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Article
Histopathologic Study for Skin Basal Cell Carcinoma

Authors: Nazar J. Metib --- Aseel H. Aboud
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2018 Volume: 11 Issue: 1 Pages: 3884-3888
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Basal cell carcinoma (BCC) is the most common Worldwide cutaneous cancer; approximately 75% of all skin cancers. It arises from the basal cells of the epidermis and pilosebaceous units. It has a long evolution, slow growth rate with up to 70% of primary BCCs occurring in head or neck region. Although it rarely results in death or metastatic disease, BCC can cause significant morbidity due to destructive local spread.Aims of the study: To determine the frequency of various histopathologic types of BCCs encountered in practice, to delineate the spectrum in setup, anatomical location, site predilection, and annual age and sex incidence each year.Materials and Methods: The analysis included two hundreds and five cases of skin tumors, 88 cases were basal cell carcinoma from Department of Histopathology, Al Hussain Medical City/ Karbala. The study was retrospective and done during the period of January 2012 to June 2016. After careful review of the Hematoxylin and Eosin (H and E) stained sections, statistical analyses were done.Results: Out of (205 cases of skin tumors) only 88 were of BCC and accounted for 42.92% of all the malignant tumors of skin. majority (87.51.%) of the lesions of BCC were located on head and neck region, solid nodular type was most common histopathologic type and average age of cases was 64 5years. Conclusion: In the present study majority (87.51.%) of the lesions of BCC were located on head and neck region, average age of cases of basal cell carcinoma was 64.5years, and solid nodular type of BCC was most common type.


Article
Clinicopathological Profile of Patients with Unilateral Sinonasal Masses in Karbala

Authors: Adil Hadi Ibrahim --- Nazar J. Metib --- Haider Jebur Kehiosh^
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 1 Pages: 2408-2416
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: A variety of non-neoplastic and neoplastic conditions involving the nasal cavity, paranasal sinuses, and nasopharynx. Most patients present with complaints of nasal obstruction. Other symptoms include nasal discharge, epistaxis, and disturbances of smell, oral symptoms, facial swelling, orbital symptoms, and ear symptoms. The presence of unilateral symptoms or pathology is regarded with caution as sinonasal neoplasms which may also present during their early stages with subtle symptoms that mimic an inflammatory pathology.Objectives: The aim of the study was to analyze the histopathologic diagnosis of patients with unilateral nasal mass and identify their different clinical presentations.Methods: A cross sectional prospective study was carried out on 34 consecutive patients with unilateral sinonasal mass at Al-Hussein Teaching Hospital and Maythem Al-Tammar Private Hospital, Karbala between April to August 2015 focusing on patient’s age, sex, and complaints. . Clinical examinations and proper investigations were carried out for all patients. Biopsy was taken from all cases for histopathologic examination to confirm diagnosis.Results: Out of total 34 patients with unilateral sinonasal masses 25 (73.5%) were males and 9 (26.5%) were females (M: F=2.8:1). The age range was 7 to 60 years with a mean age of 29.2 years. Twenty two patients were found to have non-neoplastic unilateral conditions (64.7%), while 12 patients had neoplastic unilateral conditions (35.3%). Inflammatory nasal polyp was the most common condition in non-neoplastic group (59.9%). Inverted papilloma was the commonest benign neoplastic condition (17.7%), 3 cases of non-Hodgkin’s lymphomas (8.9%) represents the commonest malignant neoplasms among malignant neoplastic group and single case of adenoid cystic carcinoma.Conclusions: Sinonasal masses have various differential diagnoses that otolaryngologists have to consider this variability in diagnosis and treatment. Nasal obstruction is the most common symptom while epistaxis and extranasal symptoms like facial pain, dental and orbital complaints were found to be higher in the neoplastic conditions. The clinician must have a high index of suspicion to rule out a neoplastic etiology in all cases of unilateral nasal mass.


Article
Correlation and frequency of HER-2/neu Status With Estrogen and Progesterone Receptors in Breast Carcinomas

