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The primary objective of this article is to examine the effect of discrete heating on MHD double-diffusive convection and thermal radiation of ternary hybrid nanofluid flow heat and mass transfer in a vertical cylindrical annulus along with Arrhenius activation energy and chemical reaction. In this study, the cavity inner wall has two distinct flush-mounted heat sources, while the outer wall is isothermally cooled at a lower temperature. The top and bottom walls are thermally insulated. The ensuing equations that govern the physical framework are solved using the implicit Crank-Nicholson finite difference technique. As the heater advances upward, the flow intensity decreases, leaving a part of the fluid static at the bottom of the cylinder. Because more heat induces high buoyant flow in the annulus, the absolute value of axial velocity and wall temperature rises as the length of the heat source rises. Enhancing the values of activation energy parameter drops the Arrhenius energy function, elevating the pace of the generative chemical process and hence the concentration. Increasing the thermal radiation parameter lowers the surface heat flux while enhancing the nanofluid temperature. The Brownian motion parameter corresponds to the random motion of nanoparticles in a fluid, and this irregular movement augments the collision of nanoparticles with fluid particles, causing the particle's kinetic energy which leads to thermal energy and hence increases temperature. Also, the heat and mass transfer characteristics are forecasted and analyzed by considering the Levenberg–Marquardt backpropagating artificial neural network technique.

Abstract Background: The occurrence of native coronary artery vasospasm after coronary artery bypass grafting (CABG) is a rare phenomenon with potentially catastrophic outcomes. The absence of a clear understanding of contributing factors and an undetermined occurrence rate underscores the importance of coronary angiography as the primary diagnostic tool for this condition. Case Presentation: We present the case of a 70-year-old Asian male with a 14-year history of diabetes mellitus, seven years of Giant Cell Arteritis (GCA), and Ischemic Heart Disease (IHD). The patient experienced severe native coronary artery vasospasm following conventional CABG, prompting intervention through coronary angiography. Management & Results: The patient underwent coronary angiography, revealing multivessel coronary artery vasospasm. Intracoronary administration of nitroglycerin and diltiazem was initiated promptly. The swift identification and treatment of vasospasm were instrumental in preventing severe myocardial injury. Conclusion: Coronary artery vasospasm post-CABG poses a significant threat, emphasizing the need for early identification and intervention. The successful management presented in this case underscores the importance of timely recognition and the administration of vasodilators in mitigating potential myocardial damage. This report contributes to the growing understanding of this rare but critical complication, highlighting the necessity for vigilance in post-CABG patient care.

Cardiovascular diseases are among the top leading causes of death worldwide. Most of the time, the patients present with no symptoms, or some symptoms resemble other diseases. This makes most cases challenging for physicians and healthcare workers to diagnose. Besides this, most of the time, not diagnosing the patient on time or delay in the start of intervention is the main cause of death in cardiovascular diseases. Proper history and examination can play a crucial role in this part. History taken in properly can help in reaching the diagnosis. Apart from this, it also helps in the start of empirical therapy. This is where most clinicians are lacking. Waiting for the labs is still time-wasting in other health issues, but it can be killing in cardiac patients. Thus the cardiologist needs to start with a good history and then go on with examinations. Then confirm their findings with the proper labs. This narrows down the diagnosis and saves a lot of time. History-taking is the most important clinical step in the management of patients. But most of the time, it is underrated, and most clinicians rely on labs rather than these basic skills. This article thus reviews the importance of history-taking in diagnosing patients with cardiovascular diseases. Besides this, it also addresses how a good history should be taken to narrow down the diagnosis and reach the proper diagnosis within time to save a patient's life.