Print ISSN: 0027-1446

Online ISSN: 2309-6217

Main Subjects : Pathology


Effectiveness of antiplatelet thromboprophylaxis in myeloma patients using immunomodulators in Kurdistan region-Iraq

Rezhen Botany; Ahmed K. Yassin; Firiad Hiwaizi; Abid M. Hassan; Hisham A. Getta; Najmaddin Salih Husen Khoshnaw; Sana D. Jalal; Akram M. Mohammed; Kawa M. Hasan; Dana A. Abdulla; Ameer I.A. Badi; Nassir A. S. Al-Allawi; Banaz M. Safar; Basil K. Abdulla; Rawand P. Shamoon; Truska A. Amin; Zeki A. Mohamed; Ali I. Mohammed; Diveen J. Hussein; Nawsherwan S. Mohammed

Annals of the College of Medicine, Mosul, 2020, Volume 42, Issue 1, Pages 35-41
DOI: 10.33899/mmed.2020.126833.1023

Abstract:

Objective: To evaluate the effectiveness of antiplatelet drugs in preventing thrombosis in multiple myeloma patients treated by immunomodulatory drugs
Methods: The study includes a hundred seventy six patients of symptomatic multiple myeloma treated in hematology unit of three centers in Kurdistan region of Iraq from February 2014 to July 2019. Demographic data were obtained from patient’s file, including the type of immunomodulatory drugs, antiplatelet use, thrombotic events and their site, presence of other comorbidity, and whether the thrombosis was before or after the diagnosis of multiple myeloma.
Background and objectives: Multiple myeloma is a malignant disease that affect both gender and associated with increased risk of thrombosis, one of the effective method of treating myeloma is through using immunomodulatory drugs especially when combined with high dose dexamethasone with in turn boost the risk of thrombosis, in this study we investigate the effect of antiplatelet in preventing thrombosis.
Methods: This is a retrospective study that include 176 cases that are collected from cancer centers at Kurdistan region of Iraq from Feb/2014 to Jul/2019 information gathered through questionnaire.
Results: Regardless the type of therapy in the study sample 11.1% who were taking anti-platelet therapy developed thrombotic attack compared with 46.9% who were not taking the anti-platelets therapy. The incidence of the thrombotic attack among those myeloma patients who used immunomodulatory drugs was 9.6% who were on anti-platelet drugs which is significantly lower than the rate (52%) among patients not taking the anti-platelet drugs.
Conclusions: As multiple myeloma is a malignant disease and treatment with immunomodulatory drugs associated with increased risk of thrombosis, antiplatelet drug is an effective measure when used as a prophylaxis for preventing thrombosis.
Keywords: Multiple myeloma, Thrombosis, Antiplatelet

Ki-67 Expression in Breast Cancer, Its Correlation with ER, PR and Other Prognostic Factors in Nineveh Province

Hatem Abd-AlMajeed Al-Nuaimi; Elaf Hamdi; Banan Burhan Mohammed

Annals of the College of Medicine, Mosul, 2020, Volume 42, Issue 1, Pages 1-10
DOI: 10.33899/mmed.2020.127375.1037

Objectives: The aggressiveness of malignant tumors of breast can be correlated with the proliferation of neoplastic cells, and this detected by immunohistochemical study of proliferative index (Ki-67). American Society of Clinical Oncology (ASCO) does not recommend the use of Ki-67 routinely to predict the outcome of breast cancers, therefore the aim of current study is to detect the expression of Ki-67 in patients with primary breast cancer in Nineveh Province/North of Iraq and to correlate it with estrogen and progesterone receptors in addition to other prognostic factors.
Methods: In this retrospective-case series study eighty cases of histologically proven primary breast carcinomas were included. The cases were collected from hospitals and private laboratories in Nineveh Province / North of Iraq and studied Immunohistochemicaly for Ki-67, estrogen receptor (ER) and progesterone receptor (PR) were done on tissue sections embedded in paraffin wax. An area with the maximum proliferation was chosen to evaluate Ki-67 and the cases with ≥20% positive nuclei were considered as high Ki-67 expression while those with <20% positive nuclei were considered as low Ki-67 expression.(10-14).
The findings of Ki-67 were correlated with the age of the patients, histological type, grade of the tumors and with the estrogen and progesterone receptors.
Results: The Ki-67 immunoreactivity was highly expressed in (45%) of the cases. Estrogen and progesterone receptors observed in (77.5%) and (67.5%) of the cases respectively. The Ki-67 was significantly associated with grade of tumor, estrogen receptor and progesterone receptor (P= 0.0057, 0.037 and 0.006 respectively). While the association with patientsˈage and histological types were not statistically significant.
Conclusion: Ki-67 expression shows a significant direct correlation with grade of tumors and a significant inverse correlation has been shown with a well-known predictive factors, (estrogen and progesterone receptors).

Endoscopical and Histopathological Interpretation of Gastritis in Nineveh Province

Wahda Al-Nuaimy; Huda M Faisal

Annals of the College of Medicine, Mosul, 2019, Volume 41, Issue 1, Pages 28-35
DOI: 10.33899/mmed.2018.161275

Objectives: To assess the diagnostic value of endoscopical findings compared to histopathological diagnosis, to delineate the relative frequency and pattern of different types of gastritis and their association with H. pylori and intestinal metaplasia in our locality, and to compare the results of this study with those of others.
Methods: In a cross sectional study 150 selected patients with different upper gastrointestinal symptoms have been examined at endoscopy units in Ibn-Sina teaching hospital and Al-Jamhori teaching hospital in Mosul city, from the first of June 2013 to the first of March 2014, all were assessed endoscopically and biopsies from both antral and body mucosa were taken for histopathological examination.
Results: This study has revealed gastritis histopathologically in 96.6% of cases, and the agreement between endoscopical and histophathological diagnosis was 88%. The chronic superficial gastritis represented the highest relative frequency  in this histopathologically diagnosed gastritis, where it was seen in 61.3% of the cases and it’s relative frequency decreased with advance age, while chronic atrophic gastritis was diagnosed in 30% of the cases and it’s relative frequency increased with advanced age, while gastric atrophy wasn’t detected in any case. Acute gastritis was detected in only 5.3% of the cases.
   Helicobacter pylori was detected in 67% of cases. A significant association was detected between chronic gastritis and Helicobacter pylori infection, and its frequency decreased with increased severity of glandular atrophy. Follicular gastritis was diagnosed in 51% of chronic atrophic gastritis and 91.3% of them were Helicobacter pylori positive cases. By the use of the special stain AB/PAS pH (2.5), intestinal metaplasia has been diagnosed in 23% of cases and it’s relative frequency increased with advanced age.
Conclusion: There is a high rate of concordance (88%) between endoscopical findings and histopathological diagnosis of gastritis. Among gastritis chronic variety was the commonest. H. pylori had a significant association with chronic gastritis (chronic superficial gastritis and chronic atrophic gastritis). Intestinal metaplasia has been detected mainly in chronic atrophic gastritis and its frequency increased with advanced age.