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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 Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
Administrative Applications of Expert Systems in Educational Leadership Departments in the Light of the Systems Approach
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Abstract

The aim of the current research is to identify the level of administrative applications of expert systems in educational leadership departments in light of the systems approach. To achieve the objectives of the research, the descriptive-analytical and survey method was adopted. The results showed that the level of availability of the knowledge base for expert systems in educational leadership departments (as inputs) was low. The level of availability of resources and software for expert systems in educational leadership departments (as transformational processes) came to be low, as well as the level of availability of the user interface for expert systems in educational leadership departments (as outputs

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Publication Date
Wed May 01 2024
Journal Name
Journal Of Orthodontic Science
Keeping the teeth in line: Exploring the necessity of bonded retainers in orthodontics: A narrative review
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In most recent studies, long-term retention after orthodontic treatment has been hypothesized that may be necessary to maintain the stability of the dentition and avoid post-treatment changes. The bonded fixed retainer is characterized by its clinical effectiveness, patient acceptance, and lack of patient complaints as compared with a removable retainer. An electronic database (such as PubMed, PubMed Central, Web of Science, Science Direct, Cochrane Library, Scopus, and ResearchGate) has been collected using specific keywords. Of the 152 articles, only randomized clinical trials that investigated different types of fixed retainers or compared fixed with removable retainers were illustrated in tables and included in this review. The

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Business Process Reengineering in the institutional performance : Research in the office of the General Inspector in the Ministry of Higher Education and Scientific Research
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Abstract

       This research is aimed at indicating the impact of business process reengineering on corporate performance in the Office of the Inspector General of the Ministry of Higher Education and Scientific Research of the Iraqi study has identified a problem in a number of the most important questions - what the impact of the Business Process Reengineering at the corporate office performance indicators respondent? What are the actual results of the analysis of paths Administrative Process Engineering and Corporate Performance respondent in the office? In order to achieve the goal of the research and answer the questions of the problem, the study applied to a sample of

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program Based on Employing the Educational Portal in Developing the Skills of the Administrative Body in Basic Education Schools in Dhofar Governorate
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The objective of the study was to identify the effectiveness of a training program based on the employment of the educational portal in the development of the skills of the administrative body in the basic education schools in Dhofar Governorate. To achieve the goal, a training program was designed that includes the skills of the educational portal to be met by the administrative body and measuring its effectiveness. A questionnaire to identify training needs, and a notecard to evaluate performance. The study sample consisted of (70) individuals of the administrative staff. The researchers used the descriptive-analytical method to identify the training needs, design and build the training program and the experimental method for applying

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Strategic leadership and its role in achieving competitiveness in industrial establishments": "A field study in Bashir Al-Siksik & Co. for the manufacture of sanitary and plastic tools
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This study aims to know the role of strategic leadership to achieving competitiveness in industrial establishments by identifying the respondents’ perceptions about the level of availability of dimensions of leadership strategies (creativity and innovation, risk tolerance, available opportunities) in Bashir Al-Siksek & Partners Company for the manufacture of sanitary and plastic ware in Gaza strip

To achieve this, a questionnaire was developed and distributed to a sample of managers, auditors, accountants, and administrative employees in the study sample company. The questionnaire tool was distributed to 60 employees and employees, of which (52) were retrieved, or 86.6%, and (8) were excluded for la

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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The impact of the proposed strategy in accordance with the objectives of science in achievement and some science operations at the second-grade middle students in chemistry
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It aim current researchs֬ to identify the impact of a proposed strategy in accordance with the objectives of science in the achievement and some science processes, where the experimental method was adopted, and define the research community was students second grade averag in Education Bagdad / Rusafa third, research sample intentionally chosen as school Radwan, and (30) students experimental group and (29) of control group, research tools were achievement test and the test of science operations and use the appropriate statistical tools to process information and data, showing results, the experimental group surpassed the control group in the collection and operations science, and light it, the researcher recommended several recommendat

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Publication Date
Mon Jan 07 2013
Journal Name
Journal Of Educational And Psychological Researches
The effective of utilization Blending learning on academic achievement in Biology course of second class students in secondary special schools in Omdurman Locality and attitudes towards it.
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This research aimed to definite Blending learning (BL) technique, and to know the impact of its use onacademic achievement in Biology course of second class students in secondary special schools in Omdurman Locality and attitudes towards it, to achieve this; researcher adopted the experimental method. The sample was selected of (41) students, chosen from Atabiyah school, were divided into two equals groups: one experimental group reached (26) students studied by using the  BL technique, and the second control group (25) students have been taught in the traditional method.

   Data has collected by using two tools: achievement test and a questionnaire for measuring the attitudes towards Blend

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
Measurable Mistakes in Architecture the Effect of Designer's Experience on the Propagation of Mistakes in Architectural Design - Residential Buildings in Al Sulaymaniyah City as a Case Study
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The importance of physical and nonphysical architectural design values made architectural designers need good experience to be experts of architectural values reasonably without neglecting any value in the design process.  The importance of such values made that ignoring any values and mistakes occurs in the design process. Simultaneously, architectural designers' different nature and the difference in their experiences are causing different understandings of the design values, thus causing architectural mistakes. The research problem appears from the randomly propagating of mistakes in contemporary architecture, which is about to become a phenomenon in Al Sulaymaniyah city. The research aims to find the main reason

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Publication Date
Thu Jan 25 2024
Journal Name
Entrepreneurship Journal For Fiinance And Business
The role of psychological ownerships' dimensions in deterring the effects of toxic leadership: Analytical research in some companies at the Ministry of Industry and Minerals in Iraq
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The research aims to clarify the role that psychological ownership, through its dimensions, plays in deterring the effects of toxic leadership, through its dimensions, in the Ministry of Industry and Minerals. The research started with a basic problem represented by the following question: "Using psychological ownership and its application in deterring the negative effects of toxic leadership." The research used the descriptive-analytical method. The sample was randomly selected from workers in some selected companies affiliated with the Ministry of Industry and Minerals in Baghdad, and the sample size reached 124 individuals. One of the most important results is that there is an effect of the psychological ownership variable, based on the

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The Organizational Climate Development in the Light of Job Stress Treatment: A Field Study in Governmental Sheltered Accommodation Houses in the Ministry of Labour and Social Affairs
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        Job stress is considered one of the most important obstacles that may appear in the work field. In order to deal with the obstacles and challenges , the idea to deal with job stress has come to address job stress as one of the most important trends that enable organizations to face those challenges through focusing on the role of job stress and the organizational climate of the organization.

       The research deals with two variables: the job stress as an independent variable, and the organizational climate as a dependent one. Each variable includes five sub-dimensions. These dimensions have been involved in an interaction to form

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