Epidemiological Study of CA Breast in Diyala Ibrahim Ahmed, Rihab; Ahmed Shakir, Shahab; Tyeyab Hamad, Mohamad ...
Diyala Journal of Medicine,
6/2022, Volume:
22, Issue:
2
Journal Article
Peer reviewed
Open access
Background: Breast cancer is becoming the most common cancer among women in both developed and developing countries . Breast cancer has been the leading cause of death among Iraqi women for three ...decades, and it is the second leading cause of death after cerebrovascular illnesses.Objective: To investigate the epidemiological and clinic pathological behavior of breast cancer in Diyala province.Patients and Methods: A retrospective cross-sectional study conducted at the Oncology Clinic of Baquba Teaching Hospital for 24 months between April 1st and March 31st, 2021. A sample of (257) patients was selected to collect socio-demographic information (age, gender, marital status, history of breast lactation ,history of contraceptive pills, history of breast cancer in family, parity status). Results: The current study shows that more than 55% of the patients were under the age of (50) years. Two hundred fifty one patients (97.6%) were female and( 6) patients (2.4%)were male. from the 251 female patient . Right breast tumor was found in 120 patients (48%) and left breast tumor was found in (127) patients (50.4%) and bilateral breast tumor in (4) patients(1.6%). In terms of breast cancer family history, 28 patients(11%) had a positive family history, while 223 patients (89%) had a negative family history. One hundred fifty seven of patients(63%) had history of breastfeeding and( 94) of patients(37%) had no history of breastfeeding . One hundred forty six patients (58%) had positive history of oral contraceptive pill while 105 patients (42%) had negative history of oral contraceptive pill. twenty two patients (9%) had positive history of smoking while (229) patients (91%) had negative history of smoking . The histopathological result were Invasive ductal carcinoma (I.D.C) in (233) patients (93%) and Invasive lobular carcinoma (I.L.C) in (18) patients. Breast cancer patients were married in 73% of cases, widowed in 13.5 percent of cases, divorced in 2.5 percent of cases, and single in 11% of cases. Most cases belonged to differentiation stage II ( 159) patients (63%), followed by stage III ( 57) patients (23%) , stage I ( 13) patients (5%) and stage IV (22) patients(9%) . Conclusion: The current study concludes that In Iraq, the majority of breast cancer patients were in the second stage, and patients' ages at diagnosis were younger than in other communities. The development and execution of screening programs, as well as the management of risk factors, appear to be critical. Keywords: Breast, Cancer, Patients
Epidemiological Study of CA Breast in Diyala Rihab Ibrahim Ahmed; Shahab Ahmed Shakir; Mohamad Tyeyab Hamad ...
Diyala Journal of Medicine,
06/2022, Volume:
22, Issue:
2
Journal Article
Peer reviewed
Open access
Background: Breast cancer is becoming the most common cancer among women in both developed and developing countries . Breast cancer has been the leading cause of death among Iraqi women for three ...decades, and it is the second leading cause of death after cerebrovascular illnesses. Objective: To investigate the epidemiological and clinic pathological behavior of breast cancer in Diyala province. Patients and Methods: A retrospective cross-sectional study conducted at the Oncology Clinic of Baquba Teaching Hospital for 24 months between April 1st and March 31st, 2021. A sample of (257) patients was selected to collect socio-demographic information (age, gender, marital status, history of breast lactation ,history of contraceptive pills, history of breast cancer in family, parity status). Results: The current study shows that more than 55% of the patients were under the age of (50) years. Two hundred fifty one patients (97.6%) were female and( 6) patients (2.4%)were male. from the 251 female patient . Right breast tumor was found in 120 patients (48%) and left breast tumor was found in (127) patients (50.4%) and bilateral breast tumor in (4) patients(1.6%). In terms of breast cancer family history, 28 patients(11%) had a positive family history, while 223 patients (89%) had a negative family history. One hundred fifty seven of patients(63%) had history of breastfeeding and( 94) of patients(37%) had no history of breastfeeding . One hundred forty six patients (58%) had positive history of oral contraceptive pill while 105 patients (42%) had negative history of oral contraceptive pill. twenty two patients (9%) had positive history of smoking while (229) patients (91%) had negative history of smoking . The histopathological result were Invasive ductal carcinoma (I.D.C) in (233) patients (93%) and Invasive lobular carcinoma (I.L.C) in (18) patients. Breast cancer patients were married in 73% of cases, widowed in 13.5 percent of cases, divorced in 2.5 percent of cases, and single in 11% of cases. Most cases belonged to differentiation stage II ( 159) patients (63%), followed by stage III ( 57) patients (23%) , stage I ( 13) patients (5%) and stage IV (22) patients(9%) . Conclusion: The current study concludes that In Iraq, the majority of breast cancer patients were in the second stage, and patients' ages at diagnosis were younger than in other communities. The development and execution of screening programs, as well as the management of risk factors, appear to be critical.
