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OBJECTIVES: The purpose of this study is to evaluate the association of MASCC score (Multinational Association for Supportive Care in Cancer Score) in patients with febrile neutropenia (as resultant treatment of hematological disorders) for risk assessment of morbidity and mortality. PATIENTS AND METHODS: Patients presenting with Febrile Neutropenia from November 2011 till December 2013 were enrolled in the study. Initially all patients were hospitalized and their MASCC score was calculated, however those with high risk stayed in hospital till full ANC recovery while low risk group was discharged earlier and keenly followed as out-patient while being on prophylactic oral antibiotics. The MASCC risk-index score was calculated and patients with risk score >21 were regarded as low-risk while <21 were labeled as high-risk. RESULTS: On the basis of 226 febrile neutropenia patient 132(58.4 %) were categorized as low risk while 94(41.5 %) as high risk patients according to MASCC risk index score. In low risk group 123(93 %) had uncomplicated infection while 9(7 %) had complicated infections. There was no mortality documented in low risk group while eight patients died in high risk group. CONCLUSION: In this study we correctly predicted outcome of 123(93 %) low risk group patients. The study had positive predictive value of 93 % with both sensitivity and specificity of 65 and 75 % respectively. The MASCC risk score is a valuable tool in determining the outcome in patients with febrile neutropenia.
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Background. Febrile neutropenia is the consequence of treatment of hematological disorders. The first-line empirical treatment should cover the prevalent microorganism of the institute. The aim of study was to establish the effectiveness of current practices used at the institution and to review the culture sensitivity pattern of isolated microorganisms. Patients and Methods. Data was recorded and analyzed prospectively for 226 hospitalized patients of febrile neutropenia from January 2011 till December 2013. Results. Out of 226 cases, 173 were males and 53 were females. Clinically documented infections were 104 (46.01%) and microbiologically documented infections were 80 (35.39%), while 42 (18.58%) had pyrexia of undetermined origin. Gram negative infections accounted for 68 (85%) and Escherichia coli was the commonest isolate. Gram positive microorganisms were isolated in 12 (15%) cases and most common was Staphylococcus aureus. First-line empirical treatment with piperacillin/tazobactam and amikacin showed response in 184 patients (85.9%) till 72 hours. Conclusion. There is marked decline in infections due to Gram positive microorganisms; however, Gram negative infections are still of great concern and need further surveillance. In this study the antibiogram has shown its sensitivity for empirical antibiotic therapy used; hence, it supports continuation of the same practice.
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OBJECTIVES: Continuous education is mandatory for all urologists, and undertaking cooperative research is a very effective means for this. We describe the experience and possibilities for continuing education for urologists in the Kurdistan region of Iraq. We hope to provide a framework for stimulating urological education and research in other countries where urologists face the same obstacles. METHODS: Data were obtained from the perspective of two academics who co-operate with urologists from Iraq, and from the perspective of two officials from the Ministry of Higher education of the Kurdistan Regional Government who are responsible for stimulating continuous education. RESULTS: Based on a co-operative and supportive attitude of both Government and Academics, urologists in the Kurdistan region of Iraq have brought the standards of education and cooperative research to an internationally competitive level. CONCLUSION: The authors hope that the examples given here can stimulate urologists from Arab countries to fully engage in new urological developments, despite the obstacles that they perceive.
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The effect of ethanolic kiam wood extract (EKWE) and commercial tannin (CT) on the gel properties of surimi produced from mackerel (Rastrelliger kanagurta) stored in ice for different times (0 to 12 d) was studied. During 12 d of iced storage, pH, total volatile base (TVB), trimethylamine (TMA), and trichloroacetic acid (TCA)-soluble peptide contents as well as thiobarbituric acid-reactive substances (TBARS) of mackerel mince increased while myosin heavy chain (MHC) band intensity decreased continuously (P < 0.05). The result suggested that deterioration, protein degradation, and lipid oxidation proceeded with increasing storage time. For corresponding surimi, TVB and TMA were almost removed and TBARS and TCA soluble peptide contents were decreased. Conversely, MHC became more concentrated. Decreases in gel-forming ability of surimi were observed when fish used as raw material were stored in ice for a longer time, regardless of EKWE or CT addition. Whiteness of surimi gel decreased and expressible moisture increased especially when the storage time increased. However, superior breaking force and deformation of surimi gel with 0.15% EKWE or 0.30% CT added, compared to those of the control gel were observed during the first 6 d of the storage. Thereafter, EKWE and CT had no gel enhancing effect on surimi. Therefore, freshness was a crucial factor determining gel enhancing ability of EKWE or CT toward mackerel surimi.