Homozygosity for the Mediterranean alpha-thalassemic deletion [hemoglobin Baits hydrops fetalis]

Hemoglobin Barts hydrops fetalis syndrome is the most severe and generally fatal clinical phenotype of alpha-thalassemia. We diagnosed a fetus at 23-weeks gestation with having hydrops fetalis, by ultrasound. At 32 weeks, intrauterine death was detected. Molecular studies revealed that the fetus had the hemoglobin Barts hydrops fetalis syndrome due to homozygosity for the Mediterranean alpha-thalassemia deletion. This clinical phenotype is generally rare in the Eastern Mediterranean, and this is the first report of this syndrome from Iraq. Techniques for molecular characterization became available only very recently in this country, in a diagnostic setting. Thus, the detection of further cases might be expected in future

Thrombophilic mutations in blood donors in Duhok-Iraq

Thrombophilia is a mulitfactorial disease due to the interplay between acquired and inherited factors. Factor V Leiden [G1691A], Prothrombin [G20210A] and MTHFR [C677T] are among the important inherited causes. The prevalence of these three thrombophilic mutations has not been addressed collectively in Iraqis, including the population of Duhok. Determine the prevalence of thrombophilic mutations among healthy blood donors form Duhok. One hundred and fifty random healthy blood donors from the regional blood bank in Duhok-Iraq were investigated using multiplex PCR and reverse hybridization to oligonucleotide specific probes to detect Factor V leiden and MTHFR C677T mutations. While the first hundred donors were also screened using the same technology for Prothrombin G20210A mutation. Factor V Leiden and Prothrombin G20210A carrier states were found in 1.25% and 3% of the individuals screened for them, respectively. The MTHFR C677T homozygous and heterozygous states were confirmed in 8 and 44% respectively. This study demonstrated that while the prevalence of Prothrombin and MTHFR mutations were rather consistent with pattern seen in surrounding countries in the Mediterranean region, Factor V Leiden prevalence was the least ever reported from any other population in the region. The latter finding suggests that the contribution of Factor V leiden to thrombotic states in Northern Iraq may not be as significant as it is in other countries in the region

Neuroblastoma in Iraq: the experience of a major teaching hospital in Baghdad

A total of 59 consecutive patients diagnosed as Neuroblastoma in the period between April 1985 and December 1991 at Saddam's Medical City, were studied. The patients had a median age of 3 years, and a male to female ratio of 1.5:1. The main features at presentation included abdominai masses in 91.5%, pallor 66.1%, bone pain 322.2%, proptosis 28.8%, and lytic bone lesion [on skeletal survey] in 47.5%. The majority of the patients were at an advanced Evan's clinical stage at diagnosis [stage IV [59.3%] and stage III [27.1%]. The overall two year disease free survival was 20.3%. Significant association was found between two year disease free survival and younger age, less advanced clinical stage, free from lytic bone lesions, higher haemoglobin values, total leukocytes, platelets and absolute lymphocytes count. The poor survival figures for advanced Neuroblastoma observed in this series warrants reconsideration of treatment strategies employed, and considering the validity of investigations and other methods for early diagnosis of malignant disease and to improve survival

Haematological changes in kala azar: a study on 82 Iraqi patients

Haematological and clinical features of 82 Iraqi patients diagnosed as visceral leishmaniasis by bone marrow aspirates. were studied. All patients except one were less than eight years old. and their major clinical presenting features were fever. splenomegaly and hepatomegaly. while their haematological abnormalities were anaemia [96.3%]. thrombocytopenia [82.9%] and neutropeni a [68.3%]. Anaemia was mostly severe to moderate in degree, and was hypochromic and microcytic in 71.9% of the cases. In the majority of the latter cases non deficiency was implicated. It was also found that, in addition to the central role of hypersplenism. the clinical. and haematological findings in this studs indicate that various factors including ineffective erythropoiesis and granulopoiesis. iron deficieney. failure of iron uptake by the erythron. megaloblastosis. And immune haemolysis have variable contributions to the various haematological changes noted in this disease