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Spontaneous Coronary Artery Dissection in Multiple Gestation Peripartum Period
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Background: Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall. SCAD is a highly uncommon cause of myocardial infarction (0.1 to 0.4 %).

Case presentation: 40-year-old African American woman, G1T1P0A0L2, with a past medical history of tobacco abuse and obesity who had uncomplicated cesarean section delivery for healthy twins two weeks prior presented with substernal, sudden onset chest pain. The pain radiated to left arm and back, pressure-like, and is associated with nausea, vomiting, and dyspnea.

On examination she was within normal limits except for a well-healed C-section wound. An electrocardiogram showed normal sinus rhythm with Nonspecific ST Abnormality. The first set of troponins less than 0.03, the second set shows troponins 0.18 and D-dimer 2340. The chest x-ray was unremarkable. An echocardiogram showed only mild to moderate mitral valve regurgitation. CT angiography of the chest showed no evidence of pulmonary embolism. She was started on a heparin drip and catheterization the next day showed no atherosclerotic coronary artery disease, but SCAD of inferior diagonal first branch noted. No intervention was done, heparin was stopped. The patient was started on aspirin, statin, Clopidogrel, Metoprolol, and Lisinopril per cardiology recommendation.

Conclusions: As an internist and primary care provider, we should keep Non-atherosclerotic SCAD in mind when a young female patient presents with acute chest pain. More studies are needed to find out the optimal management.

Current recommended conservative medical management includes long-term aspirin, beta blocker, and one year of clopidogrel, with the addition of a statin in patients with dyslipidemia.

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Using Public and Private Cloud Computing in developing the Evaluation System of annual employees' performance at Iraqi Universities: A comparative study
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Abstract

Business organizations are using the technological innovations like cloud computing (CC) as a developmental platform in order to improve the performance of their information systems. In that context, our paper discusses know-how in employing the public and private CC to serve as platforms to develop the evaluation system of annual employees' performance (ESAEP) at Iraqi universities. Therefore, we ask the paper question which is Is it possible to adopt the innovative solutions of ICTs (Like: public and private CC) for finding the developmental vision about management information systems at business organizations?”. In addition, the paper aim

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Publication Date
Mon Jul 24 2023
Journal Name
Research Journal Of Pharmacy And Technology
Comparison of the effects of Methotrexate and Etanercept on RANKL and OPG as Bone Metabolism Biomarkers in patients with Rheumatoid Arthritis
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Rheumatoid arthritis is an autoimmune diseasecharacterized by chronic inflammationthat affects joints and cartilage. Bone complications such asRA-relatedosteoporosis are one of the most extra-articular manifestations. Many inflammatory mediators are released during RA disease pathophysiology; these mediators stimulate osteoclast genesis of bone by direct effects on RANKL and OPG. The study aimedto measure RANKL, OPG in RA patients treated with Etanercept only and other groups treated with Methotrexate onlyat baseline and after three months to evaluate bone state. An observational case-control prospective study was done on 30 RA patients who received MTX, 30 RA patients who received ETN, and 30 healthy,age-matched control groups. The

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Usage of non-linear programming in building a mathematical model for production planning according to discount constraints put on bought amount
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Abstract

 This research deals will the declared production planning operation in the general company of planting oils, which have  great role in production operations management who had built mathematical model for correct non-linear programming according to discounting operation during raw materials or half-made materials purchasing operation which concentration of six main products by company but discount included just three products of raw materials, and there were six months taken from the 1st half of 2014 as a planning period has been chosen . Simulated annealing algorithm  application on non-linear model which been more difficulty than possible solution when imposed restric

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Publication Date
Mon Mar 01 2010
Journal Name
Al-khwarizmi Engineering Journal
The Effect of Mechanical Combined Contact Stress with Buckling Load on the Stress Distribution in the Ball and Socket Joint Mechanism
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The design of components subjected to contact stress as local compressive stress is important in engineering application especially in ball and socket Joining.  Two kinds of contact stress are introduced in the ball and socket joint, the first is from normal contact while the other is from sliding contact. Although joining two long links (drive shaft in steering cars) will cause the effect of flexural and tensional buckling stress in hollow columns through the ball and socket ends on the failure condition of the joining mechanism. In this paper the consideration of the combined effect of buckling Load and contact stress on the ball and socket joints have been taken, epically on the stress distribution in the contact area. Different

