ObjectivesSquamous cell carcinoma (SCC) is by far the most common malignant neoplasm of the oral cavity. A number of etiologic factors have been implicated in its development. During the past few decades, a particular focus has been placed on the investigation of valid biomarkers predictive of cancer behavior and cervical lymph node metastasis in head and neck Squamous cell carcinoma (HNSCC).The present study was designed to investigate the expression of epidermal growth factor in these tumors in relation to proliferation, apoptosis, angiogenesis and lymphangiogenesis.Materials and methodsImmunohistochemical (IHC) evaluation of epidermal growth factor receptor (EGFR) expression in 40 retrospective OSCC specimens and its correlation with proliferating cell nuclear antigen (PCNA), antiapoptotic antibody (P53), vascular endothelial growth factor (VEGF), and D2-40 monoclonal antibodies (Mab), in relation to the clinicopathological parameters.ResultsData revealed positive EGFR immunoreactivity in 35(87.5%) cases. There was a statistically significant correlation regarding EGFR extent score with respect to intratumoral lymphatic vessel density (ILVD) (r = 0.35) as well as EGFR intensity score with respect to ILVD and peritumoral lymphatic vessel density (PLVD) (r = 0.33, r = 0.36 respectively). EGFR expression was not correlated with the clinicopathological parameters. Conclusions: EGFR is expressed by most of the cases. EGFR correlation with D2- 40 positive lymphatic vessels suggests a higher tendency of OSCC for lymphatic dissemination. Lack of correlation among the studied markers suggests their independent effect on tumor behavior.

BACKGROUND: Preeclampsia (PE) is a possible etiology of obstetrical and neonatal complications which are increased in resource-limited settings and developing countries. AIM: We aimed to find out the prevalence of PE in Iraqi ladies and specific outcomes, including gestational weight gain (GWG), cesarean section (CS), preterm delivery (PD), and low birth weight (LBW). METHODS: All singleton pregnant women visiting our tertiary center for delivery were involved over 3 years. PE women were compared with non-PE ladies. Complete history and examination were done during pregnancy and after delivery by the attending obstetrician and neonatologist with full documentation in medical records. RESULTS: PE prevalence was 4.79%, and the affected women had significant (p < 0.05) higher age, body mass index, and GWG, but lower gestational age at delivery. The mean significant difference of GWG in PE and non-PE patients was 1.82 kg. PD and LBW had significant higher frequencies in PE. After considering several confounding factors, crude and adjusted odds ratio (OR) of PE with 95% confidence interval (95% CI) were significant in CS (crude OR = 2.25 and 95% CI = 1.42-2.87 while adjusted OR = 2.89 and 95% CI = 1.43–3.06) and PD (crude OR = 2.41 and 95% CI = 1.73–2.46 while adjusted OR = 3.96 and 95% CI = 2.65–6.37). On the other hand, only the crude model touched significance in LBW (crude OR = 3.67 and 95% CI = 2.51–4.99). CONCLUSIONS: Prevalence of PE in Iraqi pregnant females was higher than other neighboring developing countries. In PE ladies, maternal parameters, including GWG and operative delivery, and neonatal complications, including PD and LBW, were significantly higher than pregnant women without PE.

Bleeding disorders in pediatrics is an important issue and can be life-threatening if not diagnosed and treated appropriately. We aimed to evaluate Iraqi pediatric practice (as an example of resource-limited settings) about the use of Recombinant Activated Factor VII (RFVIIa) in bleeding disorders, with emphasis on its effectiveness and safety, in comparison with adjuvant therapy. Budget restrictions may affect the availability of even lifesaving drugs such as (RFVIIa). Therefore, we tried to investigate the local experience of pediatric bleeding, with the evaluation of the potential ability of adjuvant therapy of blood products and vitamin K to substitute RFVIIa in case of non-availability. During a complete one year`s period, 35 patients were recruited prospectively and divided into two categories; study group (on RFVIIa, with or without adjuvant therapy) and control group (only on adjuvant therapy of blood products, and vitamin K), involving 19, and 16 patients, respectively. The mortality rate in the study group was significantly less than the control group; (36.84%) versus (56.25%). Larger drops in prothrombin time (PT) (42%), and partial thromboplastin time (PTT) (47%), with less multi-organ dysfunction (29%) were noticed with the use of RFVIIa. Septicemia-associated disseminated intravascular coagulation was the most frequent indication of both groups; (31.58%) versus (37.50%), with a significant positive outcome in the study group. Total serum bilirubin levels were found to be lower in all neonates with jaundice within the study group. One patient had venous thrombosis following the RFVIIa administration.In conclusion, RFVIIa has the potential to stop pediatric bleeding episodes significantly better than adjuvant therapy alone, with significantly less mortality. Safety was ensured in all survived cases except one who had thromboembolism. Neonatal jaundice was improved by the use of RFVIIa.

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