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 aim of the research is to evaluate the response of the researched leaders towards practicing the concept of the lens, which is its dimensions with (stakeholders, resource mobilization, knowledge development, culture management) and the nature of its relationship to tax pioneer performance represented in its dimensions (strategic direction, leadership indicators, growth, renewal and modernization, efficiency, Effectiveness) The questionnaire was approved as a main tool in collecting data and information from the sample members in the General Authority of Taxes, which number (91) Who are on (M. General Manager, Division Director, Deputy Director, Senior Division Director, Deputy Director, Second Division, Division Officer, M. D
... Show MoreThe advent of UNHCR reports has given rise to the uniqueness of its distinctive way of image representation and using semiotic features. So, there are a lot of researches that have investigated UNHCR reports, but no research has examined images in UNHCR reports of displaced Iraqis from a multimodal discourse perspective. The present study suggests that the images are, like language, rich in many potential meanings and are governed by clearly visual grammar structures that can be employed to decode these multiple meanings. Seven images are examined in terms of their representational, interactional and compositional aspects. Depending on the results, this study concludes that the findings support the visual grammar theory and highlight the va
... Show MoreThe judgment enjoys many potential sources. If we look at these sources with analytical view that enable us to identify the potentials of strength in them which is the existence of features that distinct each place from the other one, which can be considered opportunities that provide the designer and the planner the possibility to design and planning which is based on subs taken from the reality of the available data of the location.
At this point outstands the role of development sources as one of the processes of re-configuring the place which appear as a result of a reality that requires setting new goals for the society and to achieve these goals it takes observations dealing with the place policies that should be taken, so this
A substantial matter to confidential messages' interchange through the internet is transmission of information safely. For example, digital products' consumers and producers are keen for knowing those products are genuine and must be distinguished from worthless products. Encryption's science can be defined as the technique to embed the data in an images file, audio or videos in a style which should be met the safety requirements. Steganography is a portion of data concealment science that aiming to be reached a coveted security scale in the interchange of private not clear commercial and military data. This research offers a novel technique for steganography based on hiding data inside the clusters that resulted from fuzzy clustering. T
... Show Moreالخلاصة
یعد والت وتمن شاعرا استثنائیا سواء أكان ذلك في المكانة التي یحتلھا في الأدب الأمریكي او في نمط
اع t ذا الإیق t لة ھ t ة وص t وافقي خاص t اع الت t تخدامھ الإیق t ي اس t دي ف t ر تقلی t عرا غی t الشعر الذي یكتبھ. لقد كتب وتمن ش
ل t ة للتوص t ف الطبیع t وافقي لوص t اع ا لت t ن الإیق t تخدم وتم t ر ، اس t بوحدة الكون الذي عبر عنھ في شعره.وبمعنى آخ
نص t ل ال t جام داخ t رابط وانس t یج مت t ھ نس t ق انظم t دف لخل t ھ تھ t اھره أدبی t واف
Given that the Crimean and Congo hemorrhagic fever is one of the deadly viral diseases that occur seasonally due to the activity of the carrier “tick,” studying and developing a mathematical model simulating this illness are crucial. Due to the delay in the disease’s incubation time in the sick individual, the paper involved the development of a mathematical model modeling the transmission of the disease from the carrier to humans and its spread among them. The major objective is to comprehend the dynamics of illness transmission so that it may be controlled, as well as how time delay affects this. The discussion of every one of the solution’s qualitative attributes is included. According to the established basic reproductio
... Show MoreBackground: Moral distress, as one of the most important issues in the nursing profession, can negatively affect the healthcare system Objectives: To examine the effect of moral distress on decision making. Methodology: A descriptive cross-sectional study a non-probability sampling method was used and a total sample collected was (126) ICU nurses Result: Moral distress among ICUs nurses were moderate and decision making was good Conclusion: Although nurses in ICUs perceive good decision making but suffered from moderate MD which affected their decision making. MD is still an important issue that nurses may face in ICUs Conclusion: Although nurses in ICUs perceive good decision making but suffered from moderate MD which affected the
... Show MoreAmpullary carcinomas are uncommon malignant tumours of the digestive system, they usually are adenocarcinomas presenting histologically as three types: intestinal, pancreaticobiliary and mixed. β-catenin is a multifunctional protein involved in physiological homoeostasis and intracellular adhesion. Abnormal nuclear accumulation of β-catenin has been described in many malignancies such as colon, breast, liver and others. The relationships between the immunohistochemical expression of β-catenin and the subtype, the grade and the stage of ampullary carcinoma are studied.