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Background: Chronic myeloid leukaemia (CML) treatment was revolutionized by tyrosine kinase inhibitors (TKIs), reducing annual mortality from 10-20% to 1-2%. This study assessed health-related quality of life (HRQoL) in patients receiving long-term TKI therapy in the Kurdistan region of Iraq.

Methods: This observational study included 161 adult CML patients (90 males, 71 females, mean age 46.1 years) across three hospitals from January to August 2024. HRQoL was assessed using EORTC QLQ-C30 and QLQ-CML24 questionnaires, comparing outcomes between different TKIs (Imatinib, Nilotinib, and Bosutinib), gender, age groups, and comorbidity impacts.

Results: Imatinib patients showed better emotional functioning than Bosutinib (80 vs. 73, p=0.027). Female patients reported more severe symptoms across multiple domains, while males demonstrated better physical, emotional, and cognitive functioning. Younger patients (<40 years) showed better HRQoL outcomes. Increasing comorbidities correlated with decreased functional scales and increased symptom burden. Significant differences were observed in pain, diarrhoea, and constipation between TKI groups.

Conclusion: While CML patients maintain a relatively good quality of life on TKI therapy, persistent impairments remain in certain domains. Younger age and fewer comorbidities were associated with better outcomes. Gender-specific approaches to supportive care and comprehensive health management beyond CML treatment are recommended. These findings can inform clinical decision-making and identify areas for targeted interventions to enhance the quality of life in CML patients.

Aim of the study: to determine the frequency of joint lesions (JnL) in children with juvenile localized scleroderma and it's possible correlation with autoantibodies and markers of fibrosis.

Materials and methods: 500 children with JLS (370 girls and 130 boys) were studied retrospectively for the joint lesion, using standard physical examination, ultrasound examination (UlS) X-ray, MRI. In 190 patients we investigated antinuclear antibodies (antinuclear factor (ANF), rheumatoid factor (RF), antitopoisomerase 1 and anticentomere antibodies, antibodies to DNA, autoantibodies to collagen (Cab) types I-IV, cryoglobulins (CG), serum fibronectine (FN) and hyalyronic acid (HA) levels.

Results: JLS patients were divided into 4 groups:124 patients with circumscribed morphea, 259- linear scleroderma, 93- generalized morphea, pansclerotic in 1 patient, mixed morphea - 23 patients. JnL were noticed in 175 patients (35%), among them the majority 151 patient (86%) with linear and unilateral forms of JLS. JnL were presented by joint pain in 47% of patients, limitation of joint movement in 60% of affected patients, mostly due to periarticular induration or tissue fibrosis. UlS showed joint effusions - in 16% of JnL, sinovitis and tenosinivitis in 45%. In 12 children joint space narrowing was detected by X ray, in 2-articular erosions. MRI was performed in 97 patients with limitation of joint movement, active synovitis, tenosynovitis found in 80 children. In 1 girl with unilateral scleroderma MRI with contrasting visualised avascular osteonecrosis of tibia. The absolute percentage of positive values detected autoantibodies and fibrosis markers was higher in children with JnL. ANF was detected in 56 % and RF in 28,4 % of patients with JnL, while sclerodermo specific antibodies and ds-DNA were detected in small percentage of JnL patients and in none without it. The levels of CG, FN, HA and Cab were elevated in patients with JnL. Cab of type I and type II were detected in most cases of JnL patients (71% and 62% correspondingly).

Conclusion: JnL occurs in 35% of JLS patients, predominantly in linear and unilateral forms of the disease. Detection of autoantibodies and fibrosis markers in 27-56% of JnL cases demonstrates the activity of autoimmune inflammation and justificates early systemic immunosuppressive therapy in JLS.

Aim: Current study was aimed to appraise the effectiveness and tolerability of apremilast in psoriasis patients at AL-Diwaniyah province, Iraq.

Materials and methods: This prospective cross-sectional study conducted at Dermatology Unit/ AL-Diwaniyah Teaching Hospital/ Iraq, during the period from January to October 2023. A total of 125 patients, 90 males and 35 females, were enrolled in this study. Patients who were eligible were treated for 6 months using apremilast at a dose of 30 mg/day. Psoriasis Area and Severity Index scoring system was used for assessment of patients' response to treatment. Data were analyzed using the Statistical Package for Social Sciences (version 26).

Results: Data from current study revealed that there was a significant reduction of mean PASI score from 20.37±6.25 at baseline to 3.72±2.09 after 6 months of treatment (p<0.001).

Conclusion: Apremilast is effective in reducing PASI mean score with negligible adverse effects. However, multi-center studies are needed to establish its efficacy and safety in Iraqi patients with psoriasis.