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Thromboprophylaxis and anticoagulant therapy face serious medical challenges in terms of how crucial it is to maintain therapeutic activity of the anticoagulant agent over the ...required period of time. Failure to do so will lead to an increased risk of clot propagation if a subtherapeutic drug level is reached. On the other hand, higher-than intended anticoagulation levels might lead to an enhanced risk of hemorrhagic complications. Nanocomplexes (NCs) for the controlled delivery of the antithrombotic Enoxaparin (Enox) with dextran sulfate (DS) and chitosan (CS) were formulated, in an attempt to circumvent therapeutic and compliance challenges associated with the prolonged administration of the current dosage form. Using polyelectrolyte complexation method, various fabrication and formulation parameters were tested. Assessment of ex-vivo stability of selected formulae in rat serum was done prior to determination of their pharmacokinetic profile.
High EE% was achieved in all systems prepared. In absence of DS, target size was obtained when 0.54mg/mL CS at an initial pH of 5 and Enox to CS mass ratio of 1:2.5 were employed at room temperature. These parameters were shifted to new optima upon introduction of DS. The anticoagulant activity of NCs (in absence/presence of DS) was significantly sustained compared to the market product (135 and >144h versus 5h, respectively).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK, ZRSKP
Malaria caused by Plasmodium falciparum parasite is still known to be one of the most significant public health problems in sub-Saharan Africa. Genetic diversity of the Sudanese P. falciparum based ...on the diversity in the circumsporozoite surface protein (PfCSP) has not been previously studied. Therefore, this study aimed to investigate the genetic diversity of the N-terminal region of the pfcsp gene.
A cross-sectional molecular study was conducted; 50 blood samples have been analysed from different regions in Sudan. Patients were recruited from the health facilities of Khartoum, New Halfa, Red Sea, White Nile, Al Qadarif, Gezira, River Nile, and Ad Damazin during malaria transmission seasons between June to October and December to February 2017-2018. Microscopic and nested PCR was performed for detection of P. falciparum. Merozoite surface protein-1 was performed to differentiate single and multiple clonal infections. The N-terminal of the pfcsp gene has been sequenced using PCR-Sanger dideoxy method and analysed to sequences polymorphism including the numbers of haplotypes (H), segregating sites (S), haplotypes diversity (Hd) and the average number of nucleotide differences between two sequences (Pi) were obtained using the software DnaSP v5.10. As well as neutrality testing, Tajima's D test, Fu and Li's D and F statistics.
PCR amplification resulted in 1200 bp of the pfcsp gene. Only 21 PCR products were successfully sequenced while 29 were presenting multiple clonal P. falciparum parasite were not sequenced. The analysis of the N-terminal region of the PfCSP amino acids sequence compared to the reference strains showed five different haplotypes. H1 consisted of 3D7, NF54, HB3 and 13 isolates of the Sudanese pfcsp. H2 comprised of 7G8, Dd2, MAD20, RO33, Wellcome strain, and 5 isolates of the Sudanese pfcsp. H3, H4, and H5 were found in 3 distinct isolates. Hd was 0.594 ± 0.065, and S was 12. The most common polymorphic site was A98G; other sites were D82Y, N83H, N83M, K85L, L86F, R87L, R87F, and A98S. Fu and Li's D* test value was - 2.70818, Fu and Li's F* test value was - 2.83907, indicating a role of negative balancing selection in the pfcsp N-terminal region. Analysis with the global pfcsp N-terminal regions showed the presence of 13 haplotypes. Haplotypes frequencies were 79.4%, 17.0%, 1.6% and 1.0% for H1, H2, H3 and H4, respectively. Remaining haplotypes frequency was 0.1% for each. Hd was 0.340 ± 0.017 with a Pi of 0.00485, S was 18 sites, and Pi was 0.00030. Amino acid polymorphisms identified in the N-terminal region of global pfcsp were present at eight positions (D82Y, N83H/M, K85L/T/N, L86F, R87L/F, A98G/V/S, D99G, and G100D).
Sudanese pfcsp N-terminal region was well-conserved with only a few polymorphic sites. Geographical distribution of genetic diversity showed high similarity to the African isolates, and this will help and contribute in the deployment of RTS,S, a PfCSP-based vaccine, in Sudan.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The objective of this study was to assess the diagnostic efficacy of combined computed tomography (CT) and magnetic resonance imaging (MRI) in detecting metastases of oral cancers to lymph nodes in ...the neck.
In total, 105 patients with previously untreated oral squamous cell carcinoma underwent both CT and MRI within 6 weeks before tumor excision and selective neck dissection. The diagnostic efficacy of combined CT and MRI was compared with published data on the efficacy of CT and MRI alone.
