Background: CHOP regimen was the standard treatment for patients with diffuse large and mixed cells Non-Hodgkin's lymphoma (NHL) even in comparison with second and third generation regimen. Recently Rituximab –CHOP is considered the standard treatment for aggressive B-cell NHL while CHOP (alone) is so for aggressive T-cell NHL, yet more than one study investigates another regimen which is VACOP-B and some showed its superiority over CHOP. Prior to the introduction of Rituximab, we used VACOP-B in the treatment of high &intermediate grade NHL in adult Iraqi patients as an alternative to CHOP.
Patients and Methods:We performed a prospective analysis of 20 adult patients who, between April 2000 and October2005, received VACOP-B chemotherapy for high and intermediate grade NHL. The weekly regimen consisted of: doxorubicin50 mg/m2 i.v. weeks 1,3,5,7,9,11; cyclophosphamide350 mg/m2 i.v. weeks 1, 5, 9; etoposide 100mg/m2iv, weeks 3,7,11; vincristine1.4 mg/m2 i.v. (2 mg max.) weeks 2, 4, 6, 8, 10;bleomycin 10 mg/m2 i.v.(max. 15 mg) weeks 2,4, 6,8, 10; methotrexate12.5 mg intratheical was given in selected patients.; prednisolone 60mg p.o.daily for 2 weeks, reduced to 60 mg every other day for 10weeks.The patients treated were aged 25-50 years, 8(40%) had high grade (Working Formulation )NHL; 12 (60%) had intermediate grade NHL;seventeen patients(85%) had Stage III/IV disease; and 3 (15%) had stage II,bone marrow involvement seen in 3(15%)patients .patients distribution regarding age adjusted international prognostic index(aaIPI)was 8(40%)with aaIPI 0,1and 12(60%)with 2,3. Follow-up time from completion of VACOP-B chemotherapy ranged from 6 months to 40 months (median 22).
Results: VACOP-B induced a complete response (CR) and partial response (PR) in 70% and 15% respectively, whilst one patient had no response to treatment and died due to progression of the disease, 2 patients died due to treatment related toxicity. The three year disease free survival (DFS) was 78%, where 4 patients relapsed, one of them in the central nervous system. This study showed 3-year overall survival (OS) 100% for those with a IPI 0-1and 48% for those with aa IPI 2-3. Tolerance to treatment was measured by WHO toxicity scores. The hemoglobin (Hb) toxicity median score for all patients was grade 1 (Hb 9.5-10.9 g/dl), and the white cell count (WCC), toxicity score was grade 2(WCC 2.0-2.9 x 109/1). No platelet toxicity was observed. Ten per cent of patients suffered grade 3 severity infections requiring antibiotics and there was two treatment related death.
Conclusions: VACOP-B chemotherapy is an effective regimen for high and intermediate grade NHL, with an encouraging result in patients with aaIPI 0, 1. although chemotherapy was given weekly, the tolerance to treatment was acceptable. Studies comparing VACOP-B vs. CHOP chemotherapy to decide the exact role of the first in treating high grade &intermediate grade NHL, in the absence of Rituximab, are still needed.
Background: Hepatitis B virus (HBV) and C virus (HCV) known to be transmitted through blood and blood products and has been implicated as a major cause of chronic liver disease and hepatocellular carcinoma worldwide.
Objective: This study aim to detect the relationship between the HBV and HCV infections with ABO blood groups and age of blood donor in Al- Ramadi city.
Patients & Methods: We conducted Hepatitis B surface antigen test strip (ACON Laboratories) (USA) and HCVAb, as step to detect the infections among blood donors at the laboratories for central blood bank in Alanbar health directory, M.O.H. The results of this study were analyzed statistically using the T-test to find the significance of&nbs
The pharmacy is the face for the health buildings and hospitals, The linking professional relationships and functional, it is been from the important places that most people go it, so according to that we must format its interior design in form that suitable with the need of most people use it or work in it, and this the search goal, dashing from the search subject which to hide finding designer treatment for the pharmacies interior spaces, to give share in the functional improvement performance or aesthetic. We define the search goals to share in educate the pharmacist in the effect of interior design for improvement of interior environment, in addition to the search consider as designer trying add to the other trying the interior desig
... Show MoreThe purpose of current study is to analyze the computer textbooks content for intermediate stage in Iraq according to the theory of multiple intelligence. By answering the following question “what is the percentage of availability of multiple intelligence in the content of the computer textbooks on intermediate stage (grade I, II) for the academic year (2017-2018)? The researcher followed the descriptive analytical research approach (content analysis), and adopted an explicit idea for registration. The research tool was prepared according the Gardner’s classification of multiple intelligence. It has proven validity and reliability. The study found the percentage of multiple intelligence in the content of computer textbooks for the in
... Show MoreBackground: Patients who have both neurological impairment and kyphotic deformity can be treated medically, and this treatment can be achieved with anti-tuberculous drugs alone.