A mental disorder is a condition that affects an individual's cognition, emotional regulation, or behavior, causing distress or impairing main areas of functioning. The effects of electromagnetic stimulation (EMS) and oxytocin (OXY) on blood corticosterone (CORT) levels in immobilized (10 days, 2 hours a day or one time, 2 hours) male and female rats while accounting for their sex hormone levels were studied. The experiments were conducted on intact and gonadectomized rats. As a result of immobilization, the content of CORT in the blood increased in both groups of rats. Chronic immobilization stress dysregulates HPA axis function in rats of both sexes. Repeated EMS and OXY intranasal (IN OXY) (18 IU) (after each session of immobilization) or intracerebroventricular (1 μl/animal) returned the blood CORT level to normal. The effects of EMS and IN OXY were significant in intact rats compared with gonadectomized rats. EMS and IN OXY enhance the negative feedback of CORT.

The addressing this question in udder tissue (main target of the metal) and test here if uranium U at low concentrations could also be a pro-oxidant. The research deals with different groups of grass-fed cows in several locations where the same phenomenon represents a case from Basra/Iraq. The histopathological examination of the udder in cows with (U) revealed hemangiomatous transformation. For the uranium, experts used a sodium iodide instrument to perform measurements and analyzed samples of cow udders as these organs are most affected by uranium. The tissues were being inflamed and they would die, becoming degenerated and necrotic (inflammatory). But, if given in high doses leads to the formation of different tumors: GGFL (gentle giants famous large udders) or clear cell carcinoma, Sarcomatoid type RCC. There is toxic uranium in the levels of grass that cattle consume and as a result there) cause defense allergies prevail over cows it is easy to induce oxidative pressure within their udders. However, even under (U) doses restraint stressors are seldom found to have additional negative effects at baseline value but the additive influence of these is never ruled out.

Background: Sarcopenia has a negative impact on the number of populations. The frequency of sarcopenia in polytrauma patients, however, is little understood. Knowing how many people face a bad outcome will raise awareness and help stop additional muscle mass loss.

Aim: This pilot study's objectives included determining prevalence of the low mass of muscle in the aged patients of poly-trauma and examining the links between complications, low muscle mass, death, and the inflammatory response.

Method: All polytrauma patients who were seen between 2017 and 2021 at the level-I trauma centre were included in the data from the regional perspective registry of trauma. The computed tomography (CT) of the abdomen's availability and the height in the subjects was screened to determine the skeletal mass index (SMI), which is utilised to calculate the sarcopenia. Additionally, factors of clinical outcome were evaluated. A multivariate regression analysis was conducted if parameters related to a poor result were found through a univariate analysis.

Results: Sarcopenia was prevalent in 33.5 percent of the population overall, but in older age groups (60-79 years), it was significantly more prevalent, reaching to 82 percent in the individuals over the 80 years old. The ISS (Injury severity score) where the p=0.026, age where the p<0.0001, the CCI (Charlson comorbidity index) where the p=0.001, injury severity score, and the 30-day or the in-hospital mortality were all associated with sarcopenia. The Injury Severity Score (ISS) is a medical scoring system to assess trauma severity based on the extent of injuries in various body regions. Sarcopenia was discovered to be a predictor of the 30-day mortality by log rank analysis (p=0.032).

Conclusion: In conclusion, we found that polytrauma patients had a significant prevalence of sarcopenia, which increased with age. Additionally, sarcopenia was found to be the predictor of the 30-day death, highlighting clinical importance of finding the low muscle mass on the CT-scan, which was already regularly performed on the majority of patients of trauma.

Aim: to analyze the short- and long-term outcomes of surgical treatment of patients with gastric cancer who received perioperative chemotherapy (PCT) FLOT (fluorouracil, leucovorin, oxaliplatin and docetaxel).

Materials and methods: A retrospective cohort study included 146 patients who received surgical treatment at the Faculty Surgery Clinic of Sechenov University for gastric cancer (GC) and/or EGJC Sievert Type II-III in the period from January 2018 to December 2022. The main group consisted of 28 patients who received PCT FLOT; there were 118 patients operated "up front" in control group. Patients in both groups did not statistically differ in average age (p=0.110), ASA (p=0.541) and ECOG (p=0.12) status, localization (p=0.063), depth of invasion (p=0.099) and histological structure of tumor (p=0.787).

Results: In 92.9% of the patients in the main group and in 94.9% of the control group, R0 resection margins (p=0.750) were achieved. The number of dissected lymph nodes was statistically significantly higher in the main group (average 26 vs 21; p=0.010). There was no difference in intraoperative blood loss (p=0.294) and time of hospital stay (p=0.992); the average duration of surgery in the main group was 319 minutes, compared to 250 minutes in the control group (p<0.001). In the early postoperative period, the total number of complications (CD Ⅰ-IV) was higher in the main group (p=0.031), however, there was no difference in the number of minor (CD Ⅰ-Ⅱ; p=0.094) and significant (CD III-V; p=0.142) complications. Postoperative mortality in the first 30 days after the surgical treatment was 3.6% and 2.5% in the main and control groups, respectively (p=0.764). The overall 6-month survival rate in the control group was 95.9% vs 90.9% in the main group, and the 12-month survival rate was 88.8% vs 75.7%, respectively. The reccurence-free 6-month survival rate in the control group was 96%, in the main group - 100%; the reccurence-free 12-month survival rate in the control group was 92.1%, in the PCT group - 93.3%.

