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The Role of Strain Elastography in Evaluating Borderline Axillary Lymph nodes
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Background: Axillary lymph node (ALN) enlargement with diffuse cortical thickening and conserved echogenic hilum may represent a diagnostic and therapeutic challenge. Sonographic strain elastography may help the characterization of borderline ALN. 

Aim: To evaluate the strain elastography of borderline ALN and to calculate a cutoff value of strain ratio (SR) that can identify suspicious ALN with the highest sensitivity and specificity to reduce unnecessary invasive procedures. 

Subjects and Methods: A prospective study included 45 patients who attended the Breast clinic in Oncology Teaching Hospital with borderline axillary lymphadenopathy (intact hilum and diffusely thickened cortex more than 3mm) who had normal ipsilateral breast, suspicious ipsilateral breast lesion, or who had ipsilateral mastectomy. B-mode sonography and elastography were performed for all participants. Four-point elasticity score (ES), and SR were obtained for the targeted lymph node followed by ultrasound-guided fine need aspirate (FNA) biopsy..

Results: Malignant ALN constituted 20% of the cohort. B mode measurements were not able to differentiate between cytologically confirmed benign and malignant ALN in terms of axis ratio (mean ± standard deviation, 0.46 ± 0.08 vs 0.50 ± 0.12) and cortical thickness (4.88 ± 1.93 vs 6.27 ± 2.46). The mean SR of all samples was 2.66 ± 2.25.  Metastatic ALN depicted significantly higher SR (P<0.0001), with 88.9% exhibiting ES score 3 and 4. None of the metastatic ALN had ES score 1. ROC curve was used to investigate the utility of SR as a diagnostic tool. The area under the curve (AUC) was 0.906 with a 95% CI of 0.814-0.997, P<0.001. SR cutoff of 2.1 was chosen with 100% sensitivity and 66.7% specificity.

Conclusion: High proportion of borderline ALNs are not malignant. Strain elasticity can improve the risk stratification of such cases and prevent unnecessary invasive procedures. We suggested an algorithm that could better tackle borderline ALN which will need further evaluation

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Publication Date
Fri Mar 29 2024
Journal Name
Surgical Neurology International
Enhancing neuro-ophthalmic surgical education: The role of neuroanatomy and 3D digital technologies – An overview
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Background:

Neuro-ophthalmology, bridging neurology and ophthalmology, highlights the nervous system’s crucial role in vision, encompassing afferent and efferent pathways. The evolution of this field has emphasized the importance of neuroanatomy for precise surgical interventions, presenting educational challenges in blending complex anatomical knowledge with surgical skills. This review examines the interplay between neuroanatomy and surgical practices in neuro-ophthalmology, aiming to identify educational gaps and suggest improvements.

Methods:

A literature search across databases such as PubMed, Scopus, and W

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Publication Date
Mon Jan 13 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Environmental Cost Management And The Role Of Sustainable Environmental Development: بالتطبيق في مصنع اسمنت باجل
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The environmental cost management focus on continuous improvement of processes and the various activities of the organization in order to improve the environmental performance by producing an environmentally friendly products lead to a competitive advantage for the organization and supports the activities of their sustainability.

  The study was carried out in Bagel cement factory, one of the pioneer projects in Yemen in manufacturing field, The study found the need to develop a separate section for environmental management in order to put plans and environmental policies and the introduction of a special division in the Department of costs cares about Management practices cost and measure environmental costs, also give solu

