In April 2008 a medical conference was organised for a group of Iraqi and

Arab Doctors. Here are the summaries of few of the presentations in the

conference:

Dr. Nada Alwan and her team presented her views about the cancer service in Iraq and the control strategy of cancer in the country.

She mentioned that recent WHO estimates indicate that cancer is the fourth ranked cause of death among adults in countries of the Eastern Mediterranean and North Africa following cardiovascular diseases, infectious diseases and injuries.

According to the latest Iraqi Cancer Registry, the most common tumours are those of the breast followed by cancers of the lymphatic system, lung, brain and bladder. Childhood cancers are 8-10 times more common than in the west. The majority of cancers in Iraq are detected in advanced stages and are thus incurable even if the best therapies could be offered.

It is essential to link therapy with early detection and to adopt health education approaches for both the public and health professionals.

Accordingly, WHO embarked upon developing a cancer control strategy within the Eastern Mediterranean countries (depending upon the available regional strengths and resources); through a coordinated approach which include: Prevention, Early Detection, Treatment and Palliative Care.

Bladder cancer is one of the most common diseases treated by urologists. It often behaves as a field change disease in which the entire urothelium from the renal pelvis to the urethra is susceptible to malignant transformation.

The objective of this study by Mr. Usama Al-Nasiri et al is to evaluate any change in the incidence of bladder cancer in the Iraqi society over 24-year period and discuss possible risk factors beyond this change.

Registries of the documented cases of cancer in general and bladder cancer in particular over the a 24- year period extending from 1976 until 1999, among the Iraqi society were revised. Regional and national differences were considered.

The findings of the study showed that there was a rising in the total number of cases during the mid nineties but the bladder cancer rank receded to the third place.

The authors conclude that national studies are essential to verify the environmental risk factors that can probably lead to the increase in the number of urinary bladder cancer in Iraq.

Professor Abdul- Monaf AL-Jadiry from The Jordanian University in Amman was presenting this study to the meeting.

Violence is aggressive behaviour that may be physically, sexually or emotionally abusive. The aggressive behaviour is conducted by an individual or group against another, or others. It is anything that denies human integrity and leads to hopelessness and helplessness.

The World Health Organization ( “WHO”) in its first World Report on Violence and Health defined violence as “the intentional use of physical force or power, threatened or actual, against oneself, another person or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation.”

Religious and political ideologies have been the cause of interpersonal violence, and violent riots, political repression, ethnic cleansing and genocide throughout history.

The fact that Iraqi civilians are the main victims of the attacks is increasingly being stressed in reports, interviews and comments.

Results from the Iraq Family Health Survey (IFHS), which was conducted in 2006 and 2007, provide new evidence on mortality in Iraq. Violence is a leading cause of death for Iraqi adults and was the main cause of death in men between the ages of 15 and 59 years during the first 3 years after the year 2003.

Now a broad interdisciplinary effort is getting under way to explore the biological nature and origins of violence. It is also shedding new light on how environmental influences, by affecting the brain, can trigger violence. In time, these insights and discoveries could lead to practical action that may inhibit violent acts.

Professor Al-Jadirey concluded that in order to transform violence into better conflict resolution, all disciplines and sectors must have input on issues that concern them. As we all learn the origins and consequences of violence, we become better equipped to resist and prevent it in our own lives.

Whether or not a postmenopausal woman with osteoporosis is offered one of these drugs:  Alendronate,

etidronate, risedronate, raloxifene and strontium ranelate, to prevent bone fractures will depend on her age, her bone density and how many risk factors for fracture and

indicators of fragile bones she has.

In principle, alendronate is recommended as a possible treatment for preventing bone fractures in postmenopausal women who have had osteoporosis diagnosed but have not had a fracture.

If a woman can’t take alendronate, risedronate and etidronate are recommended under certain circumstances as possible alternative treatments to prevent fractures.

If a woman can’t take alendronate or either risedronate or etidronate, then strontium ranelate is recommended under certain circumstances as a possible alternative treatment to prevent fractures.

Raloxifene is not recommended as a treatment for preventing fractures in postmenopausal women with osteoporosis who have not had a fracture.

The guidance from NICE (National institute for health and clinical excellence/UK) says that women who are 75 or over may not need a bone scan to diagnose their osteoporosis (guidance issued in November 2008).