Authors: Nazar J. Metib --- Haider Jebur Kehiosh --- Sabah K. Hamzah
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 2 Pages: 2588-2599
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Breast cancer is the most common malignant tumor in Iraqi females accounting for a third of registered female cancers. Prognosis and management are influenced by the classic variables such as histologic type and grade, in addition to tumor size, lymph node status, status of hormone receptors of the tumor and HER-2/neu status. HER-2/ neu, also known as c-erb B-2 (HER-2), a proto-oncogene located on chromosome 17, is amplified and/or the protein (HER-2) overexpressed in 15% to 25% of invasive breast carcinomas and is associated with a worse clinical outcome. The interrelationship of ER(estrogen receptor), PR (progesterone receptor), and HER-2 expression in invasive breast cancer has come to have an important role in the management of breast cancer. It has been shown that patients with breast carcinoma overexpressing HER-2 do not respond to tamoxifen therapy.Objectives: To evaluate HER-2/neu overexpression in breast cancer by immunohistochemical study and to study the correlation between HER-2/neu status and expression of ER and PR receptors and other clinicopathological features in invasive breast carcinoma.Patients and methods: Immunohistochemical analyses were performed successfully for ER, PR, HER-2/neu by streptavidin biotin indirect immunohistochemical methods using monoclonal antibodies for 41 specimens of formalin-fixed, paraffin embedded breast cancer tissue.Results:. There was a significant difference in HER-2/neu overexpression between invasive ductal carcinoma of NOS (Not Otherwise Specified) type from other histopathologic types (lobular, and specified type ductal carcinoma). No significant correlation was observed between HER-2/neu overexpression and higher histological grades of invasive ductal carcinoma. The expression of ER or PR was decreased significantly in HER-2/neu positive tumors in comparison with HER-2 negative tumors .Only 7.3 % of all cases (3/41) were negative for estrogen , progesterone receptors (ER/PR) and HER2/neu oncoprotein (Triple negative breast cancers).The two cases of lobular carcinoma and the three cases of the special-type carcinomas were negative for HER-2/neu. Conclusions: HER-2/neu protein was expressed more in ductal carcinoma ( NOS type ) than in lobular or in carcinoma of special type and frequently detected in higher-grade invasive ductal carcinoma tumors.The expression of ER or PR was decreased significantly in HER-2/neu positive tumors. HER-2/neu positivity was not correlated with other clinico-pathological parameters like age of the patient, menopausal state, primary tumor size and axillary lymph nodes status.

Keywords

Breast carcinomas --- HER-2/neu --- ER --- PR


Article
Haemangioma of the Nose and Paranasal Sinuses

Authors: Adil H. Ibrahim --- Alaa Ch. Mutar --- Nazar J Metib
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 2 Pages: 2695-2701
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Haemangiomas, are rapidly growing benign vascular tumors rarely seen in paranasal sinuses. They are of two major types, capillary and cavernous depending on the dominant vessel size on microscopy. The sinonasal cavity is an uncommon site of haemangiomas of the head and neck. Most nasal haemangiomas arise from the nasal septum or vestibule and are of lobular capillary type. Only a few arise from lateral wall of the nose or the inferior turbinate and these are usually cavernous.Objective: To assess the sinonasal haemangioma and to increase awareness about its clinical presentation and management. Methods: A retrospective study was conducted in the Department of ENT at Al-Hussein Teaching Hospital, Karbala, from December 2013 to December 2015. Ten cases of sinonasal haemangiomas were collected. Evaluation of the patients done according to age, sex, occupation, complaints regarding headache, nasal obstruction, epistaxis, nasal discharge, feeling of nasal mass ,radiologic assessment and pathologic diagnosis . Endoscopic sinus surgery was performed under general anesthesia for all patients, the masses excised completely and sent for histopathological study.Results: Ten patients were collected. Four patients were males and six patient females with female to male ratio 1.5:1. The age range was 14 to 50 years with a mean age of 32 years. Nine patients (6 females) and (3 males) presented with nasal obstruction and epistaxis. Four patients with left sided nasal obstruction, five patients with right sided nasal obstruction, and only one patient with absolute bilateral nasal obstruction without epistaxis. Conclusion: Sinonasal haemangiomas are extremely rare especially cavernous type. Sinonasal tumors with bone erosion should not always be presumed to be malignant .Endoscopic sinus surgery with complete removal is the treatment of choice.


Article
Proliferating Trichilemmal Tumor: Case Report

Authors: Ahmed Mjali --- Mohammed Ahmed Alshami --- Nazar J.Metib --- Asaad Hashim
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 2 Pages: 2800-2803
Publisher: Kerbala University جامعة كربلاء

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Abstract

a proliferating pilar tumor (PPT) is a rare neoplasm arising from the isthmus region of the outer root sheath of the hair follicle. It is also commonly called a proliferating trichilemmal cyst. It was first described by Wilson-Jones as a proliferating epidermoid cyst in 1966. PPT was then distinguished from proliferating epidermoid cysts in 1995. It occurs most commonly on the scalp of middle age women. Most tumors arise within a preexisting pilar cyst. Even though they usually are benign in nature, malignant transformation with local invasion and metastasis has been described. They may be inherited in an autosomal-dominant mode, linked to chromosome 3.Aim of study is to report case of proliferating trichilemmal tumor.


