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.
The presented work shows a preliminary analytic method for estimation of load and pressure distributions on low speed wings with flow separation and wake rollup phenomena’s. A higher order vortex panel method is coupled with the numerical lifting line theory by means of iterative procedure including models of separation and wake rollup. The computer programs are written in FORTRAN which are stable and efficient.
The capability of the present method is investigated through a number of test cases with different types of wing sections (NACA 0012 and GA(W)-1) for different aspect ratios and angles of attack, the results include the lift and drag curves, lift and pressure distributions along the wing s
... Show MoreResveratrol, (RES), a phytoalexin, is well-known for its anti-inflammatory and anti-oxidant properties. SEB, a superantigen, is known to trigger ALI and cause mortality. In the current study, we tested the effect of RES in a dual-dose model of SEB exposure that triggers ALI and causes 100% mortality in C3H/HeJ-mice. The data revealed RES attenuated SEB-induced ALI and prevented mortality. Forty eight hours post-SEB exposure, lung-infiltrating mononuclear cells were tested for microRNA expression profile to determine the epigenetic regulation by resveratrol. SEB-activated splenocytes were pre-treated with 50 μM of RES or vehicle for metabolic profile analysis by measuring oxygen consu
Background: Adenoiditis is a common cause of otitis media with effusion (OME) in children & perhaps OME is one of the most common diseases leads to hearing impairment in children with subsequent impairment of speech development & learning difficulties , however, treatment remains controversial. Objectives: To evaluate if there is a significant advantage of tympanostomy tube insertion in association with adenoidectomy over adenoidectomy in association with myringotomy alone in treatment of children with OMEType of the study: This is a prospective study. Patients & methods: The study consisted from 63 children diagnosed as cases of bilateral OME & variable degrees of adenoid hypertrophy. The patients were divided randomly i
... Show MoreStudies from our laboratory have shown that Δ9-Tetrahydrocannabinol (THC), an ingredient found in marijuana plant Cannabis sativa, can attenuate acute lung injury induced by Staphylococcus enterotoxin B (SEB). In the current study, we investigated the role of THC on the metabolism of SEB-activated lymphocytes. To this end, we determined metabolic potential of SEB-activated lymphocytes treated with vehicle or THC by performing the Cell Mito Stress Test. The oxygen consumption rate (OCR) in THC-treated cells was decreased when compared to vehicle-treated group whereas the extracellular acidification rate (ECAR) was similar in both the groups. Specifically, electron transport chain inhi
Background: Refractory/relapsed acute leukemia has always been a challenging problem for hematologist. Over the past decade emphasis has been made in the development of regimens containing fludarabine, combined with cytosine arabinoside for the treatment of refractory/relapsed acute leukemias. The aim of this study is to evaluate the efficacy and toxicity of the combination of fludarabine, high dose cytarabine, and granulocyte colony stimulating factor in refractory relapsed cases of acute leukaemia,
Methods: a prospective study is being conducted at the national center of hematology and hematology unit /Baghdad teaching hospital from July 2008 to July 2010.Twenty Patients with refractory/relapsed acute leukemia were treated with flud
Atrial fibrillation is associates with elevated risk of stroke. The simplest stroke risk assessment schemes are CHADS2 and CHA2DS2-VASc score. Aspirin and oral anticoagulants are recommended for stroke prevention in such patients.
The aim of this study was to assess status of CHADS2 and CHA2DS2-VASc scores in Iraqi atrial fibrillation patients and to report current status of stroke prevention in these patients with either warfarin or aspirin in relation to these scores.
This prospective cross-sectional study was carried out at Tikrit, Samarra, Sharqat, Baquba, and AL-Numaan hospitals from July 2017 to October 2017. CHADS2
... Show MoreDiabetes mellitus type 2 (T2DM) is a metabolic disorder that influences above 450 million individuals around the world. Type 2 diabetes is a lack of insulin due to pancreatic β-cell malfunction and insulin resistance. This study aimed to detect insulin resistance using homeostasis model assessment (HOMA IR) and determined the correlation with glutathione-s-transferase (GST) activity in T2DM and neuropathy patients as a predictor of oxidative stress, which occurs when the oxidation-antioxidant equilibrium is disrupted. Reactive oxygen species causes vascular injury and a series of inflammation. In the present study, the results show there is no significant difference in diabetic patients (DM) and neuropathy patients (NU) versus healthy p
... Show MoreThe problem of Bi-level programming is to reduce or maximize the function of the target by having another target function within the constraints. This problem has received a great deal of attention in the programming community due to the proliferation of applications and the use of evolutionary algorithms in addressing this kind of problem. Two non-linear bi-level programming methods are used in this paper. The goal is to achieve the optimal solution through the simulation method using the Monte Carlo method using different small and large sample sizes. The research reached the Branch Bound algorithm was preferred in solving the problem of non-linear two-level programming this is because the results were better.
In this work, oral lesions belong to 17 patients, 7 males and 10 females. Their ages range between 15 and 45 years. Follow up was conducted after one day, 7 days, 14 days, one month, and finally 3 months postoperatively. The study lasted for 1.5 year. Surgical diode laser with wavelength of 810 ± 20 nm, with two power levels of 10 and 15 W were used in contact and in non-contact mode via optical fiber. The postoperative outcome revealed; greater haemostatic capability, dry, sealed wound and noticeable lack in pain sensation