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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
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Excellence in Language Education
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The primary goal of the study is to practise some systematic strategies for foreign language instruction despite the fact that no single approach to language classroom instruction is inherently superior to others; instead the choice of an approach should be determined by the teacher, students, the subject matter, and the situation. The paper adopts certain strategies which may assist EFL teachers to excel in their work and continue their professional development. Hence, it is intended for language teachers who understand the value of good teaching and like to produce academically successful students. The study could also help college student teachers to acquire new strategies in order not only to succeed but also to excel in their learni

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Publication Date
Sun Sep 01 2013
Journal Name
Iosr Journal Of Applied Chemistry (iosr-jac)
Neonatal Omphalitis in Iraq
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Publication Date
Fri Jun 30 2023
Journal Name
College Of Islamic Sciences
Hisba system in Islam
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Through research it shows that the calculation has an effective role in the maintenance of Islamic law and save. And that the calculation religious function to attach religious matters and it closeness to God, whether calculated or assumed carried out by volunteers. And scientists from the description of the calculation as a social function to attach to morality and kinship and charity to the poor and the dissemination of science. By definition it shows that the injury will not be exposed only to the evils of any phenomenon that do not break and was checking to search for evil, but he must intervene if he saw visible in front of him. And that of the areas that could see the calculation are the field of information and educ

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Publication Date
Sun Apr 07 2013
Journal Name
Journal Of Educational And Psychological Researches
Psychophysiological Control in Behavior
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         The Feedback Concept has been spread as an organized trend for scientific research since it has a significant importance for human behavior and how it has been directed and controlled by the individual, feedback has numerous definitions but the simplest definition is; feedback is the information received by the individual from the output of his behavior, In addition to the mutual relationship between the individual and the stimulation that provide him with the basic information by the biological control of his behavior, Since feedback cannot be accomplished without receiving information from the inner and outer environment, the biological and physiological information become the ma

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Publication Date
Wed Oct 30 2019
Journal Name
Cambridge Scholars Publishing.
Intelligent systems in building;
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Publication Date
Wed Oct 06 2021
Journal Name
College Of Islamic Sciences
antonyms in Quranic readings
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This research aims to investigate the impacts of Quranic readings on the meanings of antonyms in the Quran, with considering the practical aspects that clarify them. The importance of this topic lies in clarifying the importance of the science of Qiraʼat, its great value and its high status. Moreover, this research sheds light on the relationship between Quranic readings and the antonyms words, following the descriptive approach in the study. The research has found several findings, the most prominent of which was: antonyms are linguistic phenomena that are proven to occur in Quranic readings, so each reading deliver a meaning that is opposite to the meaning learned from the other reading.In addition, Quranic readings are considered as

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Publication Date
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
Tadpole Domination in Graphs
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A new type of the connected domination parameters called tadpole domination number of a graph is introduced. Tadpole domination number for some standard graphs is determined, and some bounds for this number are obtained. Additionally, a new graph, finite, simple, undirected and connected, is introduced named weaver graph. Tadpole domination is calculated for this graph with other families of graphs.

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Publication Date
Thu Sep 15 2022
Journal Name
Aladab Journal
Adjectives in Shakespeare's Sonnets
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The present paper studies the use of adjectives in Shakespeare's Sonnets (4, 5, 6, & 9), which are chosen randomly, on the three levels: grammar, lexis and conversation. It tackles adjectives as a literary term with presenting their forms and functions. The presentation is done according to the themes, their forms and functions in conversation, the adjectives are shown in this paper as for their forms, frequency and meanings in the sonnets and their effects on studying. The analysis is done according to Quirk et al. (1985) and Quirk and Greenbaum (1973). Then, all adjectives have been calculated in the sonnets. The results of the analysis have shown that compound adjectives which occurred (31) are used more than the Suffixation

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Publication Date
Sun Sep 15 2019
Journal Name
Al-adab Journal
Romanticism in Virtual World
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When Romanticism had passed since its appearance at the end of the eighteenth century, it seemed that this important intellectual and philosophical development had been absent but not really lost. Romanticism remained in the poems of poets, philosophers and writers even after they had escaped cultural life in general. If it is difficult to itemize all the principles of romance, the apparent is the assertion of individualism and the love of autism with nature and its potential with its mysteries as well as the glorification of emotion, compared to the mental orientation of the writers in the seventeenth century in their classical approach. The language is the most important to what the Romans have proven in their poetry and their artistic wo

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Publication Date
Mon Feb 01 2010
Journal Name
Alustath Journal
Persuasive Language in Blurbs
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Advertisement is a general phenomenon in our everyday life. In most cases, it is established for commercial purposes i.e. it is oriented for certain goals and waiting for results. One form of advertisement is a blurb. In this study, the researcher applies Fonton and Saint-Dizier (2010) and Hymes (1962) models on 23 blurbs. These two models are chosen on consideration of accounting grammatical categories and speech events respectively. The study tends to answer the following question: How do blurb’s writers exploit language to convince the reader to buy the intended book? Therefore, the aim of the study can be stated as analyzing the blurbs according to these two models and finding which category scores higher and serves in ad

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