Background: Breast cancer is the most common cancer among women worldwide. The presence of axillary lymph node metastases in breast cancer is an important factor in assessing prognosis and determines management after surgery. The study aimed at identification of the factors that predict axillary lymph node involvement in CA breast. Addressing the prognostic effect of axillary lymph node involvement in turn of predicting the recurrence of CA breast.Methods: This is a prospective review of one hundred cases of Ca breast who have underwent modified radical mastectomy and axillary clearance at Al-Karama Teaching Hospital during the period from January 2014 to December 2018.Results: Positive axillary involvement was found in (74/100, 74%). The highest occurrence of positive axilla was found in (less than 30 and 30-39 years) age groups (27/74, 36%) with the outer quadrants (upper and lower) constituting the majority (50/74, 68%). Positive axillary involvement was mostly notified in tumor grade T4 (39/74, 53%) and in poorly differentiated lesions (47/74, 64%). The highest recurrence rate was found in patients with positive axillary metastases (12/74, 16%), nodal involvement of ten or more nodes (9/41, 22%), nodes with extracapsular extension (10/51, 20%) and in patients who have not taken and/or completed their chemo-radiation sessions (9/11, 82%).Conclusions: Positive axillary lymph node involvement was seen mostly in: young age patients, outer quadrant lesions, tumors with skin involvement, and poorly differentiated lesions.

Background: Diabetic foot disease is a foot that exhibits any pathology that results directly from diabetic mellitus or any long-term chronic complication of diabetes mellitus. The aim of the study was to determine the risk factors and indications for amputations among diabetics.Methods: this clinical prospective study includes 120 diabetic foot patients admitted to AL- Karama teaching hospital from 1st January 2015 to 1st January 2019. All patients assessed for age, gender, duration of diabetes, hyperglycemia at admission and control of diabetes, history of smoking, hypertension, assess dominant foot and examination of diabetic foot lesion and classify it according to Meggit-Wagner grading status, indications for amputation and outcome.Results: The male to female ratio was 2:1. Most frequent age group of patients treated by amputation was between 50-80 years. Among patients treated with amputation (68.33%) of patients had diabetes mellitus for 11-20 years. From patients admitted with diabetic foot (53.33%) were smokers. Regarding hypertension (93.33%) of all patients were hypertensive. It was noted that (65%) of patients lesion occur in dominant foot Regarding Wagner's grading system (36.66%) of patients were grade 4 followed by grade 1 (21.66%). regarding mode of treatment (53.33%) of patients treated by amputation and other treated conservatively. Only 3 patients from 60 died while other discharged well after complete treatment.Conclusions: Increasing in age, long duration of diabetes mellitus, poor control of diabetes, smoking and occurrence of lesion in dominant foot all considered as a significant risk factors for increase liability amputation.

Background: The solitary thyroid nodule, defined as a palpable discrete swelling within an otherwise apparently normal gland, is usually a benign lesion. However, patients and physicians alike are typically concerned about the possibility of thyroid cancer. This study describes a strategy for the treatment of clinically euthyroid patients who have a solitary thyroid nodule that prevents unnecessary testing while identifying the few patients who require therapy.Methods: This is a prospective study of randomly selected patients with clinically palpable, solitary thyroid nodule diagnosed and treated at Al-Karama Teaching Hospital from September 2015 till December 2018. Initially 176 patients were diagnosed by clinical examination to have solitary thyroid nodule but after investigation and operative finding, 42 patients were found to have multinodular goiter and all excluded from the study.Results: All the 134 patients included in the study (21 males and 113 females) have been evaluated by clinical examination; thyroid scan and fine needle aspiration, ultrasound and the results of the evaluation have been correlated with operative histologic diagnosis. The study was undertaken to obtain information on the usefulness of the above measures for predicting or ruling out malignancy in solitary thyroid nodule.Conclusions: The incidence of malignancy seems to be higher among male, presented with hard nodule at palpation, those associated with hoarseness or palpable cervical lymph nodes. A cytological diagnosis of malignant tumor is reliable and provides sufficient basis of definitive surgery for thyroid cancer.