Fibro-adenoma is the most common lesion of the breast, it occurs in25%of asymptomatic women (1,2 )
It is usually a disease of early reproductive life, the peak incidence is between the ages15 and 35 years.(3,4) It presents as firm highly mobile, non tender mass .(5)
Less than 5% of fibro-adenomas grow rapidly and display the clinical and histologic characteristics of giant fibro-adenoma which is defined as a-tumour either having a diameter greater than 5 cm. And /or amass weighing more than 500 grams, and are conventionally a benign tumor of breast.(6)
Giant fibro-adenomas appear as well-circumscribed but not encapsulated masses on mammography and solid and the texture is homogenous and hypoechoic with low level echoes on U/S. (6, 7)
It is hormone dependent that lactates during pregnancy and involutes along with the rest of the breast in perimenopause.(5)
Excessive estrogen stimulation and /or receptor sensitivity, or lack of estrogen antagonist havebeen implicated in the etiology. (2)
Giant fibro-adenoma is often confined to one breast as a solitary mass occupying part or the whole breast and in rare cases it may be multifocal and involve both breasts. (8)
Giant fibro-adenomas are benign and do not become malignant. (9)
Histological cut surfaces have a lobulated grey-white myxoid semitransparent to dens fibrous appearance, it consist of epithelial and fibrous components, the pericanalicular fibro-adenoma maintains round and oval dilated ductal spaces whereas in the intracanalicular type the ductal lumens are compressed by polypoid fibrous stroma creating slit –like irregular spaces , the ducts are lined by two layers of cells: epithelial and myoepithelial cells and under influence of hormones the ducts become hyper plastic with papillary formation and more than two layers of cells varies from myxoid and hypo cellular to fibrous and moderately cellular . (2)
Surgical treatment of giant fibroadenoma ranges from shelling the tumour out in case it occupies part of the breast, to simple mastectomy. (10)
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Background: The treatment of moderate-to-severe psoriasis has advanced significantly with the use of biologic treatments. Objective: To compare the effectiveness, safety, and impact on quality of life of biologic therapies versus conventional systemic therapies for moderate-to-severe psoriasis, using evidence from 2015 to 2025, focusing on the implications for understudied regions such as Iraq and the Middle East. Methods: Data was collected using "Embase," "MEDLINE," "PubMed," and "Cochrane Central Register." The study includes 45 randomized controlled trials. Additionally, 25 key real-world evidence studies were included for qualitative synthesis to provide context on long-term drug survival, quality of life, and regional applicab
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Background: The study was designed for the assessment of the knowledge of medical students regarding pandemics. In the current designed study, the level of awareness was checked and the majority of students were found aware of SARS-CoV and SARS-Cov2 (Covid-19).
Objective: To assess the awareness of SARS-CoV and SARS-Cov2 (Covid-19) among medical students of Pakistan.
Subjects and Methods: A cross-sectional survey was carried out in different universities of Pakistan from May to August 2020. A self-constructed questionnaire by Pursuing the clinical and community administration of COVID-19 given by the National Health Commission of the People's Republic of China was used am
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The influence of culture on accounting systems and practices, including financial reports and accounting information through the values identified by Gray and derived from social-cultural values, and the four accounting values were derived from generally accepted accounting principles represented by (Conservatism, Uniformity, Secrecy, and Professionalism). Important and significant in maximizing financial performance, and measuring the extent of the role of these values in improving financial performance through attention to the values of accounting culture, this research
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he current research aims at showing the correlation and effect of the internal environment analysis in the quality of health service in AL_Elwiya Maternity Teaching Hospital, researcher depended on the integral method in the "analytical descriptive method" for the study of the relation between the main variables and the sub-variables throughout data collection required by the theme of this study, a case study" in tackling the data and information related to the financial aspects of the internal environment.
The problem of the study was manifested in the essential question, that is (is there internal struc
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In the period after the collapse of the Soviet Union in 1991, the Federal Republic of Russia witnessed a setback in the overall strategic performance of the country, as it went through a stage of performance flop between the orientation towards Europe in the era of President Boris Yelsen (1991-1999), or the change of direction towards Eurasia, as the Russian Federation managed After President Vladimir Putin assumed power in 2000, from rebuilding the same state and preserving national unity and social cohesion, as well as building a phased military doctrine that made clear moves in Russian strategic thought and future directions towards regions of eternal importance in Russian strategic perception Lack of a set of motivations based on it:
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Background A prospective clinical study was
performed to compare the efficacy of the use of lowmolecular-
weight heparin group (enoxparin group)
with control group in the prevention of deep-vein
thrombosis after total knee arthroplasty.
Aim of the study: to assess the prevalence of DVT
after total knee arthroplasty and evaluate the
importance of the use of low molecular weight
heparin in the prevention of this DVT.
Methods Thirty-three patients undergoing total
knee arthroplasty were randomly divided into two
groups. One group consisted of 12 patients who
received no prophylaxis with an anticoagulant (the
control group), other group consisted of 21 patients
who received the low-molecular-weight h