Early repolarization (ER) changes, characterized by J point elevation with or without ST-segment elevation, are dynamic in their presentation and can be exacerbated by factors such as hypothermia, hypercalcemia, vagotonia, and certain medications. There is limited research regarding the mechanism of these changes and the dynamic changes of ER secondary to diabetic ketoacidosis (DKA). This case report highlights the augmentation of early repolarization changes resembling ST-segment elevation myocardial infarction (STEMI) in a patient with DKA that resolved with the treatment of acidosis. The misinterpretation of ER changes on electrocardiogram (ECG) as STEMI or pericarditis may result in the inappropriate utilization of resources, increased patient risk, and elevated morbidity and mortality. Recognition of the potential of DKA to cause ER changes can potentially avoid these unfavorable outcomes.

“Ancient Armenian Geography” (or “Ashkharatsuits”, literally — “World Map”) calls Phrygia the fifth among all the countries of Universal Asia, which is located between Lycia and Paphlagonia. Partly based on “The Geography” by Ptolemy, “Ancient Armenian Geography” complements the Greek author with its information. Outlining the borders of Phrygia, “Ashkharatsuits” shows the territorial limits that this state reached in the first half of the I millennium BC (especially in the 8th–6th centuries). These centuries can be characterized as the “golden era” of Phrygia since almost all of western Asia Minor was part of this kingdom, and Phrygia reached its apogee during this period. The authors of the Armenian source do not mention any historical person and speak exclusively about geography (administrative territorial divisions, urban map orography, hydrography, plains, etc.). All the data of the Armenian text have been scrupulously examined and compared/collated with the information of Ptolemy, as well as with the information ranging from the Bible and Strabo’s “Geography” to the works of the Roman historian Ammianus Marcellinus. Only a hermeneutic approach to the issue will make it possible to remove all the “brackets” since if the main text of “Ashkharatsuits” was written in the 5th century by Khorenatsi, then from a geographical perspective the source was supplemented in the 7th century by Shirakatsi. Information about the administrative division of Onoratia is also important, as well as its historical and geographical description — all this sheds light on the problem of studying both Onoratia and Phrygia. “Ashkharatsuits” traces the evolution undergone by Phrygia during its history.

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Introduction: Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, EMS physicians are trained in a variety of specialties. Armenia is also a country prone to disasters, and recently, the Armenian EMS system was challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic. Study Objective: This study aims to assess the current state of disaster preparedness of the Armenian EMS system and the effects of the simultaneous pandemic and war on EMS providers. Methods: This was a cross-sectional study conducted by anonymous survey distributed to physicians still working in the Yerevan EMS system who provided care to war casualties and COVID-19 patients. Results: Survey response rate was 70.6%. Most participants had been a physician (52.1%) or EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%). Experience in battlefield medicine was limited prior to the war, with the majority reporting no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing surgical procedures (52.1%), and many reporting minimal to no experience in treating gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%). Participants had moderate experience in humanitarian medicine prior to war. Greater experience in battlefield medicine was found in participants with more than three years of experience as a physician (z-score -3.26; P value <.01) or as an EMS physician (z-score -2.76; P value <.01) as well as being at least 30 years old (z-score -2.11; P value = .03). Most participants felt they were personally in danger during the war at least sometimes (89.6%). Conclusion: Prior to the COVID-19 pandemic and simultaneous 2020 Nagorno-Karabakh War, EMS physicians in Armenia had limited training and experience in Disaster Medicine. This system, and the frontline physicians on whom it relies, was strained by the dual disaster, highlighting the need for Disaster Medicine training in all prehospital medical providers.

The reign of the kings of the Artashes dynasty in ancient Armenia from the beginning of the II century B.C. E. was a turning point for the country in many spheres of life, including religion. In Armenia, as in all countries of the Near and Middle East, the cults of Greek gods were widespread. Armenian historian of the 5th century Movses Khorenatsi singles out the goddess Artemis (Artemis) among all Greek gods, who, as demonstrated in the work, not only complemented the functional characteristics of the Armenian gods, but also successfully syncretized with the Armenian pantheon.