Article
Biochemical Bone Markers in Prostate Cancer Patients with Advanced Bone Metastasis
الدالات الكيموحيوية للعظم لمرضى سرطان البروستات المنتشرالى العظم

Authors: Narjis Hadi Al-Saadi --- Nazar J. Metib Al-Daami --- Aziz Hussain J.
Journal: journal of kerbala university مجلة جامعة كربلاء ISSN: 18130410 Year: 2014 Volume: 12 Issue: 4 Pages: 143-149
Publisher: Kerbala University جامعة كربلاء

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Abstract

Prostate cancer is now recognized as one of the most important medical problems facing the male population and it is one of the most common cancer types. For this reason led us to investigate the prostate tumor markers for detection prostate cancer. In advanced stages, the prostate cancer is metastasis and arrived to the bone this led to lose of bone mineral density (BMD) and cause osteoporosis, therefor we measured urinary deoxypyridinoline (DPD) as a marker of collagen degradation activity, serum total-alkaline phosphatase activity, and measurement of calcium and phosphate as minerals of bone. This study included 46 patients with prostate tumor their ages ranging (50-80) year and 30 healthy subjects, matched in age with patients as control. Patients were classified according to stage of tumor. 7 patients with benign prostate hyperplasia (B.P.H) , 39 patients with carcinoma, 24 patients with metastasis prostate cancer (M.P.C), and 15 patients with localized prostate cancer (L.P.C). The results showed a significant (p< 0.0001) increase in levels of PSA, DPD, T-ALP, Ca+2 and PO4-3 in prostate tumor compared with the control group. In addition the results revealed a high significant (p < 0.000) increase in the level of urine DPD , serum PSA in patients with M.P.C compared with L.P.C and B.P.H patients, also there was a high significant (p < 0.01) increase in the level of Ca+2 and PO4-3 in patients with MPC compared with L.P.C and BPC patients. The data suggest that serial monitoring of deoxypyridinoline (DPD) could be clinically useful as marker of metastatic bone tumors and for treatment monitoring.

يعد سرطان البروستات من احد المشاكل الطبية المهمة التي تواجه الرجال وهو اكثر انواع السرطان انتشارا. وهذا قادنا الى التحري عن علامات دالة لتشخيص سرطان البروستات. ينتشر سرطان البروستات في مراحله المتقدمة ويصل الى العظم ويؤدي الى فقدان وفرة المعادن في العظم مسببا هشاشة العظام , لذا تم قياس مادة الديوكسي بايريدونيلين في الادراركعلامة لهدم فعالية الكولاجين, وفعالية انزيم الفوسفاتيز القاعدي وايضا تم قياس الكالسيوم والفو سفات كمعادن موجودة في العظم. تضمنت هذة الدراسة 46 مريضا مصابا بورم البروستات , تراوحت اعمارهم من (50-80 ) سنة و 30 شخصا من الاصحاء تتطابق اعمارهم مع مجموعة المرضى كمجموعة سيطرة. قسموا المرضى وفقا الى درجة الورم. 7 مرضى كان لديهم ورم بروستات حميد, 39 مريضا كانو مصابين بسرطان البروستات,24 منهم كانوا بمرحلة سرطان البروستات المنتشر و 15 مريضا مصاب بسرطان البروستات الغير منتشر. اظهرت النتائج زيادة معنوية (p< 0.0001) في مستوى ) (PSA, DPD, T-ALP, Ca+2 and PO4-3 عند مرضى ورم البروستات مقارنة بمجموعة الاصحاء. بالاضافة الى ذلك اظهرت النتائج زيادة معنوية عالية (P<0.000) في تركيز DPD و PSA في مرضى سرطان البروستات المنتشر مقارنة بمجموعة السرطان الغير منشر ومجموعة الورم الحميد, كذلك كان هناك زيادة معنوية عالية (p<0.01) في مستوى كل من Ca+2 و PO4-3 في مرضى سرطان البروستات المنتشرمقارنة مع سرطان البروستات الغير منتشرومجموعة الورم الحميد.


Article
Surgical Outcome of Parotid Gland Tumours: An experience from two institutions in Iraq

