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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
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The typical path of compliance control in the verification of tax revenues
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The research aims to contribute to the consolidation of scientific knowledge of compliance control and its role in verifying the proper disposal of funds to manage the wheel of the economy towards achieving targeted development and preserving public money, as well as clarifying the role of tax revenues in strengthening the public treasury and achieving social justice. The analytical descriptive approach was adopted in the process of analyzing The quantitative data collected through personal interviews, and the research reached a set of conclusions, the most important of which is the contribution of compliance control according to its three principles. (Transparency, accountability, and inclusiveness) on the availability

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Publication Date
Mon Oct 03 2022
Journal Name
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THE SEEDS OF ECOCRITICISM: A STUDY IN THE POETRY OF JOHN CLARE
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Nowadays, the worldwide issue of the environment occupies the minds not only of ecological experts and politicians but also is addressed in cultural fields and literature in particular. The conceptualization of ecocriticism, whether in the ecological field or cultural studies, has come as a response to the increasing public awareness of numerous environmental crises. Most ecocritics regard John Clare (1793-1864) as a 'proto-ecological' British poet since his poetry incorporates ecological issues which were not then categorized as they are now. The study offers a precise illustration of ecocriticism coupled with a number of the most significant ecological concepts proven in selected poems by John Clare. The ecocritical reading of Clare's po

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Publication Date
Wed Jul 10 2024
Journal Name
The Open Neuroimaging Journal
The Efficacy of Bedside Chest Ultrasound in the Detection of Traumatic Pneumothorax
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Background

Chest X-rays have long been used to diagnose pneumothorax. In trauma patients, chest ultrasonography combined with chest CT may be a safer, faster, and more accurate approach. This could lead to better and quicker management of traumatic pneumothorax, as well as enhanced patient safety and clinical results.

Aim

The purpose of this study was to assess the efficacy and utility of bedside US chest in identifying traumatic pneumothorax and also its capacity to estimate the extent of the lesion in comparison to the gold standard modality chest computed tomography.

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of quality costs in improving the quality of health services
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Improving the quality of health services in the health sector is an important and necessary matter that must be taken care of and improved, and this study seeks to demonstrate the role of quality costs in improving the quality of health services and achieving a high level of quality to satisfy the beneficiaries and to provide health services of good quality, and the research concluded that the main point of service provision Good health is the costs of prevention and evaluation (costs of quality conformity) and attention to it, and that technical competition contributes greatly to the development of the level of quality, as well as the use of health and medical staff with competent expertise, and that the costs of internal failure and th

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Publication Date
Mon Oct 20 2025
Journal Name
Al-adab Journal
The Sense of Freedom in Kate's Chopin's The Story of an Hour
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Publication Date
Tue Sep 30 2008
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
COMPUTATIONAL ANALYSIS OF THE MIXING ZONE IN THE COMBUSTION CHAMBER OF RAMJET
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A theoretical analysis of mixing in the secondary combustion chamber of ramjet is presented. Theoretical investigations were initiated to insight into the flow field of the mixing zone of the ramjet combustor and a computer program to calculate axisymmetric, reacting and inert flow was developed. The mathematical model of the mixing zone of ramjet comprises differential equations for: continuity, momentum, stagnation enthalpy, concentration, turbulence energy and its dissipation rate. The simultaneous solution of these equations by means of a finite-difference solution algorithm yields the values of the variable at all internal grid nodes.
The results showed that increasing air mass flow (0.32 to 0.64 kg/s) increases the development o

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Publication Date
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
Evaluation of the Ecosystem Services of the Central Marsh in Southern Iraq
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Ecosystems provide humans with services that include benefits from food, fresh water, climate regulation, and socio-economic assets. The Mesopotamian marshlands are among the largest wetlands in the Middle East and they provide various benefits. However, ecosystem services of the Marshlands are consistently undervalued in national economic analysis and decision making. This study focusses on the Central Marshes, the first National Park in Iraq, and is the first attempt at valuing a series of ecosystem services from a valuable natural ecosystem in Iraq. We adopted the Toolkit for Ecosystem Services Site-Based Assessment (TESSA) for the determination of biophysical and economic values of services at the site level. Data on key ecosystem se

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Publication Date
Tue May 12 2009
Journal Name
World Environmental And Water Resources Congress 2009
Modeling the Evolution of Incised Streams in Hammar Mesopotomian Marsh with Emphasis on the Contribution of Tidal Flow in the Filling Requirements
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Publication Date
Thu Jul 30 2020
Journal Name
Journal Of Sustainability Science And Management
THE DIFFERENTIATION IN WORK ENRICHMENT STRATEGIES AND ORGANIZATIONAL CREATIVITY FUNCTION: A PERSPECTIVE FROM THE LEADERS OF THE MINISTRY OF OIL IN IRAQ
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Publication Date
Mon Oct 19 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The effect of using the interactive video accompanying the static training in learning some basic skills of a model school in squash
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Lately great interests have emerged to find educational alternatives to teach and improve motor skills according to modern educational methods that take into account individual differences and speed in learning for the learner through individual learning that the learner adopts by teaching himself by passing through various educational situations to acquire skills and information in the way he is The learner is the focus of the educational process and among these alternatives the interactive video, the researchers noted through the educational training units at the Model Squash School of the Central Union, and that most of the methods and methods used in learning basic skills take a lot of time in the educational program and do not involve

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