Background: Several recent studies have shown an increased incidence of hypothyroidism in many chronic inflammatory diseases, especially rheumatoid arthritis, and others studies have shown a relationship between hypothyroidism in patients with rheumatoid disease and the degree of disease activity. Aim of the study: To know the extent of hypothyroidism in a sample of patients with rheumatoid arthritis in Al-Assad and Al-Mowasat University Hospital in Damascus, to link this to the effectiveness of rheumatoid disease, and to compare with a group of healthy controls. Materials and methods: a cross-sectional/case-control study was conducted on 134 patients diagnosed with rheumatoid arthritis, and a healthy cohort of 134 people from the University Hospitals in Damascus. The presence of hypothyroidism was compared between the two groups of patients and controls. Hypothyroidism in patients was also compared with the disease activity index, after dividing them according to the effectiveness index (DAS28-ESR) into three groups: mild, moderate, and severe disease activity. The data was analyzed using the statistical analysis program (SPSS) version (25) and the variable was considered statistically significant when the P-Value is less than (0.05). Results: The average age of both patients and controls was (50.6±3.9) and (44.3±2.01) years, respectively. The proportion of females in the sample of patients was (%84.3) and the percentage of females in the control sample (%80.6), the number of patients with hypothyroidism was 43 patients (%32), and the number of infected controls was 10 people (%7.5) P-Value < 0.000. The type of hypothyroidism in patients was classified into clinical hypothyroidism (%67.44) and subclinical hypothyroidism (%32.56). %24.6 of patients and %6 of controls had positive TPO antibodies (P-Value < 0.000). The study has shown a positive correlation between hypothyroidism and disease efficacy indicator (DAS28-ESR). Conclusion: Increased incidence of hypothyroidism and TPO antibodies in patients with rheumatoid disease compared to healthy subjects, and an increase in the degree of disease activity in patients with rheumatoid disease diagnosed with hypothyroidism compared to patients with rheumatoid disease without hypothyroidism.

Aim and background: The study aims to detrmaine the risk factors for endometrial hyperplasia and endometrial cancer in patient with abnormal uterine bleeding and thus early diagnositric investigations to detect the disease and limit its development Methods: The study sample includes women attending AL-zhrawi Hospital with acomplaint of abnormal uterine bleeding and who fulfilled the entry criteria. The women in the sample were divided according to the result of the pathological autopsy into : The first group “control group” : it the the group that showed normal endometrioses by histopathology . The second group “cases group” : it is divided into two categories: the first category it is the group that showed endometrial hyperplasia through histopathology. The second category : the category that showed the presence of endometrial cancer through histopathology. Results: The mean age in the endometrial cancer group was 58.6 ± 6.5 years, the BMI value was expressed as the arithmetic mean of values for each group, and the highest mean in the cancer group was 28.75 kg/m2. The differences between the endometrial and control groups and the two hyperplastic groups The control is statistically significant with a P value of 0.001, and 60% of endometrial cancer patients were in menopause, and this is associated with hormonal changes accompanying the age of transition to menopause, and 45% of them were not giving birth. 35% of patients with cancer were found in this study. Endometriosis have diabetes, and this value was statistically significant compared to the control group with (P<0.05), and arterial hypertension was recorded in 80% of our patients, and it was statistically significant (P<0.05), a family history was found. of endometrial cancer in 50% of endometrial cancer patients, and half of the cases were in the mother and the other half in the sister. Conclusion: In this study, according to the set conditions, 123 women suffering from abnormal uterine bleeding were recruited. The number of diagnosed endometrial cancer cases was 20, and each of the following factors was statistically significant for the development of endometrial cancer: advanced age - high BMI - early puberty - anuria - female childbirth - the presence of a family history of endometrial cancer - diabetes mellitus - High arterial pressure, while the following factors were not statistically significant: Increased number of births - Intensity of vaginal bleeding

Background Intestinal fistula is an irregular opening that enables the contents to flow out. Surgical procedures, diverticular illness, inflammatory bowel disease, cancer, radiation, and injury from trauma or foreign bodies are all common causes of intestinal fistulas. Aims The goal is to see if smoking is a risk factor for relapsing in patients with intestinal fistula, as well as to learn more about the most common cause of perianal abscess or fistula, which will provide us with more information about risk factors that can be avoided and early diagnostic investigations that will help us detect the disease early and limit its progression. Methods Patients who presented to Damascus Hospital with complaints of intestinal fistula symptoms and were diagnosed and treated in the general surgery and gastroenterology divisions between 2015 and 2022 and met admission requirements were included in the retrospective analysis. Results Out of 104 cases of fistula, the average age was 34.96, with a male-to-female ratio of 67–33%. The overall percentage of smokers in the sample is 59%, and the pathological history includes 43 cases of Crohn's Disease and eight cases of colon cancer. A history of surgery was found in 63% of the participants. Surgical treatment was used on 53% of the fistulas, whereas conservative treatment was used on 47%. The proportion of patients who relapsed was 77% in smokers and 31% in nonsmokers, with a statistically significant difference. In addition, when we looked at the occurrence of perianal abscess or fistula in patients with Crohn's disease, we discovered that 96 percent of patients with perianal fistula have Crohn's disease, indicating a statistically significant relationship between these two conditions. Conclusion Smoking and Crohn's disease have a statistically significant relationship with relapsing and the development of a perianal abscess or fistula.