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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
Mon May 16 2016
Journal Name
Far East Journal Of Mathematical Sciences (fjms)
MINIMIZING WAITING TIMES USING MULTIPLE FUZZY QUEUEING MODEL WITH SUPPLY PRIORITIES
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Publication Date
Sun Mar 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
The Behavior of Scouring Around Multiple Bridge Piers Having Different Shapes
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Abstract<p>In this research, a numerical simulation was conducted to study the behavior of the scouring pattern and the effect of spacing between bridge piers at specified hydraulic conditions such as velocity, depth of flow, and the sediment effective diameter. Moreover, the cross-section shape of piers and their effect on the scouring depth around bridge piers was studied, using Computational Fluid Dynamics (CFD), ANSYS (Fluent) software. A comparison of the simulation results obtained with previous laboratory investigations was done to verify the validity of the numerical model. Generally, the scour pattern using the CFD software gave good agreement with the experimental study. A reversed pro</p> ... Show More
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Publication Date
Fri Jun 03 2022
Journal Name
Journal Ofxi'an University Of Architecture & Technology
Extent of mathematics teachers' appreciation of the mathematical problem `multiple solutions
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Aims to find out the (Extent of mathematics teachers' appreciation of the mathematical problem `multiple solutions) Research sample consisted of (100) mathematics teachers distributed on the General Directorates of Education in Baghdad (Rusafa 1/2/3) and (Karkh 1/2/ 3) There was two research approach which are: The first - two different answers of students to the same issue where teachers must assess each answer and explain which one the teacher will accept and why? The second - Different solutions of students' to the same issue, including wrong answers , Teachers should correct the answers and give them final grades (0-10). Descriptive and analytical Approch was used in this research methodology And zero hypotheses, which are as f

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Publication Date
Thu Sep 15 2022
Journal Name
Romanian Neurosurgery
Impact of dome projection on operative steps during clipping of a ruptured pure posteriorly directed posterior communicating artery aneurysms
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Background: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a

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Publication Date
Tue May 11 2021
Journal Name
Photonics And Nanostructures - Fundamentals And Applications
The spontaneous emission performance of a quantum emitter coupled to a hybrid plasmonic waveguide with specified output polarization for on-chip plasmonic single-photon source
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Nowadays, most of the on-chip plasmonic single-photon sources emit an unpolarized stream of single photons that demand a subsequent polarizer stage in a practical quantum cryptography system. In this paper, we numerically demonstrated the coupling of the light emitted from a quantum emitter (QE) at 700 nm wavelength to the propagation mode supported by an on-chip hybrid plasmonic waveguide (HPW) polarization rotator. Our results proved that the light emitted is linearly polarized at 0º, 45º/−45º, and 90º with propagation lengths of 5 μm, 3.3 μm, and 3.9 μm, respectively. Moreover, high power-conversion efficiency was obtained from an applied transverse magnetic (TM) mode (0º-polarization) to a transverse electric (TE) (90º-polari

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Publication Date
Thu Jul 01 2021
The spontaneous emission performance of a quantum emitter coupled to a hybrid plasmonic waveguide with specified output polarization for on-chip plasmonic single-photon source
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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The role of Rabi’a tribe in the history of Iraq in the rightly guided caliph’s period Prof. Dr.: The role of Rabi’a tribe in the history of Iraq in the rightly guided caliph’s period Prof. Dr.
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Abstract:
Rabi’a tribe lived on the land of Euphrates since the first century of the
Christ. Then that land becomes her homeland. The Persians tried many times
to drive her away from that land, but with out result.
In the course of time Rabi’a become more knowledgeable of Persia.
This tribe proved her love and sanctification to the land of Euphrates, in the
battle of Dhyqar.
Rabi’a converted to Islam quickly and helped the Muslims to conquer
Iraq with a big number of fighters in many battles like al- Qadisyyah. That
influenced the anger of Mudriat Arab tribes who were their old enemies.
Mudriat tribes did their efforts to reduce the importance of Rabi’a because of
some its branches were among of t

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Publication Date
Mon May 24 2021
Journal Name
Turkish Journal Of Computer And Mathematics Education (turcomat)
Historical Review: Athletics and Heroic Sports Encouraged and Played at Islamic period and Greek
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The paper is highlighting the athletics and heroic sports which encouraged and played at Greek and Islamic period. The paper is identifying the Islamic athletics and heroic sport and compare them with Greek sports, as it is the model of sports while the sport during the Islamic period was not undertaken by scientific researches or articles even in Wikipedia. Although, this period was encouraged and practice many sports such as archery, sword grappling &nbsp;and wrestling, equestrianism, jogging and running whereas there are many Arabic references revealed during the Islamic 610 A.D. while the Greek and Olympic was known at 732 A.D. The paper is followed the literature review and historical to shied a light scientifically about tradition

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Kinds of Food and Drinks in Morocco in the Period of Al-Murabteen and Al-Moahideen
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Cooking was of great importance in the Islamic Arabic culture and the
people of Morocco have shown great interest in this aspect and also in the
variety in the making of food. They used all kinds of meat of and have shown
interest in preserving and distributing it .The people of Morocco used the
additives in their cooking such as salt, saffron and many other kinds to add
special flavor and taste and their cooking a distinctive flavor.
Sweet and pastry, in addition to the drinks, represented another aspect of the
Moroccan kitchen. At that time women were brought as slaves from Sudan
and as a result they brought their experience in the making of sweets and
pastry with them to Morocco, they used sugar, fat, wheat

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Publication Date
Thu Aug 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Public Bank Debt and Foreign reserve constraint in Iraq for the Period (2017-2004)
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Abstract

Public debt has posed a major challenge to both developing and developed countries, which has focused attention on the optimal limits (threshold of debt) and its determinants.

The study examines the effect of the Public bank debt on the foreign reserves and the work of the foreign reserve as a limitation on the process of bank debt (part of the internal debt) for the period (2017-2004), in addition to finding the type and nature of the relationship between them according to the hypotheses of the study, Public bank debt and foreign reserves.

The study was based on data from the Iraqi banking sector, which showed that Iraq has a foreign reserve in line with internat

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