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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
Fri Feb 15 2013
Journal Name
American Journal Of Health-system Pharmacy
Pharmacy in Iraq: History, current status, and future directions
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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The role physical service factors in achieving customer satisfaction
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The development in the presentation and presentation of the service in order to distinguish them from the same, was one of the most important reasons to choose the current issue to upgrade the level of service, especially in the Iraqi restaurant sector, which has become today of the important sectors successful. The problem of research was to try to answer a range of questions: to what extent are Iraqi restaurants interested in physical service factors? Do Iraqi restaurants apply physical factors in a way that leads to customer satisfaction? Are Iraqi restaurants interested in the satisfaction of their customers? The objective of the current research is to try to determine the extent to which the

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Publication Date
Wed Nov 20 2024
Journal Name
Diabetes Mellitus
Serum visfatin in patients with type two diabetic retinopathy
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BACKGROUND: The primary cause of blindness in diabetics is diabetic retinopathy (DR), the most common microvascular complication of diabetes, and visual impairment. Visfatin is an adipocytokine that aids in insulin activity during gestational diabetes and pregnancy.

AIM: This study aimed to estimate serum visfatin levels in DR, proliferative (PDR), non-proliferative (NPDR), and healthy subjects (HS).

MATERIALS AND METHODS: A 120-patient case-control study with a history of T2DM for more than 5 years as well as 30 healthy subjects enrolled in the study. Patients group divided into three sub-groups, DM, PDR, and NPDR. Visfatin levels w

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Publication Date
Sat Apr 01 2023
Journal Name
Physics Of Atomic Nuclei
Differences in Ground State Properties of Some Mirror Nuclei
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Publication Date
Fri Aug 09 2024
Journal Name
Theory And Practice In Language Studies
Fallacy as a Strategy of Argumentation in Political Debates
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This study aims to study argumentation in political debates by figuring out the logical fallacies employed in the debates of Clinton and Trump, the presidential nominees of the 2016 elections, and Biden and Trump, the leading contenders in the 2020 United States presidential election. The study attempts to answer the questions: (1) What relevance fallacies are adopted in the debate between Trump and Clinton? (2) What rhetorical devices are used to influence the audience and gain voters besides fallacies in the debates selected? The study analyses two texts from two arguments using Damer's (2009) taxonomy of relevance fallacy and rhetorical devices based on Perrine’s (1969) model of communication and interpersonal rhetoric to answe

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Publication Date
Wed Oct 06 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Image segmentation by using thresholding technique in two stages
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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Analysis the Impact of Corruption on Investment in Iraq
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There are different types of corruptions such as administrative, political, economic and financial corruption. The corruption forms also varied such as bribery, nepotism and extortion. All types and forms of corruption play significant role in the all economic variables generally and on investments in particular, and the corruption used to be an intermediate means in reducing the rate of economic growth.  The corruption contributes in reducing the domestic investments via pay bribery by investors to officials’ persons for supplemental contracts and tenders which finally leads to reduction in the investment efficiency. The corruption also contributes in rise of operational costs for the investment projects.  In additio

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Publication Date
Thu Jun 01 2023
Journal Name
Baghdad Science Journal
Gogny interaction and nuclear charge distribution in 48Ca Nucleus
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Charge multipole Coulomb scattering form factors in 48Ca nucleus have been reproduced utilizing the theory of nuclear shell. The efficient two-body nuclear potential fpbm is considered to construct the-spin orbit term LS vectors with Harmonic Oscillator HO potential as a wave function of single particle in Fp shell. Discarded spaces ( core + higher configuration) are taken into account through the Core polarization effect by model space with accurate two-body potential of Gogny to  interact the LS operating particles with the discarded space pair ( particle-hole) with energy of excitation equal to 2ћω. Gogny interaction has been selected as it had succeeded in nuclear shell theory. The computed results were compared with th

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Publication Date
Tue Feb 04 2014
Journal Name
American Journal Of Pharmacological Sciences
Self Medication Practice among Iraqi Patients in Baghdad City
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The practice of self medication is continuously increasing worldwide due to its important roles in curing minor conditions or symptoms. This study was conducted to evaluate the factors associated with self medication practice of Iraqi respondents residing in Baghdad City. This study was designed as cross sectional study in which data was collected via direct interviews with respondents using a previously prepared questionnaire. This study investigated 348 respondents from different age groups. The majority of respondents were male aged between 30-60 years, married with secondary or academic level of education and employed with accepted monthly income. The main reason for practicing self medication was previous experience with the same condi

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Publication Date
Tue Jan 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
Phonological Metathesis in Iraqi Arabic Dialect: A Synchronic Perspective
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Phonological metathesis can be defined as an alternation in the normal sequence of two sounds under certain conditions. The present paper is intended to give a detailed synchronic description of phonological metathesis in Iraqi Arabic dialect. For data collection, the researchers have adopted two naturalistic techniques, viz., observation and notes taking. A synchronic analysis is carried out to provide some evidence that describe the sequential change of phonological metathesis in the dialect under investigation. Such sequential changes of metathesized sounds are presented and tabulated. The study concludes with the following finding that this process is not limited to cases where two consonant sounds are transposed, but three consonant

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