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Publication Date
Sat Feb 12 2022
Journal Name
Journal Of Education College Wasit University
The Role of Picture Books in Raising Children's Understanding of English Literature and Life Science Concepts: Selected Stories by Eric Carle
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Abstract The current study is a theoretical study that aims to underline the role of picture books as a serious genre of children's literature in raising children's understanding of English literature and life concepts; especially for non-English speakers. Unfortunately, most Iraqi people have developed a social phobia of learning English since childhood. This phobia is resulted from the heavy traditional reading and writing assignments as well as hard exams. Therefore, this study suggests incorporating more interesting literary material like picture books that would bring pleasure and help in raising children's love and cognition of English Language. More significantly, it calls to replace the old curriculum with a more vital

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Publication Date
Fri Dec 28 2018
Journal Name
Advances In Language And Literary Studies
Simplification Strategies in the Production of English Word-final Obstruent Clusters by Iraqi EFL College Students from A Markedness Theory Perspective
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This study investigates the phonotactics of English obstruent clusters in the word-final position from a markedness theory perspective among Iraqi EFL College Students whose native language, Arabic, prefers only two-member word-final obstruent cluster as a maximum. The markedness of clusters is measured depending on Iraqi EFL College Students’ utilization of the simplification strategies. This study tries to answer whether or not word-final obstruent clusters are marked or unmarked for Iraqi EFL College Students, and whether or not the markedness of the obstruent cluster increases as to its length. In order to answer these questions, a test has been distributed among 60 Iraqi EFL Fourth-Year College students, Department of English, Colleg

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Publication Date
Mon Jul 15 2024
Journal Name
Wisdom Journal For Studies & Research
The effect of rehabilitative exercises according to some kinematic variables in relieving lower back pain for women aged 25-35 old
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Abstract The purpose of this paper is preparing exercises according to some biomechanical variables for women with low back pain and identifying the effect of exercise according to some biomechanical variables and relieving lower back pain for women. The researchers used the one-group experimental design. The sample was chosen by the intentional method to provide the necessary conditions for conducting the study, and they represent the research community and its sample. The researchers also excluded (2) of the injured women because they did not adhere to the rehabilitation sessions, and for the purpose of ensuring the homogeneity of the sample members, the researchers used the arithmetic mean, standard deviation, and the torsion coefficient

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Publication Date
Wed Apr 01 2020
Journal Name
Canadian Journal Of Physics
Influence of the variation in the Hubbard parameter (<i>U</i>) on activation energies of CeO<sub>2</sub>-catalysed reactions
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Accurate description of thermodynamic, structural, and electronic properties for bulk and surfaces of ceria (CeO2) necessitates the inclusion of the Hubbard parameter (U) in the density functional theory (DFT) calculations to precisely account for the strongly correlated 4f electrons. Such treatment is a daunting task when attempting to draw a potential energy surface for CeO2-catalyzed reaction. This is due to the inconsistent change in thermo-kinetics parameters of the reaction in reference to the variation in the U values. As an illustrative example, we investigate herein the discrepancy in activation and reaction energies for steps underlying the partial and full hydrogenation of acetyl

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Efficacy of Combination of Meropenem with Gentamicin, and Amikacin against Resistant E. coli Isolated from Patients with UTIs: in vitro Study
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         Seventy five E. coli isolates were collected from urine of patients with urinary tract infections in AL-Kadhimia and AL-Yarmook teaching hospitals in Baghdad for a period between 22/11/2009 to 15/3/2010,  from these samples twenty five isolates were selected according to their pattern of the highest resistance as these showing multi-drug resistances and tested to specify their minimum inhibitory concentration for (meropenem, gentamicin and amikacin), meropenem was found having the lowest MIC comparing with others. This study also includes in vitro effects of various combinations of three types of antimicrobials (meropenem, gentamicin and amikacin) against twenty five E. c

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Publication Date
Fri Dec 31 2021
Journal Name
Dental And Medical Problems
Effect of the local application of bupivacaine in early pain control following impacted mandibular third molar surgery: A randomized controlled study
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Background: Postoperative pain is one of the main complications following impacted mandibular third molar (IMTM) surgery. Objectives: The aim of this study was to assess the effect of the local application of bupivacaine on reducing early postoperative pain following IMTM surgery. Material and methods: A prospective, single-blinded, randomized controlled study was conducted on 40 patients who had undergone the surgical removal of an IMTM under local anesthesia. In the study group (n = 20), absorbable gelatin sponge (AGS) soaked in 3 mL of 0.5% plain bupivacaine hydrochloride was locally applied in the post-extraction socket. In the control group (n = 20), AGS soaked in 3 mL of normal saline was used. Pain intensity was assessed using a pa

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