Conclusion: PCT FLOT in the treatment of GC does not increase the level of intraoperative blood loss, the number of postoperative complications and the duration of hospital stay. The 6-month and one-year survival rates did not differ in the two groups. Considering that the majority of patients in the PCT group belonged to the cN+ category, with an initially less favorable treatment prognosis, it can be assumed that comparable survival results were achieved thanks to PCT.

Introduction: Artificial intelligence techniques such as machine learning have made it possible to create neural networks for the recognition of MRI and X-ray images, which has improved the diagnosis and treatment of orthopedic diseases. The purpose of our review was to synthesize and analyze publications on the use of artificial intelligence in the diagnosis and treatment of diseases of the musculoskeletal system.

Materials and methods: Utilizing a systematic narrative review method, we evaluated 348 publications from 2019 to 2024, with 201 of these being openly accessible. These publications were sourced from the Scopus and PubMed databases, focusing on key terms such as "Machine Learning", "Orthopedic Diagnostics", "Virtual Reality", and "Diseases of the Musculoskeletal System". We selected 89 publications for detailed analysis to identify the primary AI methods employed in orthopedics and to assess their diagnostic and therapeutic efficacy. During the literature analysis, the main areas were determined: the main methods of artificial intelligence used in orthopedics and the results of their application for diagnosis and treatment.

Results: The analysis of publications showed the effectiveness of the use of AI in the analysis of MRI, CT and X-ray images. Techniques used by AI, such as machine learning, deep learning, virtual reality, and their effectiveness in performing diagnostic and treatment procedures were considered.

Conclusions: The use of artificial intelligence in the diagnosis and treatment of orthopedic diseases demonstrated an increase in diagnostic accuracy, which contributed improvement of treatment results.

Introduction: The objective of this study was to investigate the heart rate variability indicators of students who had contracted COVID-19 after performing physical activity. The aim was to uncover the potential cardiac complications and dysregulations of the autonomic nervous system.

Material and method: We explored about 11 heart rate variability indicators and their changes immediately after a 5-minute physical activity performed by using Proteus pes 3320 bicycle odometer. Furthermore, we conducted electrocardiographic recording using variational pulsometry. Recording and the analysis of ECG were carried out on a computer using special programs "Cardio reg" and "Cardio prog".

Results: The study revealed that the activity of the heart rhythm regulation indices among students infected by coronavirus was significantly elevated compared to the healthy controls (p<0.05). After the physical activity, the Tension Index, VBI, VRI and LF/HF indicators characterizing the sympathetic tone of HRV regulation were increased, while the coefficient of cardiointervals variation decreased among infected group students. Moreover, the ECG recording showed that after physical activity, the disturbances of cardiac functioning changed, accompanied by tachycardia.

Conclusion: The findings of this study demonstrate that short-term physical activity contributed to the transition of cardiovascular system indicators from the adaptive stress zone to the tense zone, which is likely due to the negative impact of COVID-19 on the capabilities of both the cardiovascular and nervous systems. Therefore, this study contributes to a deeper understanding of changes in HRV in the context of post-COVID-19 cardiovascular dysfunction among young adults.

Massive upper gastrointestinal bleeding still remains a challenge, which can cause serious clinical problems especially in high-risk patients. We present a rare case of patient with complex pathology successfully managed by endovascular treatment. A 78-year-old man with a medical history of chronic bronchitis, several minor strokes, type II diabetes, a 30-year history of smoking, and a family history of cardiovascular disease, presented with severe pain on the left side of his chest radiating to his left arm. Urgent coronary angiography (CAG) revealed subtotal occlusive thrombosis of the proximal right coronary artery (RCA). An immediate percutaneous coronary intervention (PCI) was conducted and after thrombus aspiration, a 4.0 mm × 30 mm drug-eluting stent (JW Medical Systems) was implanted in the proximal RCA. 12 hours after surgical intervention the patient experienced a sudden syncopal episode. Emergency fibrogastroscopy revealed active gastroduodenal bleeding from a chronic anterior duodenal ulcer measuring 2.0 mm × 1.5 mm. Endoscopic hemostasis failed and due to patient's unfavorable risk factors (hemorrhagic shock, hemodynamic instability, coagulopathy and etc.,) open surgery was considered as a very high-risk procedure according to the Rockall score. As a last and alternative method, the embolization of the gastroduodenal artery was performed via a radial approach, using a hemostatic sponge and embolization coils (Cook Incorporated, USA). The rapid hemostasis was achieved, patient's condition stabilized post-intervention, and he was discharged in satisfactory condition on the 10th day of hospitalization. Our case illustrates that transcatheter arterial embolization is a safe and feasible method of treatment and real alternative to surgery and failed endoscopic approaches especially in complex and high-risk patients.