Karbala Journal of Medicine

b; Sixteen percent of women who are 40-70 years old consult the primary health clinics for
breast symptoms, 4% of them are expected to have breast cancer. The cure rate is over 95% when the
early breast cancers are properly treated at time.
Objectives; The epidemiology of women Breast diseases and the clinical workup to detect early breast
cancer in Karbala.
Method; Retrospective analysis of the workup carried out for the surgical breast cases attending the
surgical units and the EBCD center of Karbala health services, from10th October 2001-10th October
2005.
Results; Total case number was 3634. Sixty percent had inconclusive criteria
The complaints were; breast pain in 67%, Mass in 57%, Nipple Discharge 10.7% and Breast Ulcer in
1.8% of the cases. The registered breast cancer cases were 46, they were advanced.
US examinations were 2017; 48.5% had Breast Masses (75%solid&25% cystic), the negative tests;
49.5% and 2% were equivocal.
Mammography exams; 157.
FNA Cytology exams were 190; conclusive in 61% and positive suspected cancer cells in 9.5%.
There were 110 ND Cytology exams," none was positive".
Conclusion; the routine work of EBCD needs revision and activation of its objective. The diagnosed
cases of breast carcinoma were late. Nipple Discharge Cytology is of no use in screening and
diagnosing breast cancer, FNAC is independable in designing breast cancer treatment. There is a need to
popularize the interventional radiological investigations and the Breast cancer Screening program.

bA retrospective study conducted on (63) patients with V.L. admitted to both Al-Zahraa’ Maternity
and Pediatrics Hospital (MPH) in Al-Najaf and Karbala’ Hospital for Children during the period from Jan.
2005 to Sep. 2006 to shade light on the epidemiological and clinical aspects of V.L. among children from
both governorates.
The number of male cases was 43 (68.2%), while female cases were 20 (31.7%), male to female
ratio was (2.1:1). Most of cases were registered during winter and spring months. 39 (62%) of cases came
from rural areas. The peak ages incidence were1 – 3 years (65%).The commonest presenting features were
fever (100%), splenomegaly (93.6%), and pallor (87.3%).
The consistent laboratory findings were anemia (87.3%) and leucopenia (58.7%). Bone marrow
aspirate were positive in 40 (81.6%) from 49 aspirates taken and 14 (22.2%) patients were treated without
bone marrow aspirate confirmation of the diagnosis
All the patients received sodium stibogluconate (Pentostam)® 20 mg/kg/day for 4 weeks. The main
complications reported were jaundice (9.5%), pneumonia (6.3%), and gastroenteritis (4.7%). Three
relapses (4.7%) have been documented. No deaths were reported

bData were drawn in the study from patients seen and/or admitted to Merjan teaching hospital in the
city of Hilla, Babylon governorate and they include:
100 healthy controlled non-smokers and 100 smokers’ non-diabetic and 240 patients with diabetes
mellitus also 100 patients with acute myocardial infarction, 52 patients with bronchogenic carcinoma.
It had been shown that there was statically significant increase in leukocyte count in smokers than in
non-smokers. There is statically significant increase in platelets count between smoker diabetic and
healthy control non-smoker. There are statically significant changes in the level of fibrinogen in
diabetic smoker from non-smoker healthy control and also smoker subject from non-smoker subject.
In patient with acute myocardial infarction we noticed that 89% of them had smoking index above
600. Also we noticed that in patients with bronchogenic carcinoma 87% of them were heavy smokers.
Most of smokers showed significant reduction in peak expiratory flow rate (PEFR) than healthy non-
smokers, also they showed higher Hb level than non-smoker to extent that venesection in 10 of them
was done to relieve symptoms of secondary polycythemia.
In conclusion tobacco usage through cigarette and other means is the most avoidable risk factors for
several human diseases including cancer.

