Background: Breast cancer is the most frequently diagnosed malignancy and the second leading cause of mortality among women in Iraq forming 23% of cancer related deaths. The low survival from the disease is a direct consequence to the advanced stages at diagnoses. Aim: To document the composite stage of breast cancer among Iraqi patients at the time of diagnosis; correlating the observed findings with other clinical and pathological parameters at presentation. Patients and Methods: A retrospective study enrolling the clinical and pathological characteristics of 603 Iraqi female patients diagnosed with breast cancer. The composite stage of breast cancer was determined according to UICC TNM Classification System of Breast Cancer and the American Joint Committee on Cancer Staging. The studied parameters comprised age of the patient, stage of the disease, marital and educational status, history of lactation and hormonal intake (for a minimum period of 6 months), family history of breast or any other cancer, the effected breast side, hormone (Estrogen and Progesterone) receptor (ER, PR) and Her2 contents of the primary cancer. Statistical analysis was performed to correlate the recorded composite stages at diagnosis with the corresponding clinical and pathological data utilizing SPSS version 16.0 statistical program. Results: Out of 603 patients, seven (1.2%) had ductal carcinoma in situ (Stage 0). Stages I, II and III and IV were documented in 9.5%, 47.1%, 33.2% and 9.1% of the patients at the time of diagnoses. Overall 70.8% of patients presented in the age group (40-59 years), 79.3% were married and 32.2% were highly educated. History of lactation, hormonal intake, family breast cancer and contralateral breast involvement was observed in 73.4%, 26.5%, 20.2% and 6.5% respectively. No correlation was elicited between the stage of breast cancer and the age of the patients, history of lactation or contralateral breast involvement. On the other hand, significant associations were demonstrated with respect to the marital and educational status, history of hormonal intake and breast cancer in the family. Immuno-histochemical evaluation revealed ER+PR+Her2+ (Triple Positive/Luminal B), ER-PR-Her2- (Triple Negative), ER+PR+Her2- (Luminal A) and ER-PR-Her2+ (Her2) subtypes in 13.4%, 11.8%, 48.2% and 9.8% of the examined breast samples respectively. When correlating the composite stage at diagnosing breast cancer with the corresponding subtypes the relationship was highly significant at p<0.01. Conclusions and Recommendations: The study reports a regression in Stage IV breast cancer at the time of initial presentation among Iraqi patients specifically in those with family history of the disease; pointing out to the fruitful outputs of initiating the National Program for Early Detection of Breast Cancer in the country. Further professional efforts, endorsed by practical policy decisions, are recommended to down stage breast cancer through promoting evidence based protocol guidelines and adopting comprehensive well designed diagnostic, screening and cancer control strategies.
Background : Although development and progress in various diagnostic methods, but still identification of remnants of skeletal and decomposing parts of human is one of the most difficult skills in forensic medicine . Gender and age estimation is also considering an important problem in the identification of unknown skull. The aims of study: To estimate volume and dimension of maxillary sinus in individuals with dentate and edentulous maxillae using CT scan, and to correlate the maxillary sinus volume in relation to gender and age. Materials and Methods : This study included 120 patients ranged from (40-69 years), divided into two groups, dentate group with fully dentate maxilla and edentulous group with complete edentulous maxilla, and e
... Show MoreBackground: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled i
... Show MoreObjective: To determine the correlation between the second derivative of digital pulse wave and the QT variability index. Method: The cross-sectional study was conducted from October 2021 to May 2022 at the Department of Physiology, College of Medicine, University of Mustansiriyah, Baghdad, Iraq, and comprised healthy women. Samples were raised by simple random technique. Digital pulse waves were captured using a fingertip pulse wave transducer. Lab Chart Pro version 7.2 was used to automatically detect and quantify the amplitude of A, B, C, D and E waves expressed by the second derivative. QT interval of each beat was recorded by electrocardiogram, and was calculated automatically via Lab chart Pro version 7.2 without averaging. D
... Show MoreThe mathematical construction of an ecological model with a prey-predator relationship was done. It presumed that the prey consisted of a stage structure of juveniles and adults. While the adult prey species had the power to fight off the predator, the predator, and juvenile prey worked together to hunt them. Additionally, the effect of the harvest was considered on the prey. All the solution’s properties were discussed. All potential equilibrium points' local stability was tested. The prerequisites for persistence were established. Global stability was investigated using Lyapunov methods. It was found that the system underwent a saddle-node bifurcation near the coexistence equilibrium point while exhibiting a transcritical bifurcation
... Show MoreConstruction projects are complicated in nature and require many considerations in contractor selection. One of the complicated interactions is that between performance with the project size, and contractor financial status, and size of projects contracted. At the prequalification stage, the financial requirements restrict the contractors to meet minimum limits in financial criteria such as net worth, working capital and annual turnover, etc. In construction projects, however, there are cases when contractors meet these requirements but show low performance in practice. The model used in the study predicts the performance by training of a neural network. The data used in the study are 72 of the most recent roadw
... Show MoreBackground: Osteoarthritis is a complicated, chronic disorder of cartilage and bone, associated with homeostasis of bio-elements. The current study aims to assess the role of serum progranulin levels among Iraqi patients with knee osteoarthritis. Patients and Methods: The study encompassed 50 patients aged 52.50 ± 3.12 years (25 males and 25 females), admitted to the at the Baghdad Medical City through the period from November 2021 to March 2022. All individuals were identified by physicians in a Rheumatology and Rehabilitation Outpatient Clinic and the clinical data was collected along with the assess¬ment of biochemical parameters. Fasting serum glucose, lipid profile, calcium, magnesium, alkaline phosphatase, vitamin D3, and p
... Show MoreBackground: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.
Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/Iraq
Material and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.
The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)
Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).
Results: Primary glomerulonephrit
Background: Assessment of function of the right side of the heart in cases of left ventricular dysfunction has been widely studied but the sensitive and specific echocardiographic parameter to be tested is still a matter of controversy. Right ventricular function is related to left ventricular function by ventricular independence so function of both should be assessed carefully. The objective of this study was to evaluate the effects of left ventricular systolic dysfunction on right ventricular systolic and diastolic functions and pulmonary pressure using conventional and tissue Doppler echocardiography. Patients and Methods: Sixty patients (39 males and 21 females) with heart failure due to left ventricular systolic dysfunction
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