Background and objectives:To evaluate the difference between pre-and postmenopausal breast cancer regarding menstrual and reproductive risk factors for ca breast.. Methods: A prospective case-control study was conducted in Nanakaly Oncology Hospital in Erbil city-Kurdistan-Iraq, between September 2009 and April 2011. Cases were breast cancer patients admitted in the oncology floor of the hospital. Controls were hospital patients without breast cancer (other cancers). The study enrolled 300 cases and 600 controls. Menstrual and reproductive history was taken from both the cases and the controls. For every risk factor age-adjusted odds ratio (OR) and 95% confidence interval (CI) was calculated by logistic regression analysis, separate for pre-and post-menopausal w o me n . Results: Among the breast cancer patients, 42.7% were pre-menopausal and 57.3% were post-menopausal. Age at menarche had no association with breast cancer for both preand post-menopausal women. Nulliparity was a risk factor for both pre-menopausal (OR = 2.42, 95% CI (1.1-4.6) and post-menopausal breast cancer (OR = 3.7, 95% CI (2.04-6.87)). Among parous women only post-menopausal females having <3 children were at increased risk for breast cancer (OR = 2.18, 95% CL (1.45-3.27) compared with females having > 3 children. Younger age at first live birth decreased breast cancer risk in both preand post-menopausal women. Breastfeeding was not associated with both pre-and postmenopausal breast cancer. Conclusion: Majority of risk factors for pre-menopausal breast cancer are also associated with post-menopausal breast cancer except less parity, which increased the risk for postmenopausal breast cancer only.
Background and objective: Acute perforations of duodenal ulcers continue as one of the real emergencies of surgery which require immediate attention and prompt operation. The aim of this study was to evaluate the probable risk factors for perforation of duodenal ulcer, highlighting any prevalent one in the occurrence of perforation in Erbil governorate. Design: Retrospective study. The cases were selected on the basis of structured protocol. Setting: The study was performed on 124 patients with perforated duodenal ulcer attending the emergency departments of the three major hospitals in Erbil city (Erbil emergency hospital, Hawler teaching hospital and Hawler private hospital) Erbil governorate located in Iraqi Kurdistan over a period of 4 years. Methods: The study was performed on 124 patients with perforated duodenal ulcer over a four year period (Jun. 2000- Jun. 2004). A number of probable risk factors for perforation of the duodenal ulcer were studied. Asymptomatic patients who perforated were studied as a separate group. Results: one hundred twenty four patients with duodenal ulcer perforation were studied, 111 male and 13 female (male to female ratio 8.5:1) about 60% of patients were within their 4th and 5th decade of age. Patients residing in the rural areas had a lower incidence of perforation (39%) than that living in the urban areas (61%). seventy four patients (59.6%) were asymptomatic before they developed the perforation. Sixty six patients (53.2% of the total number) developed the perforation during Ramadan fasting months (four out of the total 48 months), sixty five percent of the cases were smokers. Stress and smoking played a significant rule in the occurrence of perforation in 83% of cases. Conclusion: Stress, smoking and fasting played a major rule as a risk factor in the occurrence of duodenal ulcer perforation. A high incidence of perforation occurs during the months of Ramadan fasting, especially those without or on irregular treatment. The incidence of asymptomatic patients who were fasting and under stress, who then perforated was high.
A new method in the management of wrist ganglion (Silk thread passed through the ganglion); in comparison with other traditional methods
Background:In this study, we aim to identify the efficiency of propofol-remifentanil anesthesia in reducing the postoperative intensive-care unit stay in patients undergoing cardiac surgery in our center, without compromising the hemodynamic stability. Subject and Methods: Two hundred patients undergoing first time elective coronary artery bypass graft surgery were recruited in this single-centered, single-blinded, prospective and controlled study. Study patients were randomized into two treatment groups: group 1 (P-R; Propofol-Remifentanil) (n=100 patients) and group 2 (M-F; Midazolam-Fentanyl) (n=100 Patients). Clinical measurement of Mean arterial blood pressure and heart rate for each patient were recorded before (T1) and after (T2) induction of anesthesia; after sternotomy (T3) and before cardiopulmonary bypass (CPB) (T4). Time from cessation of anesthesia to tracheal extubation was also recorded (T5). Results: Comparing the hemodynamic parameters between the two groups at T1, T2, T3 and T4 set points revealed statistically significant difference (P < 0.5) in hemodynamic variables in all parameters measured apart from HR at T3. The mean recorded times from cessation of anesthesia to tracheal extubation (T5) were 99.32 minutes and 183.33 minutes in group 1 and 2, respectively. A statistically significant difference was noted between T5 in both groups (P value = 0.003). Conclusions: Our study has shown that Propofol-Remifentanil anesthesia helps to reduce the time interval between cessation of anesthesia and extubation and, by doing so, it can potentially reduce the postoperative ICU stay, without compromising hemodynamic stability. Duhok Med J 2017; 11 (1): 39-47.
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