Background and objective: Variation in paranasal sinus anatomy, as shown on computed tomographic scans, is of potential significance as it may pose risks during surgery or predispose to certain pathologic conditions. This study aimed to investigate the frequency of anatomic variants of the nasal cavity and paranasal sinuses in our population and determine their relationship with gender and find out the association of these variants with mucosal abnormalities. Methods: This was a cross-sectional study conducted at the College of Medicine, Hawler Medical University from October 2017 to January 2019. A review of computed tomography scans of the paranasal sinuses of 300 patients was done; special attention was directed toward identifying bony anatomic variants and mucosal abnormalities. Results: Frequent variants were: Agger nasi cells (72%), nasal septal deviation (71.7%), Haller cells (70.7%), concha bullosa (61%), elongation of uncinate process (69.7%) and different variants of the sphenoidal sinus (78.8%). The frequency of variants did not differ significantly with respect to gender, except for sphenoidal variants along with Keros types and asymmetry of the ethmoidal roof. A significant association was found between middle concha variants and inferior turbinate enlargement (P <0.001). Conclusion: Anatomic variants of the paranasal sinus region were common in our population; the most frequent ones were those involving the nasal septum, ethmoid air cells, sphenoid sinuses, and middle turbinates. The study of these variants is important for the management of paranasal sinus region disease.

Background and objective: Many epidemiological studies and clinical manifestation studies of multiple sclerosis have been done in Iraq. Up to our knowledge, no such observational study to the radiological feature of the multiple sclerosis lesion has been done yet in Erbil in comparison to other worldwide studies. This study aimed to assess the distribution of multiple sclerosis lesions in brain regions detected by magnetic resonance imaging among Erbil population. Methods: This was a cross-sectional study conducted at the College of Medicine, Hawler Medical University, from April 2018 to July 2019. A review of magnetic resonance imaging scans of the brain of 120 patients was done. Special attention was directed toward identifying the variance in multiple sclerosis lesions distribution in the brain regions and their MR signal intensity characteristics. Results: Periventricular lesions were observed in more than 90% of the study sample. The next common was juxtacortical lesions (24.8%), followed by corpus callosum lesions (16.8 %), while brain stem lesions were the least observed proportions. No significant difference was detected in the distribution of multiple sclerosis lesions among ethnicities and genders, except for basal ganglia lesions, which were significantly more common in women (P = 0.016).The magnetic resonance imaging signal intensity of the lesion was significantly variable among disease duration. Conclusion: The T2 hyper intense lesions were most commonly seen in the periventricular region. Juxtacortical and corpus callosum lesions were also frequently observed. The proportions of the brain stem and cerebellum lesions appeared to be lower in comparison to previous studies. Keywords: Multiple Sclerosis; Magnetic Resonance Imaging; Distribution; Lesion.

Background: Accurate assessment of axillary lymph node status is important for breast cancer staging and treatment. Sonography can detect metastatic lymph nodes with varying degrees of sensitivity and specificity, while its routine use in the preoperative assessment of axillary lymph nodes remains controversial. The aim of this study was to assess the diagnostic accuracy of pretreatment axillary sonography in our clinical setting and to determine whether sonographic evaluation of the axilla as a tool for regional staging of breast cancer should be performed routinely in all cases. Methods: The study recruited 185 women with histologically confirmed breast cancer from September 2021 to December 2022. Axillary ultrasound was performed on all patients to assess lymph node status using predetermined criteria. The ultrasound findings were compared to the histopathology results. Results: Axillary sonography had 94.1% sensitivity, 87.7% specificity, 95.5% positive predictive value, 96.0% negative predictive value, and 92.4% accuracy in detecting metastatic lymph nodes in newly diagnosed breast cancer patients. In comparison to benign axillae, malignant axillae were significantly more likely to meet the lymph node criteria for "lobulated or irregular margin," "round or irregular shape," "focal or eccentric cortical thickening ≥3 mm," "totally replaced cortex," and "non-hilar blood flow" (p < 0.001). Conclusions: Pretreatment sonography of the axilla had a high accuracy rate and a good outcome in the evaluation of lymph node status in newly diagnosed breast cancer patients, and it should be performed routinely in all cases. Trial registration: Not applicable

Introduction Postmenopausal bleeding refers to vaginal bleeding that occurs after twelve months of amenorrhea in a woman of the age where the menopause can be expected. 1 It can also be defined as the time in a woman's life when the woman stops having a menstrual period permanently and is no longer fertile. 2 However, it can be applied to younger women following premature ovarian failure or premature menopause. 3 Vaginal bleeding is a common post menopausal complaint representing 5% of all gynecology outpatient consultations. 4 The incidence of postmenopausal bleeding is 10% in the general population immediately after menopause. 5 The causes of postmenopausal bleeding include endometrial atrophy (approximately 75% of cases), 3 endometrial polyps, submucosal fibroids, endometrial hyperplasia (simple, complex and atypical), endometrial carcinoma (approximately 10%), and estrogen withdrawal. 6 Non-gynecological causes include trauma, systemic diseases like hypertension, hypothyroidism, and bleeding disorders. 3 Endometrial abnormalities are common diagnostic challenges facing the radiologist and referring specialist gynecologist. Ultrasound is the primary imaging modality in this workup; findings if further investigations done like sonohysterography, hysterosalpingography, magnetic resonance imaging, and computed tomography are often correlated Background and objective: Post-menopausal bleeding due to endometrial abnormalities is a common diagnostic challenge facing the ultrasonogists and referring gynecologists. This study aimed to detect the validity of transvaginal ultrasound to detect endometrial pathologies and its sensitivity and specificity for determining endometrial carcinoma in women with postmenopausal bleeding. Methods: A diagnostic accuracy study of transvaginal ultrasound and diagnostic curettage was conducted for evaluation of endometrial pathology in the College of Medicine, Hawler Medical University from October2016to January 2018. The sample size included 55 women with post-menopausal vaginal bleeding. The ultrasound findings were compared with histopathological results of endometrial biopsy. Results: Out of 55 women, 49.09% had endometrial atrophy, 29.09% had endometrial hyperplasia, 16.36% had endometrial polyp, 3.64% had endometrial carcinoma, and 1.82% had hyperplasia with atypia according to histopathological findings. The sensitivity of ultrasound in detecting cancer was 66.7%, the specificity was 100%, the positive predictive value (PV) was 100%, and the negative predictive value was 98.1%. The total agreement rate was 98.2%. Conclusion: Transvaginal ultrasound is an excellent diagnostic tool to determine whether further investigation with histopathological examination of endometrial biopsy is necessary for postmenopausal vaginal bleeding.