BACKGROUND Multiple myeloma (MM) is a plasma cell disorder characterized by the infiltration of clonal plasma cells in the bone marrow and the detection of a monoclonal immunoglobulin in serum and/or urine. Renal failure, anemia, hypercalcemia, and the presence of bone lesions are the hallmarks of the disease. The study aimed to evaluate the clinical, hematological, radiological, and immunophenotypic features of MM patients and to identify prognostic factors influencing survival outcomes. This cohort study included 77 newly diagnosed, untreated MM patients. Their clinical presentation, laboratory data, imaging results, and the expression of flow cytometry markers were analyzed in correlation with the 1-year overall survival (OS). The mean age was 59.29 ± 12.1 years, bone pain was the most common symptom (81.8%), and anemia was observed in 87% of patients. Radiologically, lytic lesions were present in 70.1% of cases, with 33.8% having pathological fractures. Flow cytometry revealed universal expression of CD319 (100%) and high expression of CD56 (98.7%). CD117 positivity was significantly associated with shorter OS ( P = 0.029), and CD28 showed a tendency toward poorer prognosis ( P = 0.054). Other markers, such as CD44 and CD49e, did not show significant prognostic associations. MM may manifest at an earlier age in specific populations. The most significant features were anemia, bone lesions, and renal dysfunction. Lower hemoglobin levels, higher blood urea and serum creatinine, along with a lower glomerular filtration rate, hyperuricemia, and hypoalbuminemia, contribute to poorer outcomes, as the expression of CD117 has an inverse prognostic outcome.
Alice Walker (1944) ranks among the greatest American writers of the twentieth century. Through her novels Meridian and the color Purple, Alice outlines many issues concerning the effect of authoritarian thinking upon its often innocent victims, and the possibility of meaningful, productive resistance. Walker's texts aim at giving a voice to those who have no voice especially those poor, rural black women who are robbed of power and the right to make decisions about their own lives by a range of forces standing against them. These texts also aim at clarifying how Walker's female protagonists, Meridian and Celia try to free themselves from oppression, misery , fear and underestimation
... Show MoreThe present work aims to study the efficiency of using aluminum refuse, which is available locally (after dissolving it in sodium hydroxide), with different coagulants like alum [Al2 (SO4)3.18H2O], Ferric chloride FeCl3 and polyaluminum chloride (PACl) to improve the quality of water. The results showed that using this coagulant in the flocculation process gave high results in the removal of turbidity as well as improving the quality of water by precipitating a great deal of ions causing hardness. From the experimental results of the Jar test, the optimum alum dosages are (25, 50 and 70 ppm), ferric chloride dosages are (15, 40 and 60 ppm) and polyaluminum chloride dosages were (10, 35 and 55 ppm) for initial water turbidity (100, 500 an
... Show MoreChronic Kidney Disease (CKD) is a public health problem and many studies support the link between kidney dysfunction and cardiovascular events. Aldosterone has been shown for decades that a plasma aldosterone concentration is elevated in CKD. Whilst, Osteoprotegerin (OPG), after its capacity to protect bone, also osteoprotegerin is elevated in patients with chronic kidney disease (CKD), where it could predict the deterioration of kidney function, cardiovascular, vascular events and all-cause mortality. On the other hand, fibroblast growth factors (FGFs), in patients with CKD, its levels seem to increase progressively as kidney function worsens. The aim of the present study is to assess the correlations between serum osteoprotegerin
... Show MoreThis study tries to examine a model involving human resources management practices, employees’ outcomes, governmental support, and organizational performance of small businesses in Malaysia. It was hypothesized that HRM practices will be positively related to the organizational performance (financial and operational), and that employees’ outcomes would serve as a mediator in the relationship between HRM practices and performance. Also it was hypothesized that the governmental support will be positively related to organizational performance. The statistical results on data gathered from a sample of 265 small manufacturing businesses will demonstrate the nature of relationships among the study variables. Theoretical and practical
... Show MoreIndustrial product is one of the things of daily use and direct interaction with the user, so the ranges of its association to the user, took a varied and multiple aspects. The user today sees the products as things have specifications related directly to the psychology of the user, so he can reflects his values, principles and ideas on the composition of the total structure of the product, making them a means by which manifested the internal entity's of the user took an external materiality. And then counting the products being things excite positive feelings among different user was a natural result given the complexity of the relationship between the user and the industrial product. So pleasure is one important effects that result fro
... Show MoreThe aim of this research is to identify the role of strategic agility achieving organizational excellence in one of the formations of the Ministry of Municipalities (Dhi Qar Sewage Directorate), as important service organizations that have a key role in serving and developing the society which faced many administrative challenges and issues and as a result of the changes in the environment is continuing and accelerating, so the adoption of modern administrative concepts such as strategic Agility and knowledge of their role in achieving organizational excellence can help them in facing these changes and achieve what they aspire to. In order to achieve research objectives, two main hypotheses have been formulated. The first hypothe
... Show MoreProved the validity of all mixtures or not to accept the bees and then resistant infection worm wax Minor has accepted honey bee colonies all mixtures beeswax with paraffin wax industrial all ratios used made ??of a mixture to DVD waxy full and used naturally in breeding Houdnth In store honey and pollen evendiversified Bravian and natural wax