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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
Mon Jan 02 2023
Journal Name
Pakistan Heart Jornal
The Effect of the Strategy of Differentiated Education According to the Auditory Learning Style by Using Assistance in Learning the Back Kick (T-Chagi) for the Young Players of …
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Publication Date
Wed Jun 19 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Elements of Promotion Mix and Their Effect in Insurance Service Marketing by Using Factor Analysis Approach: An Exploratory Research foe views of works Sample at the National Insurance Company
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The insurance is considered as one of the sectors that is impact is vital to the national economy and development programs, Insurance companies as financial institutions have an effect an aspects of social, economic as well as the participation of enterprises in compensation for the risk potential losses and individuals, Insurance sector provides insurance service insurance which should be characterized by quality and satisfy  needs and desires of the customer , so the  raise insurance awareness in the community its members and institutions will help in  maintaining the movement of production and service delivery standards, quality sought by the insured to obtain, as well as the development of promotional programs, and use

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Publication Date
Fri Oct 02 2020
Journal Name
International Journal Of Pharmaceutical Research
Effectiveness of Self-Instructional Strategy and the Traditional Teaching Approach on Nursing Students' Knowledge toward Cardiopulmonary Resuscitation at the College of Nursing in University of Baghdad: Randomized Comparative Trial
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Background: Cardiopulmonary resuscitation (CPR) is a technique or procedure that combined chest compression and rescue breathing to maintain enough circulation that prevents brain damage until other essential steps are taken to control the main cause of cardiac and respiratory arrest. The health care personnel should be qualified in the performing of cardiopulmonary resuscitation (CPR) to improve the survival rate of the victims. Therefore; it is necessary to use new methods for learning [1]. Objectives: the study aims to compare the effectiveness of self-instructional teaching strategy and traditional teaching approach on student’s knowledge toward cardiopulmonary resuscitation. Methods: A randomized comparative trial (RCT) design was ca

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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Teaching Problems Faced by Female Teachers of Students with Intellectual Disability in Special Education Programs and the Proposed Solutions for that from their point of view - a qualitative study
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This study aims to identify the teaching problems that teachers of students with intellectual disabilities face, in addition to exploring the solutions suggested by them in order to overcome such problems or challenges. The researchers used a qualitative approach in order to understand the teachers' perceptions about these problems in a more in-depth way. The interview tools (in-depth and semi-structured interviews) were used to collect data from (3) female teachers from special education programs in the Asir region. The results revealed a number of themes including problems related to students, teachers and the teaching methods they use, curricula, school environment, and school administration. Moreover, the results indicated that famil

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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
Analysis Of Elements Of The Iranian Story In The Story Of Rustom And Suhrab - A Stylistic Study: بررسی عناصر قصه ایرانی در داستان رستم و سهراب، با رویکرد سبک‌گرایی
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Iranian stories have been one of the most important aspects   of Iranian society's culture and have reflected us as a mirror of all its cultural, societal and political dimensions.Among the important elements of the story can be the creation of space and the movement and the creation of characters and conflict and content and the angle of vision and landscape, language and subject. Studying the elements of the story leads to more understanding and determining the strength and skill of the author by studying the elements of his story. The story of Rustom and Suhrab is also one of the many stories in which the elements of the story are often noticed and show the skill of the great professor Al-Fardousi to benefit from these eleme

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Publication Date
Tue Oct 01 2019
Journal Name
International Journal Of Research In Social Sciences And Humanities
IMPACT OF LEADERSHIP CHARACTERISTICS IN CRISIS MANAGEMENT STRATEGY FOR THE MEMBERS OF THE IRAQI NATIONAL PARALYMPIC COMMITTEE FROM THE POINT OF VIEW OF THE MEMBERS OF THE CENTRAL UNIONS
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Welcome to International Journal of Research in Social Sciences & Humanities (IJRSSH). It is an international refereed journal of Social Sciences, Humanities & Linguistics in English published quarterly, both print and online.

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Publication Date
Fri Jul 01 2022
Journal Name
Translation & Linguistics
TO THE QUESTION ABOUT THE USE OF METAPHORS IN THE CREATION OF ART (ON THE EXAMPLE OF THE STORY BY D. RUBINA "YOU AND ME UNDER THE PEACH CLOUDS")
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The article reflects the results of the analysis of the use of metaphors when creating the image of the main character of the story by D. Rubina "You and me under the peach clouds" - a pet, a dog named Kondraty. Through metaphorization, the image of the dog is filled by the author with purely human qualities, thus passing into the category of a full member of the family. The article is a continuation of the study of the work of D. I. Rubina.

Publication Date
Fri Jul 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Immunohistochemical expression of MMP1 and TIMP1 as markers of migration in Hodgkin’s and non-Hodgkin’s lymphoma of the head and neck region (A comparative study)
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Background: Malignant lymphoma is a term that describes primary tumors of the lymphoreticular system, almost all of which arise from lymphocytes.MMP-1 is the most ubiquitously expressed interstitial collagenase, a subfamily of MMPs that cleaves stromal collagens. It is also called collagenase-1.TIMPs which inhibits MMP activity and thereby restrict extracellular matrix breakdown, TIMP-1 is a stromal factor that has a wide spectrum of functions in different tissues. Material and Methods: This study was performed on (68) formalin-fixed, paraffin-embedded blocks, histopathologically diagnosed as lymphoma (head and neck lesions). Immunohistochemical staining of MMP1and TIMP1 was performed on each case of the study sample. Results: The expressio

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Relationship between the age of the pregnant mother and the values hemoglobin blood and packed cell volume (PCV) in the Third Trimester for different age groups (descriptive study)
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Pregnancy pose an additional burden on the body of the mother so as to meet their needs and the needs of the fetus and the body's need to iron increases excessively during pregnancy and iron is an essential element for the formation of hemoglobin blood Either hemoglobin is the key ingredient for red blood cells which carries oxygen to parts of the body, alas, most of the pregnant women begin their pregnancy inadequate stocks of iron in their bodies, which does not cover their need and requirement of the fetus, especially in the second and third trimesters of pregnancy When you reach the mother to the period in which they did not have the adequate amount of iron to produce hemoglobin become the mother was anemic So emerged the problem of

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Publication Date
Wed Nov 14 2018
Journal Name
Journal Of Engineering And Applied Sciences
DEMONSTRATE OF MAGNETIC FIELD EFFECT ON THE CAPABILITY OF ADSORPTION PROCESS IN THE REMOVAL OF AZO DYE FROM THE AQUEOUS SOLUTIONS ON CALCINED IRAQI BENTONITE CLAY MINERAL VIA COLUM
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