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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 Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional Program Concerning Healthy Lifestyle on Patients’ Attitudes after Percutaneous Coronary Intervention at Cardiac Centers in Baghdad City
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Abstract:

Objective: The study’s aim to evaluate the effectiveness of instructional program about healthy lifestyle on patients’ attitudes after undergoing percutaneous coronary intervention.

Methodology: Quasi-experimental design/ has been utilized for the current study starting from December 2018 to March 2020 to achieve the objectives of the study. Non-probability (purposive) sample of 60 patients was divided into intervention and control groups. Data were analyzed by the application of descriptive and inferential statistical methods.

Results: findings reported that before intervention both study and control groups demonstrated low total mean of score relat

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Publication Date
Mon Jan 02 2017
Journal Name
Intraventricular Pressure Ventr
The Use of Rate of Increase of Intraventricular Pressure During Isovolumetric Contraction (dP/dt) in Assessment of Left Ventricular Function in Acute Coronary Syndrome
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BACKGROUND: Acute coronary syndrome (ACS) is the clinical manifestation of acutely diminished coronary arterial blood supply. The rate of increase of intraventricular pressure during isovolumetric contraction (left ventricular dP/dt) represents the rate of change of pressure during ejection. OBJECTIVE: The aim of this study is to evaluate the usefulness of the rate of increase of intraventricular pressure during isovolumetric contraction (dP/dt) in assessment of left ventricular function in patients with acute coronary syndrome and its relation to certain clinical and echocardiographic features. PATIENTS AND METHODS: The study is a cross sectional study including 50 patients with an established diagnosis of acute coronary syndrome. The

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Publication Date
Sat Aug 01 2020
Journal Name
Key Engineering Materials
Performance of Reinforced Concrete Beams with Multiple Openings
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The present investigation focuses on the response of simply supported reinforced concrete rectangular-section beams with multiple openings of different sizes, numbers, and geometrical configurations. The advantages of the reinforcement concrete beams with multiple opening are mainly, practical benefit including decreasing the floor heights due to passage of the utilities through the beam rather than the passage beneath it, and constructional benefit that includes the reduction of the self-weight of structure resulting due to the reduction of the dead load that achieves economic design. To optimize beam self-weight with its ultimate resistance capacity, ten reinforced concrete beams having a length, width, and depth of 2700, 100, and

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Publication Date
Mon Sep 23 2024
Journal Name
Medical Journal Of The Islamic Republic Of Iran
The Association of Neutrophil to Lymphocyte Ratio and Other Complete Blood Count Parameters with Global Registry of Acute Coronary Events Risk Score in Patients with Non-ST Segment Elevation – Acute Coronary Syndrome: A Single-Center Study
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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Financial Depth Measurements / Analytical Study in Selected Countries for the Period 1980-2008
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This research deals with the most important indicators used to measure the phenomenon of financial depth, beyond the traditional indicators, which are called quantitative indicators, which is shown to be inadequate to show the facts accurately, but it may come in the results of a counterfactual, although reliable in econometric studies done in this regard.

Therefore, this research has sought to put forward alternative indicators, is the structural indicators, and financial prices, and availability of financial instruments, and cost of transactions concluded, in order to measure the phenomenon of financial depth.

After using and analyzing data collected from countries the research

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Publication Date
Thu Jun 15 2023
Journal Name
Romanian Neurosurgery
Sellar hematoma as a new potential radiological clue for superior hypophyseal artery aneurysm rupture
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Background. In cases of spontaneous subarachnoid haemorrhage (SAH) with multiple intracranial aneurysms (MIAs) detected on angiography, some radiological clues assist in determining the site of a ruptured aneurysm which is bleeding is quite beneficial for the selection of the best treatment strategy. Case description. We report a case of a 60 years old patient who presented with spontaneous SAH, sellar hematoma, and three different aneurysms detected in angiography. Although the right Posterior communicating artery (PcomA) aneurysms showed Murphy’s teat on angiography intraoperatively, we discovered that the right superior hypophyseal aneurysm (SHA) was the source of the index bleeding. Both aneurysms were clipped successfully. Co

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Publication Date
Thu Jun 15 2023
Journal Name
Romanian Neurosurgery
A giant A4-A5 distal anterior cerebral artery aneurysm treated with microsurgical clip reconstruction
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Background. Aneurysms of the distal anterior cerebral artery (DACA) are uncommon; they often form near the pericallosal-callosomarginal junction and are typically small. To our knowledge, giant DACA aneurysms developing from the more distant parts of the anterior cerebral artery (ACA), A4-5, have been described only once in the literature. Case description. A 66-year-old gentleman reported with a brief loss of consciousness followed by weakness in his right lower leg. The patient was admitted with a Glasgow Coma Score (GCS) of 15. A computed tomography (CT) scan of the head revealed a left hyperdense mass in the frontal parasagittal supracallosal region. Contrast MRI revealed a heterogeneously enhancing mass measuring 35x30x25 mm. C

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Publication Date
Mon Aug 30 2021
Journal Name
Al-kindy College Medical Journal
Diagnostic Evaluation of Uterine Artery Doppler Imaging for the Prediction of Early Abnormal Pregnancy
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Objective: to assess the predictive value of Doppler imaging of the uterine artery in the identification of early intrauterine abnormal pregnancy as compared to a normal intrauterine pregnancy. Subjects and methods: one hundred and twenty pregnant ladies, at their 6-12 weeks of gestation, with a singleton pregnancy were included in this population-based case-control study. Thirty women with a missed miscarriage, 30 with hydatidiform mole, 30 with a blighted ovum, and 30 as a control group, without risk factors, underwent Doppler interrogation of the uterine arteries. Resistive index (RI), pulsatility index (PI), and the systolic/diastolic ratio (S/D) were measured for both sides. The t-test, or ANOVA test when appropriate, was

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Success rate of Percutaneous Coronary Intervention of Chronic Total Occlusion in Ibn Al-Baitar Hospital for cardiac surgery and Al-Nassyeria cardiac center
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Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI

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Publication Date
Fri Sep 11 2026
Journal Name
Aip Conference Proceedings
Multiple routes solution of brute force method with ambiguous values in assignment problems
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The evaluation of assignment problems for job suppliers is necessary to meet demands; therefore, academics in the operations research field and management factories have paid considerable attention to assignment problems. Notably, because the central point of classical assignment models with parameters assumes that supplier management oversees all inputs and outputs are fixed data, these types of models cannot provide exact and accurate data. Hence, specific inputs and/or outputs can be improper and ambiguous. Consequently, existing studies have explored various approaches to determine an optimal route that corresponds to assignments to suppliers when ambiguous values are involved. However, the computation of multiple routes for each assign

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