Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Objective: This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic. Methods: The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements. Results: Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions. Conclusion Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Objective: This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic. Methods: The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements. Results: Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions. Conclusion Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Objective: This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic. Methods: The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements. Results: Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions. Conclusion Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Objective: This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic. Methods: The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements. Results: Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions. Conclusion Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Objective: This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic. Methods: The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements. Results: Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions. Conclusion Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Ethylene glycol (EG), commonly used as antifreeze, is frequently ingested accidentally or in suicides, and causes acute renal failure. We report an unusual case of EG poisoning with acute liver injury. After vomiting and loss of consciousness, a 48-year-old male was admitted to the emergency room. Despite prompt conservative treatment for metabolic acidosis, kidney function deteriorated, necessitating the continuous renal replacement therapy. Blood toxicology results, showing EG levels of 510 mg/L, arrived 10 hours after admission. Oral ethyl alcohol therapy commenced 16 hours post-admission. By 36 hours, liver function tests indicated significant liver damage, and the patient died 45 hours upon admission. On autopsy, histological findings were hepatic centrilobular necrosis, cerebral perivascular neutrophilic and lymphocytic infiltration with calcium oxalate deposition, and renal tubular necrosis with calcium oxalate deposition. EG concentrations in the blood and gastric contents were 18.7 mg/L and 45.0 mg/L, respectively. Glycolic acid and oxalic acid, metabolites of EG produced by alcohol dehydrogenase in the liver, cause metabolic acidosis, renal tubular calcium oxalate deposition, and acute renal failure, leading to death. Generally, because fomepizole or ethyl alcohol block alcohol dehydrogenase in the liver, acute liver injury by EG poisoning is rare. To the best of authors’ knowledge, only one relevant report was found in the literature described a case in which EG caused centrilobular necrosis in liver. In the current case, delays in diagnosis and antidote therapy without gastric lavage allowed continued metabolism of EG which led to acute liver injury and acute renal failure.