Authors: Ahmed Abdullah Alwan --- Ali Azeez Ali --- Dhea Ghazy Taher --- Nazar J. Metib
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2015 Volume: 8 Issue: 1 Pages: 2077-2084
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Approximately 80% of salivary gland tumours occur in the parotid gland. Of these, approximately 75- 80% are benign. Physical examination is the first diagnostic tool. Ultrasonography, CT and/or MRI are useful complementary studies for correct surgical planning. Fine-needle aspiration cytology (FNAC) is also indicated by some authors.Objectives: To analyze the different types of parotid gland tumours, the modalities of surgical treatments and their complications, and the role of FNAC.Methods: Data of 45 patients who were treated for parotid gland lesions, were analyzed retrospectively. FNAC was performed in 31 patients and concordance between FNAC and final histological diagnosis were assessed.Results: Forty-five patients involved in this study (mean age 36.6 years); there was a female gender predominance. Most of the cases were benign. Pleomorphic adenoma was the most common benign tumour while mucoepidermoid carcinoma was the most common tumour in the malignant group. All tumours were localized in the superficial lobe. Most of our patients underwent a conservative superficial parotidectomy. FNAC was performed in 31 patients; there was 87% concordance between FNAC and final histological diagnosis. Sensitivity and specificity rates were 75% and 100% respectively and diagnostic accuracy was 97%.Conclusions: The diagnosis of parotid gland neoplasm must be considered in any patient presenting with a mass near the mandible. Pleomorphic adenoma and Warthin‟s tumour were the most frequent histological types. Superficial parotidectomy appears to be the treatment of choice. Preoperative FNAC plays an important role in the accurate diagnosis of parotid tumors. Surgery was the only tool for definite diagnosis and definitely prevents long term malignant degeneration.


Article
The Clinical and Pathological Characteristics of Colorectal Cancer in Young Age Group in Karbala Province/ Iraq

Authors: Rasha Abdul Raouf ALSafi --- Nazar j. Metib --- Ameer Dhahir Hameedi --- Abulmahdi F Mohammed
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2018 Volume: 11 Issue: 2 Pages: 4025-4031
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Colorectal cancer (CRC) is a major health problem in Iraq. Aim: to identify the clinicopathological characteristics of colorectal cancer in young Iraqi patients in Karbala. Design of study: Retrospective study was conducted in a single center, Imam AL-Hussein general teaching hospital during the period from January 2009 to April 2017. Patients and Methods: A sample size of 96cases of Colorectal Carcinoma was diagnosed during the study period. The clinic-pathological parameters were reported. Results: The mean age of the patients was (51.68). There is a general increase in the incidence of colorectal cancer across the years with percentage of (41.7%) being younger than 45 years. There was slight male predominance. The predominant site of the tumor is colon in (75%) of cases followed by rectum (17.7%). The most common type was adenocarcinoma (82.1%) followed by mucinous type (27.3%), most patients presented with grade I (61.5%). In the majority of patients the malignancy reaching the pericolic fat (54.5%). About (43.6%) of patients presented with N1 and (50.9%) with stage III followed by stage II in (30.9%). For all cancer grades, the frequency of CRC was higher among patients > 45 years with the majority of patients with grade III being younger than 45 years and this make a significant difference between both categories, (P=0.043). With respect to the depth of invasion, those with advance disease (T3), 17 out of 30 cases were younger than 45 years, thus there was significant difference between 2 age groups. Conclusion: the incidence of colorectal cancer is upgrading in those younger than 45 years

Keywords

colon cancer --- young age --- epidemiology --- stage --- grade


Article
The Frequency of Gall Bladder Pathology in Consecutive 576 Cholecystectomies

Authors: Layth A. Alshareefi --- Mohammed A. Ali --- Nazar J. Metib --- Mahdei Jasim
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 1 Pages: 4154-4162
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Cholecystectomies with relevant frequency of gall bladder pathologies is not clear. Patients and methods: Throughout 2016 and 2017 in pathology unites of two hospitals, 576 cholecystectomy cases were analysed. The age of the patients range from 2 to 80 years with a mean of 42.60±15.62 years. Male to female ratio was 152:424 (1:3).All the samples reviewed by two consultant pathologists.Aim of study: To Study the frequency of histopathological changes in 576 cholecystectomies.Results and discussion: Of the total sample which was 576, 437 cases (75.9%) had gall stones, 51 cases (8.9%) were acute cholecystitis, 464 cases (80.6%) were chronic cholecystitis, 9 were malignant (1.6%) and 52 were normal (9%). All the malignant cases were solid variant adenocarcinomas and only one was metastatic from sigmoid colon. Acute suppurative cholecystitis were seen in 24 cases (4.1%), xanthogranulomatous cholecystitis 34 (6.1%), Rokitansky – Aschoff sinuses were seen in 223 (38.7%), inspissated bile 24 (4.2%), adenomyomatous changes 146 (25.3%), focal abscess formation 26 (4.5%), cholesterosis 31 (5.4%), metaplasia 465 (80.7%), single adenomatous polyp, eosinophilic cholecystitis 25 (4.3%).In adenomyomatous changes the epithelial proliferation was florid with Rokitansky – Aschoff sinuses and smoth muscle hypertrophy. Metaplastic changes were of pyloric, intestinal and mucous glands types, the adenomatous polyp was of biliary type with low grade epithelial atypia.Conclusion: The available data may provide basic knowledge of the gall bladder pathology in holey Karbala

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