Antiphospholipid syndrome, Review of 24 Iraqi patients

Antiphospholipid syndrome [APS] is a disorder in which vascular thrombosis and/or recurrent pregnancy losses occur in a patient who has laboratory evidence of antibodies against phospholipids or phospholipids binding protein cofactor. Usually the patient presents at an age between 35-45 years, with equal male to female ratio. Mostly they present with thrombosis or Pregnancy complication. A quarter of the patients have thrombocytopenia and about one fifth have hemolytic anemia. The diagnosis rests on the criteria set as the Revived classification criteria for the Antiphospholipid syndrome During the period from 1st Jan. 2002 until the Jan. 2006. 24 patients who met the criteria of APS [according to Revised class classification criteria for the antiphospholipid syndrome] were included in the study. The diagnosis of deep venous thrombosis [DVT] was done by using Doppler study of the selected organ, while brain CT and magnetic resonance imaging, were used to diagnose cerebrovascular thromboses. Serological evidence of APA were either an abnormal KCT and KCT index and/or a positive aCL antibody test on 2 occasions. Three quarter of our patients were females more than half them aged 21-30 years 54.16% of our patients presented with thrombosis the commonest site of which was DVT of lower extremities. Abortion alone was the presenting problem in two patients and two patients presented with thrombosis following abortion Another two patients presented with bleeding problems. Gathering the history follow up abortion occurred in ten of the thirteen premenapausal married ladies, of whom five had more than three abortions. ILaboratory evaluation revealed anemia in 8 patients [33.33%] and thrombocytopenia in 5 patients [20.8%].The KCT and KCT index were suggestive of he 23 patients tested [60.86%] and the aCL was positive in 15 of the 19 tested patients [78.94%] We think that our study, although small, highlights some of the clinical and laboratory findings of this syndrome in Iraq patients, larger studies are needed for better evaluation

Acute lymphoblastic leukaemia with lymphomatous features: poor response to conventional induction therapy

Thirty three patients [age 12-56 Y] with newly diagnosed acute lymphoblastic leuckaemia [A.L.L] who were admitted to Baghdad Teaching Hospital Jan 1994 and June 1995 were studied. Thirteen patients has Lymphomatous A,L,L and 20 patients did not show such features and served as the control group. Both groups received the same induction chemotherapy with Vincristine. Doxorubicine, and Prednisolone for 6 weeks. The rate of complete remission [C,R was 46% for the Lymphomatous A,L,L group and this difference was statistically significant [P < 0.05]

Bleomycin doxorubicine and prednisolone combination for induction therapy for high risk acute lymphoblastic leukaemia

In the period between September 1993 and January 1994, Vincristine was not available in Iraq. During this period, ten patients [aged 13-40 years] were admitted to one of the medical units at Baghdad Teaching Hospital - Baghdad with the diagnosis of high risk Acute Lymphoblastic Leukaemia [ALL] [seven were newly diagnosed cases, while three were relapsed ALLs]. These patients received an induction therapy consisting of Bleomycin, Doxorubicine and Prednisolone. Of the seven newly diagnosed ALL so treated, six obtained complete remission, 2 of whom were still in remission at their last follow up 110 weeks of their initial diagnosis. The remaining 4 patients relapsed 2-80 w after diagnosis due to non-compliance with maintenance therapy. None of the three relapsed ALLs cases achieved complete remission. This regimen was not a trial and was stopped as soon as Vincristine became available again, however the encouraging results noted warrant in our opinion reconsidering the role of Bleomycin in induction protocols for newly diagnosed high risk ALLs

Acute non lymphoblastic leukemia in adults results of attenuated chemotherapy

Between September 1993 and September 1995, 30 patients with acute non-lymphobastic leukemia [ANLL] were studied. Their age range was 14-58 years. Sixteen patients received a regimen of 2 days of doxorubicine and 7 days of cytosine arabinoside, 10 patients [62.5%] went into complete remission and the 2 years disease free survival was evident in one patient [6.25%]. Death during induction occurred in 5 patient [31.25%]. Seven patients received low dose cytosine arabinoside and only one patient went into complete remission with an induction related mortality of 28.4%. No long form re mission was observed. The remaining 7 patients died before treatment [pretreatment death]

value of C-reactive protein in the diagnosis of bacterial infections in patients with acute leukaemia

Thirty- four patients with acute leukaemia were studied regarding the level of C.R.P. during acute bacterial infections using the latex agglutination test with positive results indicating a level > 6mg/1. Sixteen patients had bacterial infections and eighteen patients made the non infected control group. The infected group had statistically significant higher number of positive C.R.P. tests and the sensitivity and specificity of a positive C.R.P. in patients with acute leukaemia and bacterial infections were 93.7% and 72.2% respectively

Community acquired staphylococcus aureus bacteremia, review of 27 cases

Twenty-seven adult patients [age range 14-77y] with community-acquired staphylococcus aureus bacteremia were studied between Jan, 1993 and Mar. 1994. Twenty patients [74%] had an underlying medical condition, 92% of the bacterial isolates were sensitive to cloxacillin while 75% of the strains were erythromycin resistant. The overall mortality was 37% and was higher among patients with underlying conditions or in patients who didn't receive antistaphylococcal antibiotics

Typhus fevers in Iraq

Fourty patients with febrile illness without apparent cause that were admitted to Baghdad Teaching Hospital during a period of one year were screened for Rickettsia Conori and Rickettsia typhi infections. Six cases, R conori and one case with R. typhi were documented