We describe a large functioning non metastasizing ACC in 8 years old boy who presented with a history of precocious puberty noticed by his parents since 3 months .Ultrasound of the abdomen showed a large well defined right suprarenal mass with calcification and necrosis . MRI  showed  the mass to be hypojntense to liver on T1 and   hyperintense  to liver on T2, and  dynamic CT scan revealed a large hetrogenous  enhancing right suprarenal mass with calcification and necrosis , clear chest .Histopathology done after surgical removal reveal adrenocortical carcinoma,so we recommend to do an abdominal ultrasound to any child with precocious puberty because it is easy,cheap and non invasive , if any suprarena

Fibro-adenoma is the most common lesion of the breast, it occurs in25%of asymptomatic women (1,2 )
It is usually a disease of early reproductive life, the peak incidence is between the ages15 and 35 years.(3,4) It presents as firm highly mobile, non tender mass .(5)
Less than 5% of fibro-adenomas grow rapidly and display the clinical and histologic characteristics of giant fibro-adenoma which is defined as a-tumour either having a diameter greater than 5 cm. And /or amass weighing more than 500 grams, and are conventionally a benign tumor of breast.(6)
Giant fibro-adenomas appear as well-circumscribed but not encapsulated masses on mammography and solid and the texture is homogenous and hypoechoic with low level echoes on U/S. (

We describe here a case of a 70 yr old man with long-standing rheumatoid arthritis who presented with low grade fever, fatigue, loss of appetite and weight, bluish discoloration of the fingers and patches of gangrenous skin on the fingers. There was intense pain in the fingers which prevented him from sleep. Along with these symptoms he developed loss of sensation in the dorsum of left foot, then left foot drop. We give below full account of the case and review of the causes of vasculitis. We want to emphasize on the importance of identifying vasculitis as one of the complications of rheumatoid arthritis and intensive treatment of this complication, as it is a life-threatening complication.

Introduction:

Renal artery aneurysm (RAA) occurs to focal dilatation of artery secondary to weakness of the arterial intima and media. RAA is a rare clinical entity with an incidence of 0.01 – 1%.1

Rupture RAA during pregnancy is extremely rare event. The obstetric and urologic literatures are deficient in this regard. Diagnosis of ru

Background: This study aimed to evaluate the outcome of long-term results of dacryocystorhinostomy (DCR) techniques in specialized eye care center in Iraq.

Subjects and Method: This is a prospective study of 650 patients from July 2014 to July 2019 with nasolacrimal duct obstruction in Ibn Al Haitham Eye Teaching Hospital. A preoperative questionnaire was done, then one month, three months, six months and one year postoperatively. The success of surgery defined as follow; Absence of epiphora completely, Resolve of dacryocele or mucocele or any new attack of daryocystitis, Appearance of fluorescein dye from nose in fluorescein disappearance test, Successful irriga

Background: Routine use of nasogastric tubes, after abdominal operations, is intended to hasten the return of bowel function, prevent pulmonary complications, diminish the risk of
anastomotic leakage, increase patient comfort and shorten hospital stay. Aim of this study is to evaluate the efficacy of routine nasogastric decompression after abdominal surgery, in
achieving each of the above goals.
Patients and methods:Two hundred and twelve patients having abdominal operations of any type, emergency and elective have been followed prospectively over a period of three years (1st December 2004 until end of December 2007) in Baghdad teaching hospital. Patients were randomized into two groups. Group 1 had naso

         Bringing about urban, economic, and social changes in rural areas similar to those occurring in urban areas aims to reduce urban-rural disparities by providing services in those areas, decentralizing the management of these services, expanding citizen participation in local governance (decentralized administration), and achieving comprehensive development, developing and empowering localities, and keeping pace with new transformations and their impacts on the functions of the center and localities. In fact, the lack of clarity of the role of local government in planning and managing services has hindered development plans, and declined the level of services in rural areas, and has negative

In this case report we discuss essential issue to be considered with regard to the clinical genetic testing in the epilepsies. The identification of genes that influence risk for the epilepsies has extremely important implications for both research and clinical practice. In a research context, information obtained may lead to the development of new treatments targeted to specific mechanisms, or even to ways of preventing epileptogenesis. In clinical practice, the use of genetic information can either clarify the diagnosis in people already known or suspected to have epilepsy (diagnostic testing), or to predict onset of epilepsy in people at risk of developing epilepsy because of a family history (predictive testing). This 8-year old girl

Aim: is to report a case of trans-oral pin, penetrating base of skull and upper cervical region, which is rarely reported in the literatures and to compare it with other studies reporting similar case.
Patients Methods: the details, the presentation, both clinical and radiological finding, and surgical approach of such a case are presented.
Results: the diagnosis was verified with plain x-rays and C.T. scan with bone study. Surgery was conducted under G.A., the patient was recovered well without neurological deficit.
Conclusion: meticulous and close pre-operative care with safe operator and careful fellow up is mandatory. Surgery only offers the best chance of care.

Background: Urinary tract infection is a highly prevalent disease all over the world and affects females more than males. In the former, it may complicate pregnancy to potentially lethal septicaemia. Therefore, the aim of current case report was to show how misinterpretation of symptoms of septicaemia can lead to inadequate, and probably inappropriate, management with subsequent medico-legal consequences. Methods: A case study of a young pregnant female who developed urinary tract infection and treated with parenteral cephalosporins. The infection developed into septicaemia with subsequent miscarriage and death of the patient. Discussion: Misinterpretation of the symptoms of septicaemia