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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 Oct 17 2017
Journal Name
Spe/iatmi Asia Pacific Oil & Gas Conference And Exhibition
Retention of Silica Nanoparticles in Limestone Porous Media
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Nanofluids (dispersion of nanoparticles in a base fluid) have been suggested as promising agents in subsurface industries including enhanced oil recovery. Nanoparticles can easily pass through small pore throats in reservoirs formations; however, physicochemical interactions between nanoparticles and between nanoparticles and rocks can cause a significant retention of nanoparticles. This study investigated the transport, attach, and retention of silica nanoparticles in core plugs. The hydrophilic silica nanoparticles were injected into limestone core as nanofluid of different nanoparticles size (5 nm, and 20 nm), concentration (0.005 – 0.1 wt% SiO2), and base fluid salinity (0 – 3 wt% NaCl) at different temperatures (23, and 50 °C). D

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Publication Date
Tue Sep 01 2020
Journal Name
Gene Reports
Efflux pumps of Gram-negative bacteria in brief
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he development of multidrug resistance in Gram-negative bacteria is a major problem faced antimicrobial therapy and management of infectious diseases. Too many resistance mechanisms were developed since the antimicrobial agents were produced and actually used. The mechanisms involved in antimicrobial agents' resistance are, modifying enzymes, alteration of the target site of antimicrobials and prevention of antimicrobials accumulation inside the bacterial cells. The latest is accomplished by two mechanisms: alteration of outer membrane permeability and efflux pumps. Efflux pumps are either chromosomal or plasmid-encoded although chromosomal encoded efflux pumps are common in Gram-negative bacteria. Resistance nodulation division (RND) efflu

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Publication Date
Sat Sep 30 2023
Journal Name
حوليات أداب عين شمس
Ethnology and globalization of image in cinematographic discourse
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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Certain Hematological Denotations in Chronic Renal Failure Patients
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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Advances In Mathematics
B-Closed Topological Spaces in Terms of Grills
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The concept of -closedness, a kind of covering property for topological spaces, has already been studied with meticulous care from different angles and via different approaches. In this paper, we continue the said investigation in terms of a different concept viz. grills. The deliberations in the article include certain characterizations and a few necessary conditions for the -closedness of a space, the latter conditions are also shown to be equivalent to -closedness in a - almost regular space. All these and the associated discussions and results are done with grills as the prime supporting tool.

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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
Tympanostomy Tube Complication in Otitis Media with Effusion
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Background: Otitis media with effusion is characterized by accumulation of fluid in the middle ear in absence of acute inflammation and  it is the most common cause of  acquired hearing loss in children, and may  negatively affect language development failure of medical treatment of middle ear effusion frequently require myringotomy and tympanostomy tube insertion.

Objectives: To determine tympanostomy tube complications of tube in children with chronic otitis media with effusion who were treated with Shah Grommet tube insertion.

Methods: The Medical records of 162 ears of 87 children (52 male and 35 female) were reviewed respectively, the patients ages wer

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
The aesthetic and communicative " dimensions in t.v photo"
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T.V photo in modern shows has emerged with special characteristics and signs that have developed in cope with the development of medium and technique. This leads to adding a variety of aesthetic dimensions which are capable of attracting audience because of its communicative elements that have an important role in increasing of T.V show Watching. As a result, the research is limited to methodological Framework as the problem. The problem of the research deals with emerging the aesthetic dimensions of T.V photo. The major question is (what are the aesthetic and communicative dimension of T.V Photo?). The research aims at finding out the aesthetic dimensions of T.V photo in modern artworks. The significance of the research on the presented

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Publication Date
Thu May 22 2025
Journal Name
Journal Of Posthumanism
Impact of Using Dust / Fiber in Flexible Pavement
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Flexible paving is the most popular type of paving used in road building and one of the biggest problems facing the world's paving business is the rising demand for scarce natural resources. Uncontrolled. Numerous studies have shown that secondary materials reduce the need for traditional materials, offer efficient waste disposal technology and lower the overall cost of paving. The current study aimed to evaluate the efficiency of both fibers and dust on the sustainability and cost of flexible pavement by studying each of polyester fibers as a waste of the textile industry and fibers or rubber particles as one of the rubber waste products, in addition to studying the efficiency of using cement dust and marble dust on the paving proc

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Publication Date
Fri Oct 01 2010
Journal Name
Iraqi Journal Of Physics
Correlation of Paschen parameters in magnetized argon plasma
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A number of glow discharge experiments has been carried out in a relatively large-volume metallic vacuum chamber containing argon at low pressure and immersed in an inhomogeneous magnetic field generated by a solenoidal coil capable of delivering 2100G. Two Paschen curves demonstrating the dependence of the discharge voltage on sparking parameter Pd and magnetic field strength B were deduced. A graphical correlation showing the behaviour of the voltage difference from the two curves on the ratio B/Pd was constructed. Investigations showed a reduction in the nominal impedance of the discharge device of nearly 20% when B reaches a value of 525G. Plasma confinement regions were found around the internal surface of the chamber at the entranc

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Publication Date
Wed Dec 30 2009
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Bio-production of Ethanol in Packed Bio reactor
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A lab-scale packed Bio film reactor was used for ethanol production by fermentation of sugar solution using a local
isolated yeast saccharomyces cerevisia and glutaraldelryde on gelating as a covalent bounding agent. In this study four
types of packing in the reactor were used. They are; polypropylene mesh, glass rashig rings, ceramic rashig rings and
glass beads. Glucose solutions were used as substrate with four concentrations; (5, I 0, I 5, 20 g/l). Results show that the
ethanol productivity was increase with increasing sugar concentration. Also it was found that polypropylene mesh
packing give the highest productivity while glass beads gives the lowest productivity. The experiments were conducted at
three temperatur

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