b Currently there are conflicts about the prevalence of proximal colorectal polyp/s among
patients with distal colorectal polyp/s discovered by sigmoidoscopy.
Design: A retrospective study.
Setting: Gastroenterology and Hepatology Teaching Hospital –Baghdad –Iraq.
Patients and methods: During the study period (1st of August-2003 to 31 of December -2004) all
patients who underwent total colonoscopy procedure were involved in this study. Out of patients with
different polyps, 96 patients were included when they did not have the Exclusion criteria.
Results: This study included ninety-six patients, (Male= 67(69.8%), Female= 29(30.2%)) mean age of
patients 51.5 year. Forty two (62.7%) of male patients had distal colorectal polyp (CRP), 30.9 %( 13 of
42) had proximal one (combined), while in female patients 21 patients had distal CRP, 14.3% (3 of 21)
had combined CRP. For adult patients with distal CRP, 26.8% (11 of 41) had combined CRP, all pediatric
patients had distal CRP, and 22.7% of them had combined CRP. Seven (14.6%) patients with distal single
CRP had combined one, while in patients with multiple CRP, 60 %( 9 of 15) of patients with distal
multiple CRP had combined one. With regard to the size of polyps, 26 %( 13 of 50) of patients with distal
small CRP (<1cm) had combined one, while in those patients who had distal CRP ≥ 1 cm, 23.1 %( 3 of
13) had combined one, 32.3 %( 10 of 31) of patients with distal neoplastic CRP had combined one, while
in patients with distal non- Neoplastic CRP, 18.8%(6 of 32) had combined CRP.

bRight ventricular infarction (RVI) complicating inferior wall myocardial infarction
(IWMI) is common. Electrocardiogram (ECG) through right pericordial leads (V4R) is a useful &
convenient toll of diagnosing RVI.
Objectives: To study the frequency of occurrence of RVI in patients with IWMI using the standard
ECG through right precordial lead (V4R), to define the risk factors for its occurrence and to identify
the associated physical signs & other ECG abnormalities.
Patients & methods: 90 patients admitted to the coronary care unit (CCU) were studied, we assessed
the prevalence of (RVI) using the right precordial lead (V4R), risk factors for its occurrence & other
important physical signs & ECG finding.
Results: RVI was diagnosed in (28.9%) of patients with IWMI, defined by the presence of o.1 mm
ST-segment elevation in V4R. Increasing age, diabetes mellitus (DM) & smoking were significantly
associated risk factors. Atrioventricular block (AV block) occurred in 23% patients with RVI
compared to 10.9% in patients with isolated IWMI. The classical triad of hypotension raised jugular
venous pressure & absence of rales on chest auscultation occurred in 7.9% of patients with RVI
compared to none of patients with isolated IWMI. Hypotension following the administration of
morphine & nitroglycerin were found in 66.6% of patients with RVI compared to non of patients with
isolated IWMI.
Conclusion: Standard surface ECG by using V4R could aid clinical recognition of concomitant RVI in
patients with IWMI. Hypotension following the administration of anti-ischemic medications &
atrioventricular block (AV block) were more common in patients with RVI. Increasing age, male sex
diabetes mellitus & previous history of ischemic heart disease were risk factors for the occurrence of

bHydatid disease ( H D) is a serious health problem in endemic areas, as
in our country. It can affect any organ in the body especially the liver. Surgery is still
the procedure of choice in most cases of H D, despite other methods of treatment
available.
Objectives : The aim of this study is to know the prevalence of hepatic hydatidosis
(H H) , and to study presentation , types of treatment, surgical procedures and
complications.
Methodes: 126 patients with H H were treated in Hammad Shihab military hospital in
5 years period ( from July 1997 to June 2002 ) . 122 patients were treated surgically.
Results: (74.6%) of patients hailed from rural area. Most of the patients were female,
with male to female ratio (M : F) was 1 : 2 . ( 32.53%) of patients were between 31
and 40 years and the mean age was ( 35.46 ) years .
(75.3%) of patients presented with abdominal pain or discomfort . The disease was
discovered incidentally in (17.46%) . Isolated liver was involved in ( 66.7 % ). The
right lobe of the liver was affected in ( 80.95 % ) . ( 67.4 % ) of cases had single
hydatid cyst ( H C ) . Synchronous pulmonary hydatid cyst (P H C) occurred in
(7.9%) of cases.
Post operative complications ocurred in ( 3.2 % ) included (1.6%) developed
recurrent hepatic hydatid cyst (H H C ) , (0.8%) had subphrenic abscess and (0.8%)
experienced biliary cutaneous fistula .
Conclusion: The right lobe of the liver was the commonest location of H H C . The
commonest presentation was abdominal pain or discomfort. All patients with HHC
should be investigated for synchronous P H C.