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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
Thu Oct 01 2015
Journal Name
International Journal Of Engineering Sciences & Research Technology
IMPROVEMENT THE MECHANICAL WEAR RESISTANCE OF METAL KNIFE USED IN HARVESTER MACHINE
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SKF Dr. Abbas S. Alwan, Dhurgham I. Khudher, INTERNATIONAL JOURNAL OF ENGINEERING SCIENCES & RESEARCH TECHNOLOGY, 2015

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Publication Date
Fri Jul 30 2021
Journal Name
Turkish Online Journal Of Qualitative Inquiry (tojqi)
A Pragmatic Study of the Student-Teacher Relationship in the Dangerous Minds
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Publication Date
Tue May 31 2022
Journal Name
Journal Of Positive School Psychology
A GENRE-BASED ANALYSIS OF POLITICAL SPEECHES IN THE UN GENERAL ASSEMBLY
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The regulatory climate in the government and private kindergarten children (Comparative Study)
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The research problem boils question is there in Riyadh organizational climate that enables them to do their work properly and whether there are differences between the government and private Riyadh depending on the organizational climate has sought Find measure: 1 regulatory climate for kindergarten 2. The difference between government and private Riyadh depending on the organizational climate. Limited research on the (200) parameter of the Riyadh government and private parameters for the year (20,142,015) In order to achieve the research objectives the researchers built a regulatory climate in accordance with the scientific steps to build a psychological scales measure After the formulation of climate regulation paragraphs of the (30) p

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Publication Date
Wed Jun 20 2018
Journal Name
Bulletin Of Iraq Natural History Museum
LIST OF INSECTS ASSOCIATED WITH MACROFUNGI IN TIKRIT CITY, SALAHADIN GOVERNORATE, IRAQ
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Publication Date
Wed Feb 18 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Sonographic evaluation of masseter muscle thickness in bruxist and non-bruxist subjects
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Background: Masseter muscle is a jaw closing muscle of the mandible involved in Para functional habits; which include lip and cheek chewing, fingernail biting, and teeth clenching or bruxism which can be classified as awake or sleep bruxism. Patients with sleep bruxism are three to four times more likely to experience jaw pain and limitation of movement than people who do not experience sleep bruxism. The aim of this study is to measure the thickness of the masseter muscle in bruxist subjects and compare it with non-bruxist subjects by using sonography. Materials and Method: Forty Iraqi subjects with age ranged (20-40) divided into two groups according to the presence of bruxism. Clinical examination was made and masseter muscle thickness

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Publication Date
Tue Jun 05 2018
Journal Name
The Cleft Palate-craniofacial Journal
Longitudinal 3D Assessment of Facial Asymmetry in Unilateral Cleft Lip and Palate
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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Evaluation of D-Dimer in the diagnosis of suspected deep vein thrombosis
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Background: Deep vein thrombosis is a multi causal disease and its one of most common venous disorder, but only one quarter of the patients who have signs and symptoms of a clot in the vein actually have thrombosis and need treatment .The disease can be difficult to diagnose. Venous ultrasound in combination with clinical finding is accurate for venous thromboembolism, its costly because a large number of patients with suspicious signs and symptoms. Venography still the gold standard for venous thromboembolism but it is invasive. The D-dimer increasingly is being seen as valuable tool rolling out venous thromboembolism and sparing low risk patients for further workup.Objectives: this study has designed the role of D-dimer to confirm diag

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Publication Date
Mon Mar 02 2015
Journal Name
Asian J. Res. Pharm. Sci.
Prevalence of Pathogenic Bacteria from Contaminated Yemeni Currency Notes in Taiz City
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ABSTRACT: Pathogenic bacteria responsible for the causation of many common diseases have been identified on currency notes. The present investigation was carried out on one hundred currency notes of all the denominations (50, 100, 250, 500 and 1000RY), obtained from different occupational mainly bus drivers, hawker street, vegetable vendor, restaurants and butchers and fish seller groups in Taiz city,Yemen. Identification and characterization revealed active participation of the following species of organisms in the ascending order of percentage as E. coli(50.28 %),Staphylococci aureus(14.04 %), Klebsiellaspp(4.39 %),proteus(4.39 %), salmonella(1.25 %), shigella(0.72 %), Coagulase negative staphylococcus(0.60 %), pseudomonas(0.50 %),

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Publication Date
Sat Jun 30 2007
Journal Name
Al-kindy College Medical Journal
Diagnostic Approach of Atypical Cells in Effusion Cytology Using Computerized Image Analysis
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Background: Cytology is one of the important diagnostic tests done on effusion fluid. It can detect malignant cells in up to 60% of malignant cases. The most important benign cell present in these effusions is the mesothelial cell. Mesothelial atypia can be striking andmay simulate metastatic carcinoma. Many clinical conditions may produce such a reactive atypical cells as in anemia,SLE, liver cirrhosis and many other conditions. Recently many studies showed the value of computerized image analysis in differentiating atypical cells from malignant adenocarcinoma cells in effusion smears. Other studies support the reliability of the quantitative analysisand morphometric features and proved that they are objective prognostic indices. Method

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