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 fludarabine 30mg/m2 and cytosine arabinoside (AraC) 2 g/m2 for 5 days, and granulocyte colony stimulating factor G-CSF 300 microgram/day from day 0 till neutrophil recovery (ANC >1.0 x 109/l).Response was evaluated by bone marrow examination on day 30-post chemotherapy.
Results: Patients included were refractory acute lymphoblastic leukemia (ALL) (n=5), relapsed ALL (n=4), refractory acute myeloid leukemia (AML) (n=8), relapsed AML (n=3). Complete remission (CR) was achieved in 9(45%) patients, 3 (15%) patients got partial remission. Three (15%) patients died of post chemotherapy complications and 5(25%) patient failed to achieve remission. Major complications encountered were: anemia, fever, bleeding, mucositis and bacterial infections.
Conclusion: FLAG protocol is well tolerated and effective regimen in relapsed / refractory acute leukemias. The toxicity is acceptable, enabling most patients to receive further treatment, including transplantation procedures
The lack of active 2019 coronavirus disease (COVID-19) pandemic treatment creates a challenge for researchers and scientists to find the most appropriate treatment for this disease. Dexamethasone, according to the findings of the RECOVERY clinical trial, declared mid-June 2020 in print media was one of those therapies. Although the results from retrospective studies are not strongly supportive of corticosteroid routine use in COVID-19 despite the signals for some benefits, the dedicated RECOVERY trial found a significant reduction in death with dexamethasone only in severe cases on a ventilator or moderate cases on supplemental oxygen therapy nevertheless, no benefit observed in mild to moderate cases requiring no oxygen. More studi
... Show MoreInfrastructure projects take a long time, are complex, multidisciplinary, use different materials and products, and have high risk. These characteristics affect the process of supplying materials. The current paper studies the ability to improve the supply chain process and decrease its cost by identifying the factors that affect it. These factors are used as variables in the mathematical model, which is working under uncertain conditions when the consumption rate of materials is not constant. The information used in this model is obtained from Building Information Modeling (BIM) and Geographical Information System (GIS) techniques and the genetic algorithm is utilized to determine the optimal supplier and the quantities of supplies
... Show MoreThe world is moving towards greening business in general and production systems in particular. At the same time, economic units seek to enhance their productivity and find any variables that can contribute to improving their elements. Economic units should not ignore the green dimension of cost management techniques because of its role in containing the green dimension of the production system and the product. However the few researches dealt with the subject of the green kaizen showed its role in reducing costs and improving the environment. Those researches did not address its contribution to raising the level of productivity. Productivity is an important indicator of economic units that expresses their level of success and progre
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Flooding hazard is an important and dangerous natural phenomenon that leads to significant material losses. It should be studied and scenario to prevent significant losses. The studies should consider the impact of many factors such as human, infrastructure, economic,..etc. The main objective of the research is the risk management procedure. The study was conducted in Baghdad, Iraq. The materials for completing this research were prepared by gathering a satellite image and Digital Elevation Model (DEM) via the USGS website, then processed, analyzed, and converted into a different flood region concerning the probability of rising water levels where the normal height of Baghdad city is 28m over sea level. This scenario defines 3m,
... Show MoreOur research addresses one of the aspects of nostalgia for one of the most well-known Israeli writers of Iraqi origin (Sami Michael) who spent his childhood in Baghdad. The Israeli government has also been forced to emigrate with its family as a result of the Zionist propaganda that the Zionist institutions have followed since the early decades of this century in the Arab unrest and massacres. The fact that the homeland is like a mother is A fact that is compelling and something of an expatriate human being; the homeland is a fact that remains in the person's consciousness to be the image of the mother: The lover, love, safety, identity. The language that is formulated, and the memories that make its past, present and future, are all concep
... Show MoreOne hundred and seventy-six cases of suspected meningitis (SMN) were included in a cross-sectional study. Their ages ranged from less than 1 year to 80 years, of whom 44.3% were male. The aim was to assess bacterial meningitis (BMN) in terms of incidence and types of causative bacteria. Cerebrospinal fluid (CSF) specimens were collected and polymerase chain reaction (PCR) analysis was conducted with universal primers designed to amplify a DNA fragment (996 bp) of the 16S rRNA gene of eubacteria. Resolving PCR products in agarose-gel electrophoresis revealed that 37.5% of CSF specimens were PCR positive, while 62.5% of CSF specimens showed no band and were considered PCR-negative. Eighty percent of the latter specimens were not
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