The sensitivity, specificity, positive and negative predictive values, and accuracy of diagnosis based on CT and MRI were 80%, 90%, 80%, 90%, and 87%, respectively. These values were similar to or higher than those reported in a meta-analysis for CT or MRI alone. The highest and lowest sensitivities were found for metastatic nodes at levels I (75%) and III (33%). The highest and lowest specificities were discovered for nodes at levels IV (99%) and I (88%).
Combined CT and MRI may be superior to a single modality alone in detecting metastatic neck nodes. This may have an advantage in both preoperative planning and neck surveillance in superficial oral cancers.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
Background: Increased myocardial fibrosis in hypertension leads to abnormalities in left ventricular diastolic function. 3D-speckle-tracking imaging (3D-STI) is a primary imaging modality used to ...detect early changes in the left ventricle (LV). The aim of this study was to assess the left ventricular myocardial function in hypertensive patients using 3D-speckle tracking imaging (3D-STI). Methods and Results: A case control, nonintervention, descriptive study was conducted in the Department of Ultrasound Diagnosis of Union Hospital of Tongji Medical College of Huazhong University of Science and Technology (Wuhan, Hubei, China). The study subjects included 64 patients with hypertension (HT) and, as control group, 44 normotensives. HT patients were divided into HT-I group (SBP of 130-139 mmHg or DBP of 80-89 mmHg, and HT-II group (SBP >140 mmHg or DBP >90 mmHg). In this study, LV geometry and function were assessed using conventional 2D- and 3D-echocardiography in a total of 108 consecutive subjects. LV volumes, global and regional strains were measured using 3D-STI. LV ejection fraction (LVEF) was in normal range in three groups, but in general, it slightly decreased in HT-II patients, compared with control and HT-I groups (62.5±2.1%, 68.0±2.2%, and 67.5±1.3%, respectively, P=0.00). Global systolic strain demonstrated a significant decrease in GLS, GCS, and GRS in the HT-II group, compared with control and HT-I groups. All regional strain parameters (longitudinal, circumferential, and radial) significantly decreased in HT-II patients, compared with control and HT-I groups. Conclusion: A significant deterioration of global LV systolic functions is found in hypertensive patients with well-preserved LVEF, especially in patients with hypertension stage II.
Objective: This review article was conducted to highlight both viral and fungal foodborne situations in Sudan and their health impacts aiming to help health policymakers in introducing strict ...intervention measures. Method: The review uses up-to-date data via manual screening of the titles and abstracts of retrieved articles using string foodborne diseases in Sudan and foodborne illnesses as keywords to obtain publications from the electronic databases PubMed, Scopus, and Google Scholar from the year 2000-2020 using the publish or perish tool, the databases were reviewed from January to April 2022. Results: Foodborne viruses and Mycotoxins produced by certain fungi; are considered among the top priorities and have become of great concern to the food industry over the last few years because their contamination can occur at any point in the nutritional supply chain besides their serious effects on human health both long and short term. Conclusion: The review on major food borne viral and fungal diseases in Sudan is an important issue to guard against contamination with such micro-organisms and prevent their illnesses.
Background
Although Subarachnoid Hemorrhage (SAH) is an emergency condition, its epidemiology and prognosis remain poorly understood in Africa. We aim to explore the clinical presentations, outcomes, ...and potential mortality predictors of primary SAH patients within 3 weeks of hospitalization in a tertiary hospital in Sudan.
Methods
We prospectively studied 40 SAH patients over 5 months, with 3 weeks of follow-up for the symptomatology, signs, Glasgow coma scale (GCS), CT scan findings, and outcomes. The fatal outcome group was defined as dying within 3 weeks.
Results
The mean age was 53.5 years (SD, 6.9; range, 41–65), and 62.5% were women. One-third (30.0%) were smokers, 37.5% were hypertensive, two-thirds (62.5%) had elevated blood pressure on admission, 37.5% had >24 hours delayed presentation, and 15% had missed SAH diagnosis. The most common presenting symptoms were headache and neck pain/stiffness, while seizures were reported in 12.5%. Approximately one-quarter of patients (22.5%) had large-sized Computed Tomography scan hemorrhage, and 40.0% had moderate size. In-hospital mortality rate was 40.0% (16/40); and 87.5% of them passed away within the first week. Compared to survivors, fatal outcome patients had significantly higher rates of smoking (50.0%), hypertension (68.8%), elevated presenting blood pressure (93.8%), delayed diagnosis (56.2%), large hemorrhage (56.2%), lower GCS scores at presentation, and cerebral rebleeding (P < 0.05 for each). The primary causes of death were the direct effect of the primary hemorrhage (43.8%), rebleeding (31.3%), and delayed cerebral infarction (12.5%).
Conclusions
SAH is associated with a high in-hospital mortality rate in this cohort of Sudanese SAH patients due to modifiable factors such as delayed diagnosis, hypertension, and smoking. Strategies toward minimizing these factors are recommended.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
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