No abstract

Chronic lymphoid leukemia (CLL), is the most common type of leukemia (a type of cancer of the white blood cells) in adults representing 25%-30% of all leukemias, CLL is a disease of adults. Most (>75%) people newly diagnosed with CLL are over the age of 50, and the majority are men, The leukemia is characterized by a clonal expansion of long-lived mature-appearing B lymphocytes that co-express the CD5, CD19, and CD23 surface antigens.CD39 (ectonucleotidase, NTDPase1) is an ADPase found on the surface of endothelial cells, normal lymphocytes and other leukocytes, Its principal function on the endothelial cell surface is to decrease platelet activation and recruitment by metabolizing platelet-released adenosine diphosphate (ADP). In leukocytes the enzyme has a variety of other direct or indirect effects as well, including modulation of cytokine expression and the inflammatory response. The aim of this study to review the role CD39 in patients with chronic lymphocytic leukemia and correlate it with the severity of the disease. A total of 5 papers were obtained using the mentioned keywords in the research of all internet-based databases. The total number of cases in all of the studies was 716 cases.The mean age was recorded in 5 papers was 64.7 years. There are different method of detection of CD39 in different studies such as flow cytometry and immunohistochimistry .

Objective :to present an updated overview of multifetal pregnancy as well as to study the problems of multifetal pregnancy in our community via a hospital-based study. Methods :data concerning maternal and neonatal adverse outcomes in multiple pregnancy was collected from feb. 2017 to jan. 2018. IBM-SPSS (version 24) was used for statistical data analysis. Results :The prevalence of multifetalprgnancy was 4.5% , Mean maternal age was 27.3 years with SD 5.9 years, and ranged from 17 to 42 years, Mean of gestational age was 31 weeks with SD 6.1 weeks, and ranged from 17 to 40 weeks, risk factors of multiple pregnancy was 17% history of ART and ovulation inducton in 53%. Only 13% had family history of multiple pregnancy and only 4% had previous history of multiple pregnancy, , 85% of the study group had a twin , 11% had a triplet and 4% had a quadriplet., that 21% had inevitable abortion, 2% had Deep venous thrombosis(DVT), 2% had threatened abortion, also 2% had missed abortion, 3% had polyhydraminos, 3% had Intrauterine fetal death(IUFD) , 27% had premature rupture of membranes(PROM), 12% had Pre_eclampsia, only 1% had eclampsia, 10% had Hyperemesis gravidarum(HEG), 2% had gestational DM, 4% had gestational hypertension , 2% had congenital anomalies and 1% had antepartum hemorrhage , 56% had CS, 23% delivered vaginally and 21% had abortion, 30% not need neonatal intensive care unit (NICU), 43% need NICU, 4% had neonatal deaths, 23% abortion and 51 % preterm baby. Conclusion :Multifetal pregnancies are associated with increased maternal and perinatal risks specially preterm delivery that increase risk of neonatal morbidity and mortality. There is a need for specialized antenatal care to reduce complications via wise used of ovulation induction , fetal reduction, single embryo transfer in case of ART .

Acute kidney injury is common in critically ill children admitted to intensive care unit. Sepsis remains a significant risk factor and it is the leading cause of acute kidney injury in critically ill children. The aim of the study is to evaluate the outcome of AKI in critically ill septic children. Sixty eight patients, who met criteria of sepsis and related syndromes, were classified into two groups (AKI and non-AKI groups). Patients with AKI are much younger than those without AKI. Hypervolemia is present in about 28% of patients with AKI and the pulmonary oedema is pesent in about 6% of those patients. Patients with AKI need more support as regard to inotropes, mechanical ventilation and the need for RRT [P value< 0.05] than patients without AKI. Patients with AKI have a higher PRISM score [20 vs.9] and a higher mortality rate [62% vs.8%] than patients without AKI. In conclusion, AKI is common among critically ill children and early diagnosis is vital to prevent and decrease associated morbidity and mortality.