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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 Nov 13 2023
Journal Name
مجلة الدراسات المستدامة
The American-European dispute over control Spanish colonies in the Ameri
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The American-European dispute is one of the important issues that dominated international relations during the nineteenth century in particular, although the previous period witnessed the emergence of a dispute over the right to control these colonies, which the United States of America, especially after the proclamation of the Monroe Doctrine in 1823, is a natural right and that It has the ability to prevent European countries from interfering in the affairs of the American continent, so the United States of America entered into continuous disputes with European countries, which were constantly directing their eyes towards the Spanish colonies in the American continent. But the American government had priority in controlling those colonies

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Publication Date
Sat Jan 01 2022
Journal Name
Materials Today: Proceedings
Application of levofloxacin and doxycycline in treatment of vaginal chlamydial infection
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Doxycycline and levofloxacin are heterocyclic organic compounds that are now popularly used to treat some bacterial infections. In this study which was conducted on patients from a private clinic, we compared the use of two commonly used antibiotics for the treatment of diagnosed cases with vaginal chlamydial infection: levofloxacin and doxycycline. Vaginal chlamydial infection is considered to be a very common sexually transmitted infection. It may have minimal symptoms which can lead to neglect by the patient until it leads to some important complications among which is the inability to become pregnant. This indicates early diagnosis and treatment of this infection. By comparing the results of treatment we concluded that there is no much

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Bridging the Gap between Graphemes and Phonemes in the Phonetic Transcription
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Bridging the Gap between Graphemes and Phonemes in the Phonetic Transcription

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Political Thought in Russia During the 21st Century, Targets and Features
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The features of strategic thought transformation in Russia based on attempt confirm the Russian influenced on Region of Eastern Europe through series of common defense treaties and mutual security between USSR and another states this treaties emphasis size on direct Russian supervision on these states in addition, Russia in trusted to formation communism regimes in its vital space, Russia inherited the status of former USSR in political and economic levels.

           Shortly we can see that Russia witnessed large Transformation in political strategic thought as a result of change in internal strategic environment and change of nature understanding which influenced on Russia. This

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Publication Date
Sun May 01 2016
Journal Name
Iraqi Journal Of Science
Efficient text in image hiding method based on LSB method principle
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The steganography (text in image hiding) methods still considered important issues to the researchers at the present time. The steganography methods were varied in its hiding styles from a simple to complex techniques that are resistant to potential attacks. In current research the attack on the host's secret text problem didn’t considered, but an improved text hiding within the image have highly confidential was proposed and implemented companied with a strong password method, so as to ensure no change will be made in the pixel values of the host image after text hiding. The phrase “highly confidential” denoted to the low suspicious it has been performed may be found in the covered image. The Experimental results show that the covere

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Publication Date
Fri Mar 12 2021
Journal Name
Medico Legal Update
Knowledge, Awareness and Attitude of Pharmacy Students towards Epilepsy in Iraq
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Background: The undergraduate students in pharmacy colleges represent a well-educated group of thecommunity according to the use of drugs and they are required to hold the appropriate knowledge of druguse and have positive attitudes toward health problems, this good knowledge about the diseases and theirtreatment will give good pharmacists in the future and this will reflect positively on patient knowledge, andtheir compliance with treatment, this due to direct contact of pharmacists with the patients.Aim: To know the knowledge, Awareness and Attitude of a sample of Iraqi pharmacy students towardsepilepsy.Method: Cross-sectional study used a structured questionnaire validated by previous studies to collectdata about knowledge, Aware

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Publication Date
Fri Sep 25 2020
Journal Name
International Journal Of Drug Delivery Technology
Investigate Retention Behavior of 2-deoxycytidine in Hydrophilic Interaction Liquid Chromatography
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A hydrophilic interaction chromatography has been investigated to separate 2-deoxycytidine chosen for nucleoside. A small molecule with specific features for human serum samples was 2-deoxycytidine tested. 2-deoxycytidine has been applied to self-made stationary hydrophilic phases (ZIC1 and ZIC5). The deoxycytidine (dCD) retention was investigated with varying concentrations of sodium acetate buffer, acetonitrile%, and pH. The results confirmed the hydrophilicity of 2-deoxycytidine. The exchanger retention mechanism was studied taking into account 2-deoxycytidine used for describing the interaction of hydrophilic and cation. For both ZIC1 and ZIC5 exchangers, we described and discussed the influence of chromatographic conditions (co

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Publication Date
Sat Mar 01 2014
Journal Name
International Journal Of Advanced Research
Ex vivo study of the importance of sphingolipid in Leishmania amastigote
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Leishmania is the causative agent of leishmaniasis, a widely distributed disease. Amastigote forms of Leishmania are intracellular and reside within the macrophage of the vertebrate host. Previous studies showed that certain Leishmania species may scavenge host factors for survival, specially sphingolipids, the key element of the eukaryotic membranes. In this study we have investigated the survival of new world L. mexicana amastigotes in murine macrophage cell-line in the presence and absence of foetal bovine serum (FBS). Results showed that there was no significance in the infectivity of amastigotes and also the number of parasite per cell; such findings suggest that L. mexicana amastigotes have its own pathway of sphingolipid intake and c

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Research In Social Sciences & Humanities
The Role of Human Resources Management Professionals' Skills in Information Technology
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The current research aims to measure the impact of the skills of human resources management professionals in information technology in Iraqi private banks, as the skills of human resources management professionals constitute the modern trend of banks' interest in employees with outstanding performance, and the presence of information technology in banks is a prerequisite for dealing with the huge amount of data. And converting it into information to support the decision-maker in light of a complex environment, and the field research problem was the presence of a clear lack of interest in the skills of human resource management professionals and the weak adoption of information technology, which was reflected negatively on the compet

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Publication Date
Tue Dec 20 2022
Journal Name
Journal Of The College Of Languages (jcl)
A Critical Pragmatic Approach to Aggression in Moriatry's Big Little Lies
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Abstract

People are supposed to use language harmoniously and compatibly. However, aggression may characterize much of human communication. Aggression has long been recognized as a negative anti-social issue that prevails in most personal interactions. If it abounds in familial communications, it is more dangerous due to its harmful effects on individuals, and consequently on societies. Aggression refers to all the instances in which we try to get our way without any consideration for others. Moriarty’s novel (2014), Big Little Lies, is argued to represent the patterns of aggressive communications. This study aims to find out the motivations behind aggressive language in familial communication in this

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