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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
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of organizational trust dimension in customer relationship management: Applied research in the general ethnic insurance company
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Abstract:

               The aim of the research is to verify the role of organizational trust as an “administrative” dimension of objective importance in the relationships adopted by the Iraqi General Insurance Company with customers, as it is one of the basic pillars in building and succeeding companies, which allows the provision of services with high confidence through the customer relationship management system in order to achieve The company's goal is to gain new customers, retain current customers, increase work in insurance companies, and develop the national economy by increasing the company's sales and profitability. The research

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact dimensions the Training process of the in components intellectual capital: Exploratory search in the National Insurance Company
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The concept of training is no longer traditionally understood Limited organize traditional training courses, but has become a strategic choice in the investment and development of human resources system, attic trying to find the answer to the core problem of the study which

is the extent to which the training process, the traditional form that meets the needs of the company the development of intellectual capital.This research aimstostatementof the impact dimensions the training process(training role, support or top management , training programs, modern technology)of the in components Intellectual Capital(Human Capital, Structural Capital, Customer Capital) and provide the top management of the Company for the development of sci

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
The Poetics of Mourning and the American Elegy in Walt Whitman's "When Lilacs Last in the Dooryard Bloom'd"
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يجترح الشاعر والت ويتمان انعطافة شعرية لعلاقة الانسان، جسدا وروحا، مع العالم. فهو يستقي الهامه في كتابته لمرثاته (عندما اينع الليلك اخيرا في فناء الدار) من مصادر جمالية واخرى سياسية. ولعل ابرزها تأثره بفكرة الروح الكوني كما جرى طرحها في سياق فلسفة التسامي الامريكية. يظهر ذلك جليا في قصائده التي تتخذ من تماهي روح الانسان مع الطبيعة موضوعة لها. ان فكرة الروح الكوني تلقي ههنا بظلالها على الرتب الانسانية التي

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Publication Date
Wed Dec 30 2020
Journal Name
Journal Of Planner And Development
Planning treatments for residential neighborhoods in the holy city of Karbala in light of the concepts of sustainability
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Establishing sustainable cities and residential neighborhoods requires the development of new planning strategies, as adopting sustainable planning strategies when planning urban land uses for residential neighborhoods is necessary due to the large number of urban land use problems that have emerged during urbanization. The most prominent modern concept concerned with the land was the concept of sustainability, as sustainable planning aspires to link knowledge with sustainability through measures to achieve it. Therefore, sustainable planning works to apply the principles of sustainability in planning.

And in view of the circumstances that our country went through, which negatively affected various sectors and aspects of life, in

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The Technicality and Spontaneity Paradoxes in the Art of the Playwright -Examples of Improvisation in Modern European Theater
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The research deals with the problems of improvisation in two basic subjects and applied a samples  and conclusion. The first topic focuses on the concept of improvisation and spontaneity and clarifies the confusion between them. The second topic deals with the foundations and principles on which the actor is based in his artistic preparation for the purpose of developing his improvisational abilities.

The research focuses on clarifying the dimensions of improvisational techniques and its multiplicity in the modern theater. It analyzes the method of improvisation and its use in the construction and composition of the theatrical performance. It deals with two important experiments, such as the experience of the Russian directo

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Publication Date
Fri Dec 20 2013
Journal Name
Journal Of The College Of Basic Education
Determination of Some heavy metals in Different vinegar Samples Applied in folk medicine by flame atomic absorption Spectrophotometry
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A study was carried out to analysis of some heavy metals in nine different types of vinegar, belong to Grape, Apple, Synthetic White, Date, Hawthorn, Garlic, Cactus, Pomegranate and Ginger vinegar, which are locally available in Iraqi folk medicine markets. The concentrations of heavy metals in the studied samples including, Cr, Mg, Mn, Zn, Fe, Cd, Ni, Pb and Ag, were determining by using flame atomic absorption spectrophotometry. All data were subjected to statistical analysis by calculating accuracy, precision and correlation coefficient for each concentrations level. The results indicate that Ni was recorded the highest concentration in all studied samples except, Ginger and cactus vinegar, each one receded the highest concentration valu

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Publication Date
Sat Jan 01 2022
Journal Name
Clinical And Experimental Hepatology
Effectiveness of sofosbuvir/ledipasvir in hepatitis C virus infection in children and adolescents with malignancy: tertiary center experience
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Publication Date
Wed Jan 03 2024
Journal Name
Kurdish Studies
The Effect of Enlightened Leadership in Strategic Alignment (Applied Research in a Sample of Private Iraqi Commercial Banks)
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The aim of the research is to diagnose the level of awareness and response of the researched sample to the concept of enlightened leadership and strategic alignment, as well as to measure the strength and weakness of the relationships between the independent variable of enlightened leadership and the dependent variable of strategic alignment with its dimensions. Thus, the research problem was defined by the main question of identifying the role played by enlightened leadership in achieving strategic alignment in a number of private Iraqi commercial banks. In light of this, the hypothetical research model was designed, embodying the relationship between the research variables. The descriptive analytical approach was adopted, and a ques

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Christian Taghlib tribe in the first century A.H: The Christian Taghlib tribe in the first century A.H
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Abstract:
Taghlib tribe had an important part in the history of the first century of
hijra. She managed to get the best social, economic and political basis in the
Arab- Islamic state. In this basis Taghlib was the best Dhimies in the Islamic
state. This tribe refused to be among the people of the book, and to be from
the people of dhima. That tribe refused to pay the Jizya and Khraj, but
accepted to pay double Sadaqa in stead of Jizya and Khraj, so in that case
many Muslims become angry.
Although their Christianity was naïve and simple, Taghlib hold it until the
end of the third century A.H. Taghlib did so because her people wanted to
keep their good relation with the Byzantine. Taghlib thought that the

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Publication Date
Wed Oct 30 2024
Journal Name
Wiadomości Lekarskie
Oral health status in relation to nutritional status amongst orphans aged (6-12) years in Baghdad city, Iraq
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Aim

Aims: Assess selected measures of oral health: Enamel defect, eruption of permanent teeth, dental caries, investigate the nutritional status of orphans by physical examination and relate the nutritional status with measures of oral health.

Material and methods

Materials and methods: 192 orphans aged of 6 and 12 who were living in all orphanages in Baghdad, Iraq, were studied. Enamel defect was derived from the WHO's modified developmental defects of enamel (DDE) index, investigation of caries using Decay -Missing – Filled index for permanent teeth (DMF), the decay-missing filled index for primary teeth (dmf) index and all of the perm

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