Association of Oral Contraceptives use with Breast Cancer and Hormone Receptor Status in Iraqi Women

BACKGROUND: Worldwide, there is a significant concern regarding the association of breast cancer risk and oral contraceptives use. Differences in demographical and pathological breast cancer characteristics in Iraqi patients have been reported compared to other western countries; however, studies addressing the risk of breast cancer among oral contraceptive users in Iraq and subsequent correlation with hormonal receptor status are lacking. AIM: The aim of the study was to evaluate association of breast cancer risk and oral contraceptives use in patients visiting tertiary oncology center and to correlate hormone receptor status with history of oral contraception use in breast cancer patients. PATIENTS AND METHODS: Two hundred women with breast cancer were compared regarding patterns of oral contraceptives use with 300 age-matched healthy female controls by personal interview and questionnaire. Patient’s records were reviewed for hormone receptor status. RESULTS: A significantly higher proportion (49%) of women with breast cancer reported a positive history of combined oral contraceptives use as compared with (35.7%) healthy controls. Ever oral contraceptives users had a significantly increased risk of breast cancer (odds ratio [OR] = 1.73; 95%, confidence interval = 1.2–2.5, p = 0.003), with the highest risk was seen in early use before the age of 20 (OR = 6.62, p = 0.02); whereas increased duration of use did not significantly increase the risk of breast cancer. There was no significant association between estrogen and progesterone receptors expression profile in breast cancer patients and combined oral contraceptive use. CONCLUSION: In Iraqi women, the risk of breast cancer increases with oral contraceptives intake particularly when starts early before the age of 20 years. The hormonal receptor status of breast cancer patients is not significantly affected by combined oral contraceptives use

Fuzzy Logic Based Self-Adaptive Handover Algorithm for MobileWiMAX.

It is well known that WiMAX is a broadband technology that is capable of delivering triple play (voice, data, and video) services. However, mobility in WiMAX system is still a main issue when the mobile station (MS) moves across the base station (BS) coverage and be handed over between BSs. Among the challenging issues in mobile WiMAX handover are unnecessary handover, handover failure and handover delay, which may affect real-time applications. The conventional handover decision algorithm in mobile WiMAX is based on a single criterion, which usually uses the received signal strength indicator (RSSI) as an indicator, with the other fixed handover parameters such as handover threshold and handover margin. In this paper, a fuzzy logic based self-adaptive handover (FuzSAHO) algorithm is introduced. The proposed algorithm is derived from the self-adaptive handover parameters to overcome the mobile WiMAX ping-pong handover and handover delay issues. Hence, the proposed FuzSAHO is initiated to check whether a handover is necessary or not which depends on its fuzzy logic stage. The proposed FuzSAHO algorithm will first self-adapt the handover parameters based on a set of multiple criteria, which includes the RSSI and MS velocity. Then the handover decision will be executed according to the handover parameter values. Simulation results show that the proposed FuzSAHO algorithm reduces the number of ping-pong handover and its delay. When compared with RSSI based handover algorithm and mobility improved handover (MIHO) algorithm, respectively, FuzSAHO reduces the number of handovers by 12.5 and 7.5 %, respectively, when the MS velocity is <17 m/s. In term of handover delay, the proposed FuzSAHO algorithm shows an improvement of 27.8 and 8 % as compared to both conventional and MIHO algorithms, respectively. Thus, the proposed multi-criteria with fuzzy logic based self-adaptive handover algorithm called FuzSAHO, outperforms both conventional and MIHO handover algorithms

Liquefaction potential analysis of reusep prestress bridge in Pidie jaya due to 6.4 mw earthquake

Pidie Jaya is one of the districts in Aceh Province – Indonesia. On December 7, 2016, Pidie Jaya experienced a shallow 6.4 Mw earthquake which destroyed some vital buildings and also human loss. Based on preliminary field investigation, some geological damages like soil movement, soil cracks, and liquefactions occur because of the earthquake. Some liquefaction phenomena scattered in the area of Ulim, Panteraja, Meunasah Balek, Manohara Beach and Sagoe Trienggadeng. An evidence of liquefaction in Pidie Jaya area was displayed in this research based on several literature review. Furthermore, these paper aims to identify liquefaction possibilities in Trienggadeng Reusep Prestress Bridge based on a geotechnical investigation of N-SPT and some seismic data by using Kishida method. The surrounded area of the bridge was first evaluated in terms of geological setting, tectonics and seismic activity related to 6.4Mw of the previous earthquake. Furthermore, it was found from the soil profile that the studied area has a potency of liquefaction because of several saturated sand layers and high groundwater level. Effective overburden pressure of sand layers was calculated and plotted with N-SPT value to determine the possibility of liquefaction. The result shows that liquefaction potential shows high possibility for sand dominant layers both from bor-log 1 in 17.5 m and 25 m depths, and bor-log 2 in the depth of 17 m and 26.5 m

