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.
The purpose of this study is to examine the dimensions of strategic intent (SI; see Appendix 1) according to the Hamel and Prahalad model as a building for the future, relying on today’s knowledge-based and proactive strategic directions of management as long-term and deep-perspective creative directions, objective vision and rational analysis, integrative in work, survival structure and comprehensiveness in perception.
The quantitative approach was used based on research, detection and proof, as data were collected from leader
Abstract
This research aims to analyze the reality of the production process in an assembly line Cars (RUNNA) in the public company for the automotive industry / Alexandria through the use of some Lean production tools, and data were collected through permanence in the company to identify the problems of the line in order to find appropriate to adopt some Lean production tools solutions, and results showed the presence of Lead time in some stations, which is reflected on the customer's waiting time to get the car, as well as some of the problems existing in the car produced such as high temperature of the car, as the company does not take into account customer preferences,
... Show MoreFolic acid modulates several disorders in humans, pregnancy mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress.Transitional metals, especially iron, which are particularly abundant in the placenta, are important in the production of free radicals. Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. In the present study we investigated the effect of regular and irregular administered folic acid in the first and second trimester of pregnancy to be compared with non-pregnant women ,and also the effect of regular and irregular using of folic acid supplement on oxidative stress parameters an
... Show MoreThe increasing use of antiseptic compounds creates selective pressure cause emergence of antiseptic resistance among Staphylococcus aureus .Resistance mechanism of antiseptic is driven mainly by multi drug resistant (MDR) efflux protein.Sixty five isolates of S.aureuswere collected from different clinical sources and subjected to 11 antibiotics most of them are recognized by efflux systems as extruded substrates. Range of efflux activity was estimated using cartwheel method. Simultaneous discrimination of antiseptic coding genes (qacA/B, smr and norA)as well as nuc and mecA genes among multidrug resistantS.aureus(MRSA) isolates was preformed using multiplex PCR assay
... Show MoreOrganic soil is problematic soils in geotechnical engineering due to its properties, as it is characterized by high compressibility and low bearing capacity. Therefore, several geotechnical techniques tried to stabilize and improve this soil type. In this study, sodium silicate was used to stabilize sand dune columns. The best sodium silicate concentration (9%) was used, and the stabilized sand dune columns were cured for seven days. The results for this soil were extracted using a numerical analysis program (Plaxis 3D, 2020).In the case of studying the effect of (L/D) (where ‘’L” and ‘’D’’ length and diameter of sand dune columns) of a single column of sand dunes stabilized with sodium silicate with a diff
... Show MoreThe current study aims to apply the methods of evaluating investment decisions to extract the highest value and reduce the economic and environmental costs of the health sector according to the strategy.In order to achieve the objectives of the study, the researcher relied on the deductive approach in the theoretical aspect by collecting sources and previous studies. He also used the applied practical approach, relying on the data and reports of Amir almuminin Hospital for the period (2017-2031) for the purpose of evaluating investment decisions in the hospital. A set of conclusions, the most important of which is: The failure to apply
... Show MoreIn this paper, the speed control of the real DC motor is experimentally investigated using nonlinear PID neural network controller. As a simple and fast tuning algorithm, two optimization techniques are used; trial and error method and particle swarm optimization PSO algorithm in order to tune the nonlinear PID neural controller's parameters and to find best speed response of the DC motor. To save time in the real system, a Matlab simulation package is used to carry out these algorithms to tune and find the best values of the nonlinear PID parameters. Then these parameters are used in the designed real time nonlinear PID controller system based on LabVIEW package. Simulation and experimental results are compared with each other and showe
... Show MorePathological blood clot in blood vessels, which often leads to cardiovascular diseases, are one of the most common causes of death in humans. Therefore, enzymatic therapy to degrade blood clots is vital. To achieve this goal, bromelain was immobilized and used for the biodegradation of blood clots. Bromelain was extracted from the pineapple fruit pulp (Ananas comosus) and purified by ion exchange chromatography after precipitation with ammonium sulphate (0-80 %), resulting in a yield of 70%, purification fold of 1.42, and a specific activity of 1175 U/mg. Bromelain was covalently immobilized on functionalized multi-walled carbon nanotubes (MWCNT), with an enzyme loading of 71.35%. The results of the characterization of free and immobilized
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