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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
Wed May 10 2023
Journal Name
Journal Of Engineering
DOUBLE DIFFUSIVE FREE CONVECTION IN A PACKED BED SQUARE ENCLOSURE BY USING LOCAL THERMAL NON-EQUILIBRIUM (LTNE) MODEL
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In the present study, free convection heat and mass transfer of fluid in a square packed bed enclosure is numerically investigated. For the considered geometrical shape, the left vertical wall of enclosure was assumed to be kept at high temperature and concentration while the opposite wall was kept at low temperature and concentration with insulating both the top and bottom walls of enclosure. The Brinkman– Forchheimer extended Darcy model was used to solve the momentum equations, while the energy equations for fluid and solid phases were solved by using the local thermal non-equilibrium (LTNE) model.Computations are performed for a range of the Darcy number from 10-5 to 10-1, the porosity from 0.5 to 0.9, and buoyancy ratio from -15 t

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of The College Of Education For Women
A Pragmatic Analysis of Questions and Responses in American Defense Attorneys' Cross-examinations: رحاب عبد الجليل سعيد العطار
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The structure of the interrogation process in cross-examinations is said to be diverse and complex in terms of question-response typology. This is because the counsel has to extract truth from an opposing party’s witness whose views are expected to advocate that party's views regarding the case. Accordingly, the study which is basically quantitative in nature aims to investigate what the examining party intends to obtain out of these questions and which of these questions are the most prevalently used. It also aims to measure the amount of cooperativity in witnesses' responses. Accordingly, three transcripts of cross-examination have been analyzed, using a pragmatically-oriented approach. The approach draws on Stenstorm (1984) and Arch

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Publication Date
Tue May 16 2023
Journal Name
International Journal Of Online And Biomedical Engineering (ijoe)
Watermarking in Medical Image
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Medical image security is possible using digital watermarking techniques. Important information is included in a host medical image in order to provide integrity, consistency, and authentication in the healthcare information system. This paper introduces a proposed method for embedding invisible watermarking in the 3D medical image. The cover medical image used is DICOM which consists of a number of slices, each one representing a sense, firstly must separate the ROI (Region of Interest) and NROI (Not Region Of Interest) for each slice, the separation process performed by the particular person who selected by hand the ROI. The embedding process is based on a key generated from Arnold's chaotic map used as the position of a pixel in

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Publication Date
Mon Oct 06 2014
Journal Name
Journal Of Educational And Psychological Researches
sexual stereotyping in Kindergarten
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The current research aims to know the sex-stereotyping among Kindergarten , male and female, study was conducted on a sample of 400 boys and girls by (200) males and  (200), females Kindergarten  from age (4-6 years) in the province of Baghdad, for the , academic year (2013-2014) In order to achieve the goals of research, the researcher built two scales measure of the prototypical male sexuality and a measure of the prototypical female sexual and be in its final form of (36) items to measure sexual stereotyping male (35) items to measure sexual stereotyping of females, were sure of the validity scale by presentation to a group of experts as well as the Statistical analysis of the resear

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Publication Date
Wed Dec 30 2020
Journal Name
Al-kindy College Medical Journal
Furosemide in Hypovolemic shock
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Background: Shock is a common clinical state, we face chocked patients in causality, surgical and gynecological  specialties like stab wounds, road traffic accidents, placenta preavia, placenta accrete, placenta pericreta, ectopic pregnancy, perforated viscus  etc. All such patients undergo surgical exploration and majority of them are shifted to ICU to complete monitoring and support. High percent of them they develop acute kidney injury intra and postoperatively and carry high mortality rate because of not so good nursing care in ICU in Iraq.

Objective: to clarify that Furosemide can protect kidney function during shock and reduce ICU admission and mortality rate.

Method: 100 shocked patient were enrolled in t

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Publication Date
Thu May 05 2022
Journal Name
Al-kindy College Medical Journal
Spinal Tuberculosis in Children
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Tuberculosis continues to be the leading cause of morbidity and mortality, with an estimated annual incidence of 10.4 million worldwide. It has been estimated that 10% of patients with extrapulmonary tuberculosis have musculoskeletal involvement, with the spine being the most common. Spinal tuberculosis (TB) accounts for 50% of cases of musculoskeletal tuberculosis.

Spinal tuberculosis is the result of infection with Mycobacterium tuberculosis. It is a secondary infection, the primary lesion of which is in the lungs, genitourinary system, or gastrointestinal tract and can be active or latent. Involvement of the vertebral segment is the result of hematogenous spread of infection along the arterial pathway or Batson's vei

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Publication Date
Thu Oct 01 2009
Journal Name
Journal Of The College Of Languages (jcl)
Schematic Coherence in Poetry
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Schemata are the underlying connections that allow new experience and information to be aligned with previous knowledge. When one reads a text he usually uses all his levels of schemata. Schemata enable us to make sense of what is perceived and experienced in the world.

In poetry, readers usually examine carefully and deeply what they are reading in comparison with other sorts of discourse. Coherence is achieved when a reader perceives connections among schemata. It is a connection between linguistic and textual features of the text, and reader's mental expectations as well as stored knowledge of the world. This paper discusses the role of schematic correlation in poetry, and the effect of different schematic background and diffe

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
Luxury in jewelry design
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The current research dealt with the presence of ornaments and jewelry since ancient times، which express the social، religious or emotional status of the person who adorns them، in addition to being distinguished by a distinct aesthetic and luxury، that is، in a sense closely related to the social and economic status of people، and we note that jewelry is considered a symbol of luxury and luxury، and hence The need to study luxury appeared in the design of ornaments and jewelry because it refers to the adornment elements that are made of metals and precious stones، which actually indicate signs of status or position that distinguish social classes from each other. The problem was identified by the following question: Determine th

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
Communication in art Education
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The aim of this research is to find approaches between the communicative process and the teaching of art education. Postgraduate/Masters studies for the academic year 2022-2023.
In the light of this tool, the researcher reached a number of results, most notably: The art education teacher performs his communicative role correctly, as well as his ability to use verbal and non-verbal expressions and positive reinforcement clearly for the benefit of his students, and stimulates the largest number of their senses

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Publication Date
Fri Aug 13 2021
Journal Name
Male Reproductive Anatomy
Epigenetics in Male Infertility
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