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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 Mar 02 2023
Journal Name
Iar Journal Of Business Management
Reducing The Costs Of Transporting Multiple Products (Linear Transport Problems) Using Excel QM
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The transportation model is a well-recognized and applied algorithm in the distribution of products of logistics operations in enterprises. Multiple forms of solution are algorithmic and technological, which are applied to determine the optimal allocation of one type of product. In this research, the general formulation of the transport model by means of linear programming, where the optimal solution is integrated for different types of related products, and through a digital, dynamic, easy illustration Develops understanding of the Computer in Excel QM program. When choosing, the implementation of the form in the organization is provided.

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Publication Date
Fri Jan 01 2021
Journal Name
Computers, Materials & Continua
Fused and Modified Evolutionary Optimization of Multiple Intelligent Systems Using ANN, SVM approaches
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Publication Date
Sat Dec 11 2021
Journal Name
Engineering, Technology & Applied Science Research
Post-Fire Behavior of Non-Prismatic Beams with Multiple Rectangular Openings Monotonically Loaded
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The main objective of this paper is to study the behavior of Non-Prismatic Reinforced Concrete (NPRC) beams with and without rectangular openings either when exposed to fire or not. The experimental program involves casting and testing 9 NPRC beams divided into 3 main groups. These groups were categorized according to heating temperature (ambient temperature, 400°C, and 700°C), with each group containing 3 NPRC beams (solid beams and beams with 6 and 8 trapezoidal openings). For beams with similar geometry, increasing the burning temperature results in their deterioration as reflected in their increasing mid-span deflection throughout the fire exposure period and their residual deflection after cooling. Meanwhile, the existing ope

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Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of the Shapiro-Wilk test Jureckova test using simulation and multiple distributions
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 إن المقصود باختبارات حسن المطابقة هو التحقق من فرضية العدم القائمة على تطابق مشاهدات أية عينة تحت الدراسة لتوزيع احتمالي معين وترد مثل هكذا حالات في التطبيق العملي بكثرة وفي كافة المجالات وعلى الأخص بحوث علم الوراثة والبحوث الطبية والبحوث الحياتية ,عندما اقترح كلا من   Shapiro والعالم Wilk  عام 1965 اختبار حسن المطابقة الحدسي مع معالم القياس
(

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Deformability of non-prismatic prestressed concrete beams with multiple openings of different configurations
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Abstract<p>This work presents experimental research using draped prestressed steel strands to improve the load-carrying capacity of prestressed concrete non-prismatic beams with multiple openings of various designs. The short-term deflection of non-prismatic prestressed concrete beams (NPCBs) flexural members under static loading were used to evaluate this improvement. Six simply supported (NPCBs) beams, five beams with openings, and one solid specimen used as a reference beam were all tested as part of the experiment. All of the beams were subjected to a monotonic midpoint load test. The configuration of the opening (quadrilateral or circular), as well as the depth of the chords, were the varia</p> ... Show More
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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Engineering Science And Technology
Air entrained vortex occurrence at sump for inclined multiple intake pipes using cfd
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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Using Quadratic Form Ratio Multiple Test to Estimate Linear Regression Model Parameters in Big Data with Application: Child Labor in Iraq
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              The current paper proposes a new estimator for the linear regression model parameters under Big Data circumstances.  From the diversity of Big Data variables comes many challenges that  can be interesting to the  researchers who try their best to find new and novel methods to estimate the parameters of linear regression model. Data has been collected by Central Statistical Organization IRAQ, and the child labor in Iraq has been chosen as data. Child labor is the most vital phenomena that both society and education are suffering from and it affects the future of our next generation. Two methods have been selected to estimate the parameter

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Publication Date
Mon Jan 01 2024
Journal Name
Pakistan Journal Of Life And Social Sciences (pjlss)
Effect of Aromatherapy on Pain Intensity for Patients Undergoing Arterial Sheath Removal after Percutaneous Coronary Intervention: A Randomized Controlled Trial
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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Structural imbalance of Iraqi trade balance for the period (2014_1994)
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Abstract:

     The use of economic resources enjoyed Iraq by especially oil resources, which constitute the main source of financial revenue, would the economic surplus outside the oil sector increases by mobilizing and rallying the labor power and turn it into an access capitalism, , was the cause of "the inaction of the productive sectors of the economy, made the investment planning process and even investment in human capital was not rationality with the increasing number of unemployed, particularly certificates and specializations high campaign, direction of the government towards market liberalism after 2003 through the, was focused not follow a clear economic policies, and the absence of planning

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Publication Date
Mon Mar 14 2022
Journal Name
International Journal Of Health Sciences
Comparing the histological effect of Thymol from multiple sources with blood lipids profile and liver enzymes in Albino Mice
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The therapeutic value of the phenolic component and pure thymol was well known; this study comprised the extraction of crude phenol from two plants (Thymus vulgaris and Artemisia annua) which contain thymol with pure thymol and evaluate their effect on hematological and histological by using three different concentrations of each plant extract and pure thymol to tested them on lab mice. All the mice were allowed free access to water and feed for 21 days in laboratory conditions; orally, pure water was administered to the control mice (group I), while groups II, III, and IV were given orally with T. vulgaris, A. annua, combination of last two crude phenol plant extract 50:50 and pure thymol respectively. The levels of CHO, TRI, and HDL were

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