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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 Nov 17 2022
Journal Name
Aip Conference Proceedings
Principles of using project management tools and techniques of mitigate components causing delays and disruption in public and private construction projects in Iraq
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Delays and disruption are a common issue in both community and personal building programs The problem exists all throughout the world, but it is particularly prevalent in Iraq, where millions of dollars are squandered each time as a outcome. Delays and interruptions may have serious consequences not just for Iraq's construction plans, but also for the country's economic and social status. While numerous studies have been conducted to investigate the factors driving delays and disruption in Iraqi construction projects, slight consideration has been given to by what means project management implements and approaches have affected the occurrence of project delays and disruption. After analyzing the crucial reasons for delays and instability in

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of corporate merger in achieving synergy (Analytical research in a sample of companies of the Iraqi Ministry of Industry and Minerals)
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The research aims to shed light on the recent experience in the Iraqi business environment, which is the experience of the merger. To evaluate a recent experience in an important sector of the Iraqi business sectors, namely the industrial sector to enable decision-makers to review that experience to judge the extent of its success and address some of the lapses that experience that by measuring synergies can be judged on the success of the merger experience or not. The research community is the governmental industrial sector. The research sample included six cases of merger (14) companies before the merger. The Holt method was used to predict the net sales and total cost values ​​before the merger as if it were not merged. Th

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Publication Date
Sun Oct 09 2022
Journal Name
Chemical Methodologies
An Evaluation of the Activity of Prepared Zinc Nano-Particles with Extract Alfalfa Plant in the Treatments of Peptidase and Ions in Water
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After harvesting, Alfalfa plant was washed, dried and ground to get fine powder used in treatment water. We used alfalfa plant with ethanol to made alcoholic extract and characterized it applying (GC-Mass, FTIR, UV) spectroscopy to determine active compounds. Alcoholic extract was used to prepare zinc nanoparticle. We characterized Zinc nanoparticles by using FTIR, UV, SEM, EDX Zeta potential and AFM. Zinc nanoparticle with Alfalfa extract and alfalfa powder was used to treat pollutant water with pesticides and negative ions by two methods, namely Batch and continuous processing. Batch process was used two times firstly, with Alfalfa plant to treat water affected by pesticides and negative ions, after 1h pesticides (glyphosate 44.76%, sulfo

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Obscene speech in the Qur'anic perspective An objective study based on the verses and interpretation of the Noble Qur’an in diagnosis and treatment
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t:

The most famous thing a person does is talk. He loves and hates, and continues with it confirming relationships, and with it, too, comes out of disbelief into faith. Marry a word and separate with a word. He reaches the top of the heavens with a kind word, with which he will gain the pleasure of God, and the Lord of a word that the servant speaks to which God writes with our pleasure or throws him on his face in the fire. Emotions are inflamed, the United Nations is intensified with a word, and relations between states and war continue with a word.

What comes out of a person’s mouth is a translator that expresses the repository of his conscience and reveals the place of his bed, for it is evidence of

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Publication Date
Sat May 11 2024
Journal Name
Tech Hub Journal
The prevailing leadership Patterns and personal traits and their relationship to innovative thinking of female physical education teachers in middle schools in Baghdad
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Teachers play a critical role in planning, organizing, coordinating, monitoring, and instructing, hence the topic of leadership styles receives a lot of attention. As a result, the physical education school is regarded as the most significant component of the educational process because it has the ability to weave together the teaching and educational skills, attitudes, and capacities that its students develop. Fits into their identities through her relationship with them. Teachers play a critical role in planning, organizing, coordinating, monitoring, and instructing, hence the topic of leadership styles receives a lot of attention. As a result, the physical education school is regarded the most significant aspect in the educational proces

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
Strategic Information Systems and their effects on the Developing of Intellectual Capital in the Electricity Distribution Company in the Hashemite Kingdom of Jordan
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This research aims to study the impact of strategic information systems on the development of intellectual capital in the Public Shareholding Electricity Distribution Company in the Hashemite Kingdom of Jordan. To achieve the objectives of the study, a questionnaire was developed for the purpose of data collection, as the number of valid questionnaires for analysis was about (135), and SPSS and AMOS 0.26 software was used to analyze the collected data. The study found out that the respondents' perceptions of the level of importance of strategic information systems and the level of importance of intellectual capital were high, and that the relational capital has ranked as first, followed by structural capital, and h

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Publication Date
Fri Sep 01 2023
Journal Name
Journal Of Education And Scientific Studies
Studying the effect of laser stress in combination with mannitol on some morphological parameters of cabbage (Brassica oleracea var L. capitata) In vitro
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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a strategy (fahs) in the development of grammar skills of a sample of secondary school Female Students in Saudi Arabia
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The aim of the present research is to measure the degree of strategic effectiveness (fahs) in the development of grammar skills of high school students in the Kingdom of Saudi Arabia and to achieve the goal of the researcher the researcher used the semi-experimental approach; On ten arbitrators specializing in grammar, morphology, curricula and methods of teaching the Arabic language. After confirming the validity of the guideline, the researcher prepared an achievement test consisting of (22) paragraphs of the type of short answer and multiple choice. The researcher trained a teacher to apply the strategy to the experimental research sample using the (screening) component of (30) students, and the same parameter taught the control sampl

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Samples of Al Samarqandi’s Selection in some of Washing Laws and the touch of the Grecians Quran in his book (The scholars’ Masterpiece)
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The Research is interested in the detailed comparative study of certain selection of
Imam Alsamarqandi in some subjects of washing and touching the Gracious Quran.
The value of this study is that it is related to one aspect of the duties obliged on Muslim
like parity.
The study has tried to collect certain scholars’ opinions of eight doctrines with the
selection of Alsamarqandi to make a comp arson between them and to show how
Alsamarqandi is able to create legal laws from his sources to lead the researchers nto have
knowledge about the syllabi of the famous scientists.
Finally we ask God to bless to what is right and to accept this study and make it part of
our good deeds, Ameen.

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Publication Date
Mon Sep 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Manual proposal to audit the automated accounting system in accordance with the framework (COBIT): Applied Research in the General Company for Petrochemical Industries
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The information revolution، the new language has become one for all the peoples of the world through handling and exchange and to participate in all key areas (economic، cultural and scientific) and Accounting episode of this revolution has turned most of the traditional systems (manual) in companies to automated systems، this transformation in the regulations summoned from the auditors that develops their traditional examination automated systems so had to provide tools for auditing help auditors to keep abreast of developments and as a result there is no evidence checksum Local Private audited automated systems came search to provide evidence helps auditors for guidance as part of COBIT، which provides audit procedures Detailed inf

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