Annals of the College of Medicine, Mosul

ABSTRACT
Background :Primary myelofibrosis is a Philadelphia-negative myeloproliferative neoplasm(MPN) with predominant proliferation of megakaryocytes and granulocytes in the bone marrow characterized by initial proliferative phase, followed by a reactive deposition of  fibrous connective tissue in the bone marrow.
Objectives : To evaluate the clinical and laboratory data in primary myellofibrosis and to correlate the genetic disorders with clinical and other laboratory parameters.
Setting : This case series study conducted at Ibn-Sina Teaching Hospital/Outpatients Hematology Department from November 2019 to April 2020.
Patients and method : Total fifteen  patients with primary myelofibrosis included in this case series (retrospective and prospective) study. The records of old cases were reviewed from patients for clinical history, clinical examination, previous blood counts, bone marrow study and genetic study. For new cases clinical history and physical examinations were noted, ten mls of venous blood were aspirated from patients (new cases) by clean venipuncture and delivered into sterile EDTA and gel tubes for doing complete blood pictures, genetic study (JAK2) and biochemical tests. Data were collected and analyzed by using SPSS software version 24.
Result : The males were (60%) of patients and females were (40%) with male to female ratio was 1.5:1, their age ranged from 43-75 years with a mean of 59.3 years. The most common complains were fatigue (86.7%), fullness in the abdomen (73.3%) and constitutional symptoms (66.7-80%). All patients(100%) had splenomegaly at presentation. The total mean Hb was 8.2 g/dl with a range of 4.7-12.5 g/dl. Leukocytosis had been observed in (40%) of patients, while thrombocytosis was found in (26.6%) of patients. Compared in hematological parameters in PMF patients with JAK2 Positive and JAK2 Negative, it was found that MPV significantly increased in JAK2 positive patients with p-value 0.03 .
Conclusion : old age groups (55-64 years) were commonly affected by primary myelofibrosis and males were predominance over females. The most common complains were fatigue and constitutional symptoms, while splenomegaly was the most common clinical sign. The mean platelets volume (MPV) significantly increased in JAK2 positive patients with p-value 0.03.

ABSTRACT
Background: The objective structured clinical examination is gaining popularity in most medical schools for its validity, reliability, and objectivity. It requires a lot of physical and financial resources and commitment.
Objective: To outline steps important to be considered when conducting objective structured clinical examination as an assessment skill for final undergraduate candidates in surgery with emphasis on the student's perception, satisfaction and acceptability.
Design: A purposive sample of 151 of 6th year undergraduate medical students attempted final objective structured clinical examination in Surgery.
Setting: Department of Surgery, College of Medicine, University of Mosul during the academic year 2011-2012.
Method: Purposive sample including 151 participants, who attempted objective structured clinical final examination in surgery for graduation. There were 65 males & 86 females. The examination was performed over 8 days. A well-organized ten objective structured clinical examination stations were chosen for assessment. The time allowed for each station was 6 minutes. An objective structured clinical examination organizing committee was established. The subjects for objective structured clinical examination stations were determined, a detailed plan of the students grouping and movement was established, and a notice for all students about objective structured clinical examination details was given. At completion of examination, students were given self-administered questionnaire and feedback to test their perception and satisfaction about the examination.
Results: Data of completed self-administered questionnaire were analyzed. Regarding station information, 78.8 %of students reported that the task questions in the stations are appropriate to the length of station, 82.7% replied that the stations are practical and 72.1% answered that the information in stations are clear. Reply from 86.7% was that the task was clearly stated, 82.1% responded that patient`s complaint in the clinical stations is brief and given in basic language, while 74.1% replied that findings are "well understood" and clearly described. Analyzing the stations structure, 80.7% of students stated that the number of the stations was enough and 84.7% agreed that the location of stations was good.
Conclusion: Objective structured clinical examination for undergraduates' surgical finals is a practical assessment tool even if large numbers of students are involved. Data of this study showed that overall student's perception, satisfaction and acceptability of objective structured clinical examination were encouraging.
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