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Publication Date
Mon Jan 05 2009
Journal Name
J. Duhok Univ
The role of red pigment produced by Serratia marcescens as antibacterial and plasmid curing agent
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Publication Date
Wed Apr 01 2020
Journal Name
Saudi Pharmaceutical Journal
Pharmacist role to enhance the prescribing of hospital discharge medications for patients after heart attack
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Publication Date
Fri Jun 20 2025
Journal Name
Baghdad Science Journal
The Role of Fear and Predator Dependent Refuge on a Stage Structure Prey-Predator System
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The present paper investigates the role of fear and predator dependent refuge in the prey-predator system. The system describes the interaction between prey and a stage structure of predator that incorporates Holling II functional response. The predator splits into two compartments immature (juvenile) and mature (adult). The mature predators can hunt and reproduce but this capability is not found in the immature predators, the immature depend on their parents. The growth rate of prey decreases due to the existence of mature predators. The existence, uniqueness, and boundedness of the solution of the system are investigated. Three equilibrium points of the system are determined. The local stability of the system is studied. The global stabil

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Publication Date
Tue Nov 18 2025
Journal Name
Journal Of Business Economics For Applied Research
The Relationship between Authentic leadership and Knowledge Sharing through the mediating Role of Creative work Behaviors: An applied study on a sample of managers in the Ministry of Labor and Social Affairs in Baghdad
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Publication Date
Wed May 10 2017
Journal Name
Journal Of The College Of Languages (jcl)
РОЛЬ СРЕДСТВ НАГЛЯДНОСТИ В ПРОЦЕССЕ ОБУЧЕНИЯ РУССКОМУ ЯЗЫКУ КАК ИНОСТРАННОМУ В ИРАСКОЙ АУДИТОРИИ The Role of the Use of Visual Aids in the Process Of Learning Russian Language in Lraq as a Foreign Language
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В статье рассматриваются понятие наглядности и ее классификация, эффективное применение принципа наглядности, возможность и преимущество использования наглядности и современные инструменты ее реализации в ираке.

 

Вследствие глобальных изменений во всем мире изменилась и роль иностранного языка в системе образования. Современный человек, шагающий в ногу со временем, не мыслит себя без зна

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Strategic leadership and its role in achieving competitiveness in industrial establishments": "A field study in Bashir Al-Siksik & Co. for the manufacture of sanitary and plastic tools
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This study aims to know the role of strategic leadership to achieving competitiveness in industrial establishments by identifying the respondents’ perceptions about the level of availability of dimensions of leadership strategies (creativity and innovation, risk tolerance, available opportunities) in Bashir Al-Siksek & Partners Company for the manufacture of sanitary and plastic ware in Gaza strip

To achieve this, a questionnaire was developed and distributed to a sample of managers, auditors, accountants, and administrative employees in the study sample company. The questionnaire tool was distributed to 60 employees and employees, of which (52) were retrieved, or 86.6%, and (8) were excluded for la

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The role of administrative supervision scope and the single window to increase the efficiency of investment (Case study: Sudanese Ministry of Investment)
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Investment drives the wheel of the development of different developed and developing countries. Sudan is a model for a developing country facing a lot of difficulties in the field of both local and foreign investment. The present study was focused on the problem of poor diversification and efficiency of both local and foreign investment in Sudan. Also, it clarified the important role of administrative supervision to strengthen the efficiency of investment, taking the experience of the Sudan as a model. The researchers used the well-known descriptive and analytical tools (questionnaire, interview, observation) to complete this study. A well designed questionnaire was used. It included all questions that could cover all aspects of

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Publication Date
Fri May 03 2024
Journal Name
Doklady Biochemistry And Biophysics
Superoxide Dismutase and Clopidogrel: A Potential Role in Peripheral Arterial Disease Treatment
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Oxidative stress plays a crucial role in the pathogenesis of peripheral artery disease (PAD). This study aimed to investigate the effect of clopidogrel on oxidative stress in PAD patients. Seventy subjects were divided into three groups: PAD patients before treatment (B-PAD), PAD patients after treatment with clopidogrel (A-PAD), and healthy controls. Serum levels of superoxide dismutase (SOD), copper (Cu), zinc (Zn), manganese (Mn), and oxidized protein were measured. SOD activities were also determined. The results showed that SOD activities, and SOD specific activities were significantly decreased in PAD patients compared to healthy individuals. After treatment with clopidogrel, SOD activities, and SOD specific activities were continuous

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