Objective: To evaluate conservative medical management of patients with tuberculosis of the spine (Pott disease). The prognostic significance of various clinical, radiological, and long-term follow-up findings in these patients was also evaluated.
Methods: Between January 2009 and January 2018 data were collected prospectively at The Neurosciences Hospital/ Baghdad/ Iraq in 44 patients with Pott disease in the thoracic and lumbar spine. These patients had no major neurological deficits or
... Show MoreThe aim of this study is to examine the effectiveness of fishbowl strategy as one of the effective learning strategies for intermediate students’ achievement in geography subject. To do this, three classes of second intermediate were chosen from Noor Al-Mustafa School for academic years (2015-2016). (64) Student were selected as a sample that distributed into two equal groups: experimental and control group. The research used the achievement test as an instrument to come up with the finding of the study. The experiment began on Tuesday 13th of October 2015 and ended on Tuesday 5th January 2016. Through this time, the researcher taught them the first and second chapter in geography of Arab homeland using fishbowl s
... Show MoreThe role and procedures for accountability in the spending units significant impact in enhancing the results of the budget it is found by studying and comparing the results of the implementation of the budget for the research sample for a period of two years to repeat the same deviations and irregularities of Guanyin, regulations and instructions that have occurred in implementation results and two consecutive Kaltjaoz customizations and low rates of implementation and the lack of exchange of allocations Finance despite the presence budget note that such remarks are always indicate in regulatory reports, but these observations repeated Bostmr in the results of the implementation of the budget. Which clearly reflects the absence of the ro
... Show MoreBackground: Sorafenib is an oral multikinase inhibitor which has been given approval by the United States Food and Drug Administration for the treatment of patients diagnosed with hepatocellular carcinoma and advanced renal cell carcinoma . However, measuring quality of life and patient-reported symptoms may provide further information for evaluating and comparing treatment efficacy and toxicity profiles during cancer treatment. Despite the critical importance of patients' quality of life while receiving anticancer treatment, neither Iraqi patients undergoing anti-cancer medications in general nor those receiving Sorafenib in particular had any published data evaluating this important parameter.
Objectiv
... Show MoreTo determine the relationship between chronic hepatitis B virus and autoimmune celiac disease, seventy five patients with chronic hepatitis B virus of ages (8-70) years have been investigated and compared with 50 healthy individuals. All the studied groups were carried out to measure antiGliadin antibodies IgA and IgG by ELISA test and anti-reticulin antibodies IgA and IgG by IFAT. There were significant elevation (P<0.05) in the concentration of AGA IgA and IgG antibodies compared to control group. The prevalence of AGA antibodies IgA and IgG was 8% and 9.33% respectively. There were a highly significant differences (P<0.01) between studies groups. The prevalence of antireticulin antibodies ARA IgA and IgG was 6.67% and 4.0% respectively i
... Show MoreFemale infection with HPV (human papilla virus) has been established as an essential cause of CIN (cervical intraepithelial neoplasia). The danger of transformation from CIN to frank malignancy should be considered. Objective: The goal of this study is to evaluate the effectiveness of CO2 laser vaporization of ectocervical lesion high grade squamous intraepithelial lesion (HGSIL). Patients and Methods: Four Female out of 150 affected with HGSIL lesions were submitted to CO2 laser vaporization and followed up in 4 months later, and 10 women with HGSIL lesion submitted to electrocautery diathermy for the comparison. Results: Among women treated by CO2 laser vaporization, 3 women had negative results (clear cervix), at 4 months follow up; o
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