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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 Feb 20 2019
Journal Name
Political Sciences Journal
Polar structure in the international system
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Conclusion The observation of the phenomenon of structural evolution of the international system and its instability on a particular situation, by its transition from unipolar to polarity to bipolarism and then to unilateralism in the early 1990s led by the United States, and to the present moment, To say that the structure by which the hierarchy of superpowers or the regime is directed in terms of its various capacities that qualify it, and with the consent of the rest of the States directing the regime to lead and lead the world's first place, has no direct relation to the stability of this system, I hope other more influential in its stability. The structure of the new international order will be completely different in terms of the r

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Publication Date
Fri Nov 01 2013
Journal Name
East Asian Journal On Applied Mathematics
Free Boundary Determination in Nonlinear Diffusion
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Abstract<p>Free boundary problems with nonlinear diffusion occur in various applications, such as solidification over a mould with dissimilar nonlinear thermal properties and saturated or unsaturated absorption in the soil beneath a pond. In this article, we consider a novel inverse problem where a free boundary is determined from the mass/energy specification in a well-posed one-dimensional nonlinear diffusion problem, and a stability estimate is established. The problem is recast as a nonlinear least-squares minimisation problem, which is solved numerically using the <italic>lsqnonlin</italic> routine from the MATLAB toolbox. Accurate and stable numerical solutions are achieved. For noisy data, inst</p> ... Show More
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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of The College Of Education For Women
Presupposition in Fitzgerald the Rough Crossing
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Presupposition in Fitzgerald the Rough Crossing

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Rationality and Freedom in Islamic Thought
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Abstract Rationality and freedom are fundamental elements of Western modernity. Although modern and contemporary Islamic thought has established its intellectual foundations on the fundamentals of intellectual thought that are at the core of its Islamic intellectual system, at the same time many of its intellectual products have been a response In spite of the fact that this Islamic intellectual response stands out from Western modernity as a negation or a positive attitude. The Islamic intellectual response differed in determining its position on Western modernity, depending on the nature of the historical stage that was The Islamic nation, as well as the nature of the challenge posed by Western civilization to other nations and other c

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Publication Date
Sun Oct 07 2012
Journal Name
Journal Of Educational And Psychological Researches
Graduate Unemployment In Iraq , Problems , Solution
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There Are Many  Communities Suffering Of Unemployment Due To Has  Great Social And Economic Impact, As Well As The Psychological Effects Devastating And Serious And That May Threaten States  With Collapse And  Leading Human Displacement And Loss And Crime, And Often Derive Unemployed People To Practice  Bad Habits Such As Gambling, Alcohol And Drug Abuse To Escape From Their Reality To Their Concerns And Problems.

It Should Be Noted, That The Largest Percentage Of Unemployment In Developing Societies Represented By The Educated Class Of University Graduates, And This Is Something Painful.

The Unemployed Know That (Each Capable Of Working And Who Want To Look For And Accept Prevailing Bricks) Is Th

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Publication Date
Sun Jul 01 1990
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
NATURAL ENEMIES OF WHITEFLIES IN IRAQ
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During the syrvey on natural enemies of whiteflies in Iraq, the following. predators were recorded.

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Publication Date
Sat Jun 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Gas Holdup in a Bubble Column
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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Engineering
Symbolic aesthetics in steel structural systems
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The aesthetic expression and its orders are important for steel structures forming. Steel structures are a compilation of structural elements, where its shapes have standard dimensions and pre-fabricated. As the steel construction systems not only aim to achieve the functional requirements for users, but must also have the symbolic aesthetics which provides visually and cognitive expression for viewers. In this sense the research interested in expressional aesthetics in these systems and highlights the importance of attention as structural items. Therefore the visual items which related with steel structures contain some of the most powerful forms of modern architecture, steel structures with a glass cladding, agility an

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Publication Date
Sun Dec 14 2025
Journal Name
Online Journal Of Art And Design
Intellectual Approach in Corona Pandemic Designs
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The intellectual approach is manifested in communicating information and achieving it in the best ways and methods, and that the philosophy of the approach falls under the sociological dimensions on the one hand and on the other hand is linked to the visual language presented by graphic design through an informative visual discourse that includes behavior and prophecy as two main axes for integration in presenting social, guiding and indicative educational topics to complete the picture of the achievement. In front of the recipient, the goals of the design were achieved in addressing the topic (Corona Pandemic), which took a social and cultural turn, and also included politics and economics, and went beyond the limits

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Publication Date
Thu Aug 17 2017
Journal Name
Journal Of Health, Medicine And Nursing
Adherence to Guidelines of Secondary Prevention in patients with Ischemic Heart Disease in a Tertiary Cardiac Center
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Coronary heart disease (CHD) is the leading cause of death in United State (U.S.). Controlling of modifiable risk factors such as smoking, hypertension (HT), diabetes mellitus (D.M.), dyslipidemia, physical inactivity & obesity will prevent other serious cardiovascular complications