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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
Sun Dec 31 2017
Journal Name
College Of Islamic Sciences
The wisdom of diversity in the Holy Quran
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Research summary

 


The first step towards the goal of coexistence with diversity, we must all recognize each one of us the rights of others regardless of his religion, color, gender, and point of view, and that each one agrees with his partnership with others, and a person’s belonging to a religion or doctrine must be based on conviction and self-motivation, and that the true Sharia prohibits a Muslim To impose on others what they do not believe and believe in, for God Almighty did not give His Prophet this right, so how about others, and it is not surprising for everyone that disharmony and rivalry impede the attempt to advance in society, and it is natural that our enemies take advantage of our division among us,

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Impact of Manager Roles in Achieving Organizational Excellence
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The current research problem is focused on the level of human resource managers' performance of their contemporary roles and the impact of this on achieving organizational excellence. The research aims at diagnosing and interpreting the nature of the relationship between the roles of human resource manager and organizational excellence. ), And oil companies located in Baghdad governorate. The research included (boards of directors), and collected data from (83) respondents representing the research community exclusively and comprehensively

represented in the positions of function (Directors-General, Associate Directors-General, heads of departments, divisions and divisions). (49) questions, as well as th

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Publication Date
Thu Oct 21 2021
Journal Name
International Journal Of Research In Social Sciences And Humanities
The Role of Green Kaizen in Productivity Enhancement
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The world is moving towards greening business in general and production systems in particular. At the same time, economic units seek to enhance their productivity and find any variables that can contribute to improving their elements. Economic units should not ignore the green dimension of cost management techniques because of its role in containing the green dimension of the production system and the product. However the few researches dealt with the subject of the green kaizen showed its role in reducing costs and improving the environment. Those researches did not address its contribution to raising the level of productivity. Productivity is an important indicator of economic units that expresses their level of success and progre

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Primary repair versus diversion in penetrating colon injuries
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Back ground: In Iraq, after 2003 had more
accidents of the shell, bullet and stab abdominal
wounds, more over colon injuries.
Objective: The aim of this study is to evaluate
the most appropriate management of penetrating
colon injuries, comparing the primary repair with
the diversion.
Methods: Eighty patient series with shell, bullet
and stab colonic injuries during 4.5 years period
from June 2006-december 2010 at Al-Yarmouk
teaching hospital. The study compared the use of
primary repair versus diversion, analyzing
variables such as sex, age, severity of injury and
mortality rate.
Results: there were total 80 patients ,62 (77.5%)
male and 18(22.5%) female .male :female ratio
3.4:1. the most

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Publication Date
Sun May 08 2011
Journal Name
Journal Of Planner And Development
spatial analysis of health services in wasit governorate
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The spatial variation of regional development means that some regions to be a center of activities and services and job opportunities and economic development, and are usually in major urban centers, while lacking in other regions to such activities and services. Perhaps the studies of spatial variation SPATIAL INEQUALITY, regional development, REGIONAL DEVELOPMENT has had the greatest impact on the operations of regional planning in particular the study of the regional dimension of any city requires that you review the basis and theoretical framework, which refers to the inevitability of the existence of disparities across regions, due to the properties of the regions population and economic political and environmental The study

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Publication Date
Thu May 02 2019
Journal Name
Oral And Maxillofacial Surgery
Reconstruction plate-related complications in mandibular continuity defects
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Purpose The purpose of this study was to evaluate the complications associated with the use of reconstruction plates with or without non-vascularized bone graft in reconstruction of mandibular segmental defects caused by trauma and tumor resection and to analyze various factors that are associated with the development of complications. Methods A retrospective observational study was conducted, and the investigated variables included the age and gender of the patients, etiology of the defect, the site of the defect, the size of the defect, whether bone graft was used or not, type of plate used, and whether the reconstruction was immediate or delayed. The outcome variables were the postoperative complications and the success rate. Results Fif

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Publication Date
Tue Apr 01 2025
Journal Name
Iop Conference Series: Earth And Environmental Science
Review Article: Iron, Zinc and Boron in Sunflower
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There is a real problem when adding micro elements to the soil as a result of fixation, sedimentation, washing or toxicity, and thus economic loss. The plant needs micro elements in very small quantities that do not burn the leaves or cause poisoning to plants, including iron, zinc and boron, as they are essential elements for growth and completing the plant's life cycle, and increase the plant's resistance to diseases and insects, activate enzymes, and form the chlorophyll molecule, in addition to their role in oxidation and reduction processes and vital processes. The use of fertilizers with their modern technology has made the process of activating seeds or foliar nutrition a matter of interest to researchers as a complementary process t

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Publication Date
Tue Oct 31 2023
Journal Name
College Of Islamic Sciences
The shield And its provisions in Islamic jurisprudence
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Since I live in a society in which violence has become widespread, and killing among its own people flared up till they began to kill under the excuse of taking shelter, in these pages I would like to explain the status of taking shelter in the light of Islamic Law (Sharia), exploring scholars’ opinions in the legitimacy or illegitimacy of this issue according to the legal standards.
And, to acquaint people, and myself in the first place, with the true nature and the gravity of this issue; to expose it to those who are unaware of it; to remind those who are already aware of it. I would refute the fabrications, remove the suspicions which surround it untill it made the forbidden permissible; the wrong right. I would explain to those

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
Dramatic construction of bullying scenes in animated films
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Given the importance of the phenomenon of bullying and its spread in the productions of animated films and the resulting impact on them, and the dominance of a large number of satellite channels that simulate different age stages and for both sexes. It is bullying others and their imitation of characters inspired by animated films with aggressive behavior that appears in them by imposing his authority by force on those who are weaker than him and in various methods that fall within the concept of bullying, and the interest of most satellite channels in this type of production that simulates different age groups, this research comes as an attempt A scientific method through which the researcher seeks to know the issue of the dramatic cons

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Publication Date
Tue Sep 19 2017
Journal Name
Al-academy
Melody tetrarchords in the Folklore Modern Iraqi songs
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The study aimed .to identify on the melody tetrachords In the Iraqi Folklore song as mall as the melody tetracords is the basic in striation song if Iraqi Folklore so the researchers prepared their researchers from four chapters. In the first chapter of the researchers theoretical framework, included the research problem, which is determined by what is the melody tetra chords in the Iraqi Folklore songs. The research time limits were specific by year (2015-2016) then the first chapter ended with the terms mentioned in the title of research. The second chapter of the theoretical framework, included two subjects the first (Iraqi Folklore song) and the second subject included (melody tetra chords) then the third chapter deals with the resea

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