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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 Jun 30 2023
Journal Name
حوليات أداب عين شمس
Peace building in Multiple Communities: South Africa is a case study
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المستخلص [English] Peace-building is a science that has its foundations and needs mechanisms, components, studies and plans based on the needs of the parties responsible for achieving peace and meeting the necessary needs of conflict societies, as it has become a goal sought by many local and regional actors and parties. The State of South Africa has realized this fact and has devoted space in its conception and planning to addressing the issues of conflict and war within the framework of its unitary work.Since security and stability in general seek to create peaceful and legal means through which existing problems can be expressed and addressed. The differences have varied to build peace and create cooperation between groups and th

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Publication Date
Sat Jan 01 2022
Journal Name
Archives Of Civil Engineeringthis Link Is Disabled
Factors affecting time and cost trade-off in multiple construction projects
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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of Estimates Nonparametric In Multiple Regression Analysis Function (Gamma ,Beta)
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The use of non-parametric models and subsequent estimation methods requires that many of the initial conditions that must be met to represent those models of society under study are appropriate, prompting researchers to look for more flexible models, which are represented by non-parametric models                  

          In this study, the most important and most widespread estimations of the estimation of the nonlinear regression function were investigated using Nadaraya-Watson and Regression Local Ploynomial, which are one of the types of non-linear

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Multi – Linear in Multiple Nonparametric Regression , Detection and Treatment Using Simulation
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             It is the regression analysis is the foundation stone of knowledge of statistics , which mostly depends on the ordinary least square method , but as is well known that the way the above mentioned her several conditions to operate accurately and the results can be unreliable , add to that the lack of certain conditions make it impossible to complete the work and analysis method and among those conditions are the multi-co linearity problem , and we are in the process of detected that problem between the independent variables using farrar –glauber test , in addition to the requirement linearity data and the lack of the condition last has been resorting to the

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The role of the Arab tribe Rabi’a in the Umayyad period: The role of the Arab tribe Rabi’a in the Umayyad period
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Abstract:
This tribe had lived in Iraq since the first century A.D. Persia tried to
keep this tribe away from Iraq, but without result. The tribe managed to get
victory against Persia in the battle of Dhyqar.
When the Muslims had come to conquer Iraq, Rabi’a welcomed them
and takes part in that action.
That tribe helped the caliph Ali in the Jammal and Sifffen wars in order
to remain Iraq the center of the Islamic caliphates this tribe had felt very sad
and sorrowful when the caliphate become to the Umayyad . This tribe did not
give up, so this tribe did what could be done to help those who had revolted
against the Umayyad. Rabi’a did that in order to get ride of the Mudriat alsham,
and favored Rabi

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Investigating Iraqi EFL College Students’ Multiple Intelligences
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Various theories on learning have been developed with increasing frequency in the last
few decades. In tandem with this, Multiple Intelligence theory appeared as a new approach to
education as well as an important theory in the field of language learning. Gardner explains
that all human beings have different intelligence fields and a potential to develop them. These
intelligences are (verbal-linguistic, logical-mathematical, visual-spatial, musical, bodilykinesthetic,
interpersonal, intrapersonal, naturalistic, and Existential).
This study aims at investigating Multiple Intelligences of Iraqi college EFL students. To
achieve the aims of the study, a questionnaire is adopted according to Birmingham model
which incl

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Publication Date
Sat Mar 04 2023
Journal Name
Baghdad Science Journal
Generalised Henstock - Kurzweil Integral with Multiple Point
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This paper deals with a new Henstock-Kurzweil integral in Banach Space with Bilinear triple n-tuple and integrator function Ψ which depends on multiple points in partition. Finally, exhibit standard results of Generalized Henstock - Kurzweil integral in the theory of integration.

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Publication Date
Thu Feb 18 2021
Journal Name
Journal Of Optical Communications
Theoretical investigation of multiple input–multiple output (MIMO) technique for line of sight (LoS) underwater wireless optical communications system
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Abstract<p>In this paper, a theoretical investigation was suggested to study underwater wireless optical communication (UWOC) system based on multiple input–multiple output (MIMO) technique. The modulation schemes such as RZ-OOK, NRZ-OOK, 32-PPM and 4-QAM applied under different coastal water types. MIMO technique enabled the system to transmit data rate with longer distance link. The performance of the proposed system examined by BER and data rate as a metrics. Several impairments such as the types of water by the attenuation of coastal water and the distance link were taken into account for the transmission of the optical signal to appreciate the reliability of the MIMO technique. The theore</p> ... Show More
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Publication Date
Mon Aug 30 2021
Journal Name
Al-kindy College Medical Journal
Diagnostic Evaluation of Uterine Artery Doppler Imaging for the Prediction of Early Abnormal Pregnancy
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Objective: to assess the predictive value of Doppler imaging of the uterine artery in the identification of early intrauterine abnormal pregnancy as compared to a normal intrauterine pregnancy. Subjects and methods: one hundred and twenty pregnant ladies, at their 6-12 weeks of gestation, with a singleton pregnancy were included in this population-based case-control study. Thirty women with a missed miscarriage, 30 with hydatidiform mole, 30 with a blighted ovum, and 30 as a control group, without risk factors, underwent Doppler interrogation of the uterine arteries. Resistive index (RI), pulsatility index (PI), and the systolic/diastolic ratio (S/D) were measured for both sides. The t-test, or ANOVA test when appropriate, was

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Publication Date
Thu Jun 15 2023
Journal Name
Romanian Neurosurgery
A giant A4-A5 distal anterior cerebral artery aneurysm treated with microsurgical clip reconstruction
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Background. Aneurysms of the distal anterior cerebral artery (DACA) are uncommon; they often form near the pericallosal-callosomarginal junction and are typically small. To our knowledge, giant DACA aneurysms developing from the more distant parts of the anterior cerebral artery (ACA), A4-5, have been described only once in the literature. Case description. A 66-year-old gentleman reported with a brief loss of consciousness followed by weakness in his right lower leg. The patient was admitted with a Glasgow Coma Score (GCS) of 15. A computed tomography (CT) scan of the head revealed a left hyperdense mass in the frontal parasagittal supracallosal region. Contrast MRI revealed a heterogeneously enhancing mass measuring 35x30x25 mm. C

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