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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 Dec 30 2024
Journal Name
Gsc Biological And Pharmaceutical Sciences
Taxonomic revision and checklist of the family (Lamiaceae) in Iraq
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The Lamiaceae L. family grows and widely distributed in Iraq. The study aimed to enumerate the species that has been preserved in several botanical herbariums: National Herbarium of Iraq- Ministry of Agriculture (BAG), University of Baghdad Herbarium (BUH), Iraq Natural History Research Center& Museum- University of Baghdad Herbarium (BUNH), College of Agricultural Engineering- University of Baghdad Herbarium (BUG), College of Agricultural Engineering Sciences- Duhok Province University Herbarium (DPUH) and College of Science - Salahddin University Herbarium (SUH). This family has not yet been registered in the Flora of Iraq. After examining more than 1000 herbarium specimens, the study found 139 species belonging to 33 genera h

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Publication Date
Sun Mar 15 2020
Journal Name
Al-academy
Expressive Discourse in the Rural Singing Form: وليد حسن الجـــــــابري
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The expressive discourse, in the form of the rural singing, is considered one of the interactive framework and the metaphorical dialogues in creating the aesthetic climate that connects the circles of its basic elements, singing, playing music, expression, costumes, sham movements and so forth.  

     The rhetorical language in this field includes all those parts and turns them into an integrated idea within the culture of the musical science, specifically the heart of the rural singing. This research dealt with a number of topics of relevance in the expressive discourse for the form of the rural singing. The first chapter consists of the methodological framework of the research, represented by the r

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Publication Date
Wed Nov 02 2022
Journal Name
Linguistics And Translation Studies
The football lexicon used in Arabic and Russian sport press
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The article is devoted to football lexicon in Arabic and Russian. The charr acteristics that determine the coincidence of lexical units in the Arabic and Russian languages are revealed. Football related words and phrases exist in different languages and in most cases they are the same. With the develop ment of football in the world and thanks to the media, new words and terms have become firmly established in the language. In Arabic, Italian and Span ish words are often used, but there are original Arabic phrases, most often consisting of two words - sports journalists and commentators actively use them. The word »mercato« was borrowed from the Italian language; in addi tion, in the Arabic language there is a phrase »Bab al-inti

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
New sizes of complete (k, 4)-arcs in PG(2,17)
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              In this paper, the packing problem for complete (  4)-arcs in  is partially solved. The minimum and the maximum sizes of complete (  4)-arcs in  are obtained. The idea that has been used to do this classification is based on using the algorithm introduced in Section 3 in this paper. Also, this paper establishes the connection between the projective geometry in terms of a complete ( , 4)-arc in  and the algebraic characteristics of a plane quartic curve over the field  represented by the number of its rational points and inflexion points. In addition, some sizes of complete (  6)-arcs in the projective plane of order thirteen are established, namely for  = 53, 54, 55, 56.

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Publication Date
Tue Sep 27 2022
Journal Name
Al–bahith Al–a'alami
Obstacles to employing social media applications in measuring public opinion
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Media and communication's research are varied in accordance to research approaches' variety which seeks to reach convergent social, psycholo

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
Symbolism in Nathaniel Hawthorne’s The House of the Seven Gables
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Nathaniel Hawthorne is famous for his psychological and moral themes. He is also famous for using symbolism in presenting his poignant themes of sin and its consequences. This research paper studies the use of symbols in Hawthorne's The House of Seven gables as an example of his general use of symbolism in his novels. The general pattern of Hawthorne's symbolism is that he presents one major symbol that embodies the main idea, and supports it with a number of minor symbols that develop and elucidate it. In The House of the Seven Gables, the major symbol is the house itself, which stands for corruption, evil, and the injustice of the past. This symbol is supported by such secondary symbols as the heart, the fountain, the

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Publication Date
Wed Oct 02 2024
Journal Name
Translation&linguistics
Verbal forms in French and Iraqi Arabic: a contrastive study
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Publication Date
Wed Jan 19 2022
Journal Name
International Journal Of Inventions In Engineering & Science Technology
Biodiversity in the Northern Region using GIS and Remote Sensing
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Biodiversity, biological diversity, biological diversity, biological diversity, biological diversity, biological diversity, biological diversity (by developmental factors) environmental factors and environmental factors environmental factors and environmental factors and environmental factors Correlation between biology and the succession of geological and historical factors of living organisms and geological and historical factors to the site and what It is surrounded by natural and tourist attractions and the pursuit of scientific methods in order to advance the studies of biological diversity in the region .

Publication Date
Fri Aug 30 2019
Journal Name
Journal Of The College Of Education For Women
Men and Women’s Education and Illiteracy in Adrar Speech Community
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In Algeria, education is compulsory for males and females. This foundational decision was taken right after the independence of the country in 1962. Soon after, in 1963, the central government decided the Arabisation of the whole educational levels starting from primary school till university. At the same period, illiteracy-eradication programmes were launched by the Ministry of Education to get rid of this post-colonial scourge. In the administrative department (or Wilaya) of Adrar, former Tuat, young males and females attend Quranic schools (Zawaya) well before any formal education, that is as early as 4-5 years of age. The adult people who are not enrolled in formal classes could sit for non-formal ones. However, actual measurements a

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Publication Date
Sat Sep 15 2018
Journal Name
Al-adab Journal
The Suicidal Vision Towards Autonomy in Marsha Norman's ‘Night, Mother’
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لقد انبثقت رؤيا حديثة في مسرح الثمانينات من القرن العشرين كان هدفها دحر حس الاسر الذي عاشه  انسان العصر الحديث وفي محاولة للارتقاء بارادته وحرية الاختيار نحو الانعتاق من محاولات المصادرة الفظة لها. وبالرغم من افتراض هذه الرؤيا انها ذات طابع سلبي, الا ان رؤيا الانتحار قدعدت بانها قادرة على ان تجعل في متناول يد الانسان احساسا طموحا بالتحكم على الاقل بنوع النهاية التي يكتبها لحياته. وقد انعكست هذة الرؤيا ال

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