Obsessive-Compulsive Disorder in Primary Care: Overview on Diagnosis and Management

Background: Obsessive-Compulsive Disorder (OCD) is a debilitating condition marked by the presence of intrusive obsessions and repetitive compulsions. The primary care setting often serves as the first line of contact for individuals grappling with mental health issues, making it a crucial frontier in the early detection and management of OCD. Therefore, the accurate diagnosis of OCD in such settings is essential for effective management. Objective: This review article aims to provide a comprehensive overview of the diagnostic process for OCD, emphasizing the clinical presentation, differential diagnosis, and various diagnostic tools available. Additionally, it explores current strategies for managing OCD, including pharmacological and psychotherapeutic interventions. Methodology: For this review, a comprehensive literature search was conducted using Google Scholar and PubMed databases. Keywords such as "Diagnosis," "obsessive compulsive disorder," and "management" were employed to narrow down relevant studies. Both qualitative and quantitative research papers were included, while non-English publications and those lacking peer-review were excluded. Results: Core symptoms of OCD include obsessions and compulsions, with the Y-BOCS being a standard measure for diagnosis. Differential diagnosis is essential to distinguish OCD from other conditions. SSRIs have been recognized as first-line pharmacological treatments. CBT, particularly Exposure and Response Prevention, remains a potent psychotherapeutic intervention. Emerging treatments like DBS and TMS offer hope for those unresponsive to conventional treatments. Combination therapies have shown enhanced efficacy in certain cases. Conclusion: The meticulous diagnosis of OCD requires recognizing its core symptoms, ruling out other conditions, and leveraging validated clinical tools. A multi-faceted management approach combining pharmacological and psychological treatments ensures optimal patient outcomes, with ongoing research introducing promising new interventions

Serum Metabolome and Lipidome Changes in Adult Patients with Primary Dengue Infection

10.1371/journal.pntd.0002373PLoS Neglected Tropical Diseases78

Regional and experiential differences in surgeon preference for the treatment of cervical facet injuries: a case study survey with the AO Spine Cervical Classification Validation Group

Purpose: The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon’s geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. Methods: A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. The survey included clinical case scenarios of cervical facet dislocation injuries and asked responders to select preferences among various diagnostic and management options. Results: A total of 189 complete responses were received. Over 50% of responding surgeons in each region elected to initiate management of cervical facet dislocation injuries with an MRI, with 6 case exceptions. Overall, there was considerable agreement between American and European responders regarding management of these injuries, with only 3 cases exhibiting a significant difference. Additionally, results also exhibited considerable management agreement between those with ≤ 10 and &gt; 10&nbsp;years of practice experience, with only 2 case exceptions noted. Conclusion: More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe

Using global team science to identify genetic parkinson's disease worldwide.

No abstract available

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Epstein-Barr virus: clinical and epidemiological revisits and genetic basis of oncogenesis

Epstein-Barr virus (EBV) is classified as a member in the order herpesvirales, family herpesviridae, subfamily gammaherpesvirinae and the genus lymphocytovirus. The virus is an exclusively human pathogen and thus also termed as human herpesvirus 4 (HHV4). It was the first oncogenic virus recognized and has been incriminated in the causation of tumors of both lymphatic and epithelial nature. It was reported in some previous studies that 95% of the population worldwide are serologically positive to the virus. Clinically, EBV primary infection is almost silent, persisting as a life-long asymptomatic latent infection in B cells although it may be responsible for a transient clinical syndrome called infectious mononucleosis. Following reactivation of the virus from latency due to immunocompromised status, EBV was found to be associated with several tumors. EBV linked to oncogenesis as detected in lymphoid tumors such as Burkitt's lymphoma (BL), Hodgkin's disease (HD), post-transplant lymphoproliferative disorders (PTLD) and T-cell lymphomas (e.g. Peripheral T-cell lymphomas; PTCL and Anaplastic large cell lymphomas; ALCL). It is also linked to epithelial tumors such as nasopharyngeal carcinoma (NPC), gastric carcinomas and oral hairy leukoplakia (OHL). In vitro, EBV many studies have demonstrated its ability to transform B cells into lymphoblastoid cell lines (LCLs). Despite these malignancies showing different clinical and epidemiological patterns when studied, genetic studies have suggested that these EBV- associated transformations were characterized generally by low level of virus gene expression with only the latent virus proteins (LVPs) upregulated in both tumors and LCLs. In this review, we summarize some clinical and epidemiological features of EBV- associated tumors. We also discuss how EBV latent genes may lead to oncogenesis in the different clinical malignancie