Background: Chronic lymphocytic leukemia (CLL) is a heterogeneous disease with an extremely variable course. Survival after diagnosis can range from months to decades and wide variability exists in the rate of disease progression and the incidence of disease-related complications among patients with CLL. Staging helps to define prognosis and to decide when to initiate therapy.
Objective: To asses response to oral alkylating therapy and to evaluate the adverse events that can complicate the disease itself or the treatment, including infections, autoimmune and other complications. The survival events are also been assessed.
Patients and methods: Forty nine Iraqi CLL patients, their age ranged between 40-90 years were followed with median duration of 28 months. During the follow up period of these patients, the events that complicated the disease or therapy were recorded. The primary endpoints were response rates, quality of response, Secondary endpoints of the study were overall survival , progression-free survival and event free survival. Response rates were calculated for 40 patients who were treated for at least 6 months. All patients were treated with intermittent pulse therapy of oral single alkylating agent.
Results: The majority of patients recruited either had intermediate or advanced stage disease in 45(91%) patients .Autoimmune phenomena, were documented in 5(10.2%)patients. There was increased incidence of infections with either viral or bacterial pathogen, complicating the course of disease in 20 (40.8%). Remission state was mainly with partial response in 26/40(65%).In12(24.4%) patients the disease progressed and death occurred in 6(12.2% ) patients ,4(8.1% )of them were CLL(related) and 2(4.08%)of them unrelated(stroke, ischemic heart disease) to CLL with median progression free survival(PFS)and overall survival(OS) for these patients were not reached, with 2 years PFS and OS were70%.
Conclusion: Although CLL is an indolent disease still the course is complicated by many events like autoimmune problem and infections whether related to CLL or to treatments. Alkylating agent were effective therapy in the treatment of CLL and the majority of patients in this study partially responded
The present study aimed to investigate the effects of cages of fish farming of Mussayyib district,The fish farming have been selected at Euphrates river with in Mussayyib districtBabylon province the area of study extend 3 Km at the river and includes 541 cages in water with in 46 fish farming . Water samples were taken from 3 stations three times within one month for each two of them were taken from two water purification stations in mussayyib ,physical and chemical examination of water quality were taken ,The results for samples from the fish farming indicated that PH and salinity of water within acceptable levels, high proporation of dissolved oxygen and vital oxygen required were very high while the turbidity was more t
... Show MoreBackground: This study compared in vitro the marginal adaptation of three different, low shrink, direct posterior composites Filtekâ„¢ P60 (packable composite), Filtekâ„¢ P90 (Silorane-based composite) and Sonic fillâ„¢ (nanohybrid composite) at three different composite/enamel interface regions (occlusal, proximal and gingival regions) of a standardized Class II MO cavity after thermal changes and mechanical load cycling by scanning electron microscopy. Materials and methods:Thirty six sound human maxillary first premolars of approximately comparable sizes were divided into three main groups of (12 teeth) in each according to the type of restorative material that was used: group (A) the teeth were restored with Filtekâ„¢ P6
... Show MoreAbstract
As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onse
... Show MoreThe research aims to identify the importance of using the style of the cost on the basis of activity -oriented in time TDABC and its role in determining the cost of products more equitably and thus its impact on the policy of allocation of resources through the reverse of the changes that occur on an ongoing basis in the specification of the products and thus the change in the nature and type of operations . The research was conducted at the General Company for Textile Industries Wasit / knitting socks factory was based on research into the hypothesis main of that ( possible to calculate the cost of activities that cause the production through the time it takes to run these activities can then be re- distributed product cost
... Show MoreThe aim of the research is to assess the practice of tax administration to diminish the strategic direction of (proactive, analytical, defensive, response) and the nature of its relationship to organizational excellence represented by (leadership, strategic planning, focus on taxpayers, information and analysis and knowledge management, focus on operations, focus on forces. The questionnaire was adopted as a main tool in collecting data and information from the sample members of the General Authority for Taxes (110) who are in the site (m. Second Division Manager, Ms The statistical program (SPSS) was used to calculate (mean, standard deviation, difference coefficient, correlation coefficient, t-test). The research reached a number
... Show MoreThe health care provided by health institutions and all kinds suffers from many problems, and since the health services provided are related to human life, it is necessary to shed light on this activity and identify the causes of these problems. This research aims to Definition of health institutions (hospitals) Performance audit of these institutions according to the latest indicators, which are the standards of health accreditation for hospitals, specifically the basic standards issued by the Health Care Accreditation Council (HCAC) to reach the level of performance and Knowledge of Constraints that lead to in an acceptable manner consistent with the approved standards. In theoretical and practical study, a number of conclusions were r
... Show MoreThe study has tackled three important variables on the strategic and organizational level, that are : (Administrative skill, strategic Entrepreneurship and organizational flexibility). Through the statistical analysis is, the research hers have sought to identify the relation among them. The study has been applied on a sample of (44) private banks in Iraq. A questionnaire, which has been designed according to a number of international standards, has been used. It's made of (29) items that cover the three variables to test their hypotheses. A number of statistical tools have been used A number of conclusion have been reached and recommendations have also been suggested.