is important to inform meticulous pre-operative planning.
Background: Osteoporosis is an extra-articular complication of rheumatoid arthritis that results in increased risk of fractures and associated morbidity, mortality, and healthcare costs. Objective: To evaluate changes in bone mineral density in a sample of rheumatoid arthritis (RA) patients on biological (anti tumor necrosis factor (TNF) alpha) and non-biological agent disease modifying antirheumatic drugs (DMARDs). Patients and Methods: A cross sectional study enrolled 60 RA patients diagnosed by rheumatologist according to the 2010 American College of Rheumatology/European League Against Rheumatism (2010 ACR/EULAR) classification criteria for RA. Thirty patient on biological agent (anti TNF alpha) and 30 patient on non-biological agent (D
... Show MoreThe aims of this study are to measure the defect rate and analyze the problems of production of ready concrete mixture plant by using Six Sigma methodology which is a business strategy for operations improvement depending basically on the application of its sub-methodology DMAIC improvement cycle and the basic statistical tools where the process sigma level of concrete production in the case study was 2.41 σ.
Abstract: The aim of the research identify the effect of using the five-finger strategy in learning a movement chain on the balance beam apparatus for students in the third stage in the College of Physical Education and Sports Science, as well as to identify which groups (experimental and controlling) are better in learning the kinematic chain on the balance beam device, has been used The experimental approach is to design the experimental and control groups with pre-and post-test. The research sample was represented by third-graders, as the third division (j) was chosen by lot to represent the experimental group, and a division Third (i) to represent the control group, after which (10) students from each division were tested by lot to repr
... Show MoreVolunteerism is an element included in many human cultures. It represents a positive cooperative act between individuals and groups. It expresses the social value systems. As a social phenomenon, it develops in societies according to innumerous circumstances and conditions. This study uses a functional approach that assumes that volunteering performs six functions for volunteers. Namely, we assume that volunteering (1) creates a sense of protection (2) meets significant cultural values (3) improves professional status of volunteers, (4) strengthens their social relationships, (5) helps them achieve a better understanding of life, and finally, (6) enhances their outlook and self-esteem. The central aim of the study is to discuss these fun
... Show MoreObjective: To Evaluate the Roley of Cytotoxic T-Lymphocytek antigen 4 Polymorphism and soluble immune checkpoint level (PD-1,PDL-1 and CTLA-4 ) in SARS-Cov-2 patients. Methods: Fromt October 2020 to April 2021, the currentk study was conducted in Baghdad-Iraq. Ninety patients with Confirmatory SARS-Cov-2 by PCR were inclusion in the study, and they were seeking treatment at Medical City in Baghdad's Teaching Hospital (BTH). Patients with SARS-Cov-2 were divided into two groups: those with Sever SARS-Cov-2 symptom and those with mild - moderate SARS-Cov-2 symptoms (cross sectional study. Patients with another form of autoimmune illness, malignant, diabetes, under the age of 18 and pregnant women were excluded. Results: Data rega
... Show MoreThere are many harmful acts that occur from drunkards in this case, especially those resulting from car accidents. The world is witnessing dozens or even hundreds of car accidents due to alcohol consumption. These accidents often result in serious injuries that could lead to the death of the drunk driver and those in the car As well as other persons present in the other vehicles with which the incident occurred or pedestrians on the street, as well as damage to private or public property, and if the order of return of the affected persons on the pretext of civil liability (tort) is made as a direct cause of the harmful act, Is entitled Do they like this refer to the liquor seller or their provider as the culprit? Or are they not related to
... Show MoreThere are two ways that the contract might be formed with (contracting between persons who are attended and contracting between absence persons).the need for determining the precise moment of the contract , is so clear because there is a specify period separate between the declaration of acceptance and the knowledge with it .and it is clear from the four theories known for jurisprudence (theory of the declaration of the acceptance, theory of exporting the acceptance , theory of the arrival of the acceptance , theory of the knowledge with the acceptance ) . It is difficult to promote one theory on another one if we look at each one and the justification of its supporters and what the opponents of each theory expose. Legal background and diff
... Show MoreThis paper examines the decolonizing methods used by Leslie Marmon Silko in her novel Ceremony (1977) to heal the indigenous people from the patriarchal traditions of the white hegemony. This study aims to emphasize the vulnerable responses of the Pueblo people to the memories of the clan and to highlight Silko’s methods to sustain the history and lifestyle of the indigenous people. Therefore, Silko’s novel can be situated historically and culturally within memory-studies. To analyze the contrasting behaviors of characters, this paper projects the relationship between the collective patriarchal doctrines and that of the individual within the framework of memory studies. Theories of Jan and Aleida Assmann are used here to explore the
... Show MoreThe importance of this topic may not be overlooked by many of the specialists, because it is one the sciences of the Arabic language, but it is an important method in the field of influencing the recipient and his aesthetic ability to create influential images as well.
The talking about Semantic (Badi'iyah)is as old as the Arabic age, so it may be talking about it not the new thing because the people who specialized have preceded us and exhausted all the talk .
This study aimed at some of the criteria used to determine the form of the river basins, and exposed the need to modify some of its limitations. In which, the generalization of the elongation and roundness ratio coefficient criterion was modified, which was set in a range between (0-1). This range goes beyond determining the form of the basin, which gives it an elongated or rounded feature, and the ratio has been modified by making it more detailed and accurate in giving the basin a specific form, not only a general characteristic. So, we reached a standard for each of the basins' forms regarding the results of the elongation and circularity ratios. Thus, circular is (1-0.8), and square is (between 0.8-0.6), the blade or oval form is (0.6-0
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