The aim of this case report is to underline the possible etiological link between paroxysmal supraventricular tachycardia and hypothyroidism, although supraventricular arrhythmias are ordinary features of hyperthyroidism. We present a case of a young patient with first time episodes of PSVT, symptomatic, the possible triggers of arrhythmia were investigated with ECG findings also suggestive of PSVT whose autoimmune hypothyroidism was diagnosed by high TSH and positive Anti TPO antibodies and thyroxin replacement therapy lead to remission of arrhythmia. Structural heart disease and systemic vasculitis were investigated and excluded.  Thyroxin replacement therapy was started first with dosages of 25 μg/day then titrated to 50 μg/day. Clinical signs improved substantially and no other episode of PSVT was noted. The classical findings of PSVT are prolonged conduction, low voltage, sinus bradycardia and different atrio-ventricular or bundle branch blocks, however, our case suggests that PSVT can also be part of the cardio-vascular anomalies during hypothyroidism. The possible mechanisms involved in the occurrence of tachyarrhythmia in hypothyroidism could be alteration of myocyte-specific gene expression, interstitial edema, myofibril swelling with loss of striation, increased arterial stiffness, endothelial dysfunction, premature atherosclerosis, disturbances of the sympathetic-vagal tone with a relative increase in sympathetic tone and autoimmunity

Hyperalgesia, Ultrasound-guided intervention, Transforaminal nerve root block, Chronic pain management, Fluoroscopy verification

We present a case of right internal mammary artery (RIMA) perforation during central line insertion, which is a rare but potentially life-threatening complication. A 67-year-old male with a history of diabetes, hypertension, pneumonitis, and sepsis underwent central line. After the procedure, the patient had hypotension and severe dyspnoea, leading to hemothorax and hemodynamic instability. Prompt recognition and immediate intervention were crucial for successful management of this rare complication. This case report emphasizes the importance of vigilance and preparedness for handling such complications during invasive intensive care procedures.

Objective: This research aimed to assess the correlation between the occurrence of middle ear effusion in pediatric patients with adenoid hypertrophy and identify the variables that contribute to the development of middle ear effusion in children residing in Baqubah city. Method: Its A controlled; prospective research was conducted on newly diagnosed cases of adenoid hypertrophy at the ENT clinic of Baqubah Teaching Hospital from March to October 2022. eighty cases observed during the study period were between the ages of 3 and 12 years. For diagnosis of adenoid hypertrophy, each case underwent nasal endoscopy and skull lateral soft tissue X-ray examinations. The parents and patients were questioned to gather information about accompanying signs and symptoms, such as nasal obstruction, rhinorrhea, mouth breathing, snoring, obstructive sleep apnea and hearing problem were documented in these patients. Tympanometry was used to diagnose the occurrence of middle ear effusion, Tympanogram result being classified as Type A, Type B, or Type C. Both types B and C indicate the occurrence of middle-period effusion, while type A consider normal. Results: The research findings indicate that the average age of the 80 cases was six years, with a higher proportion of females (female to male ratio of 1.6:1). Out of the 80 patients (160 ears), 70 ears (43.75%) exhibited type B tympanograms, 50 ears (31.25%) exhibited type A tympanogram and 40 ears (25%) exhibited type C tympanograms. Out of the entire population of patients with adenoid hypertrophy, the occurrence of otitis media with effusion was 56.25%. Among these cases, 30 (66.67%) had bilateral middle ear effusion, while 15 (33.33%) had unilateral middle ear effusion, including both type B and C tympanogram, with type B and C being the most prevalent. The results also showed that patients with Grade 3 and 4 adenoid hypertrophy were prevalent. Furthermore, there is a substantial correlation between Grade 3 and 4 adenoid hypertrophy and the occurrence of middle ear effusion. Conclusion: The research identified a significant association between the presence of middle ear effusion in children and adenoid hypertrophy, specifically in boys. The association was particularly strong in pediatric patients who had grade III and IV adenoid hypertrophy. The majority of patients had bilateral middle ear effusion, with hearing impairment being the most prevalent symptom. Given these data, we advise that all children with adenoid enlargement undergo screening for middle ear effusion and get suitable treatment to attain the most favorable result.

Toothpaste, commonly found in households, is often used as a remedy for minor burns. However, its typical pH range of 7 to 10 poses a significant risk of irreversible eye damage upon contact. This case study focuses on a 12-year-old girl who suffered an accidental burn near her eye from a burning wooden stick. In an attempt to treat the burn, toothpaste was applied around the eye, a traditional home remedy. This application inadvertently led to the toothpaste contacting the cornea, resulting in a substantial epithelial defect. The child experienced immediate burning sensations and was rushed to the emergency room. Upon arrival, she underwent an extensive normal saline wash followed by the application of a pad and patch, along with topical antibiotics. Previous incidents have highlighted the potential consequences of ocular injuries caused by toothpaste, which can lead to severe eye problems. It is crucial to raise awareness about the judicious use of toothpaste and the potential harm it can cause to the eyes. Additionally, it is important to educate clinicians about the severity of injuries caused by toothpaste and the necessity for prompt and appropriate management of such cases.

Breast cancer is common in Salahdeen governorate 77 (7.25%) and most of the patients aged 41-60 years 43(56%), followed by 61-80 years 19(25%) and 20-40 years 13(17%). Risk factors of breast cancer were, diabetes mellitus, (20.7%) hypertension (19.5%), contraception pills (16.9%), hormonal replacement therapy 3 (3.9%), positive occurrence of breast cancer within the (45.5%) and additionally feeding their babies bottle milk (26%). Most of those who had positive family history had 1st degree relative alone or plus 2^nd degree relative had breast cancer 23(65.7%), while12 (34.3%) had only 2nd degree relative had breast cancer. Mass was the common complaint (71.4%) followed by pain (18.5%), nipple discharge (3.9%), nipple cracking (2.6%). The majority of instances of breast cancer were found to be in stage II (59.7%), stage III (28.6%) and stage IV. Most of the diagnosed breast cancer were intraductal carcinoma (96.1%), Intralobular carcinoma (2.6%) and Paget disease of the nipple 1 (1.3%). Breast cancer is common in Salahdeen governorate and diagnosed at late stages, therefore there is need for increase the health awareness of breast cancer screening among Salahdeen population. There’s need for Implementation of health education programs among, population, nursing staff and doctors about breast cancer.