Maaen Journal for Medical Sciences

Background: Venous thromboembolism (VTE), a vascular disorder, is a serious and sometimes fatal problem, ranking
as the second-deadliest complication for people with cancer. VTE includes pulmonary embolism, superficial vein
thrombosis, deep vein thromboembolism, and internal vein thrombosis. It is important to note that cancer patients have
almost nine times higher odds of dying from this illness.
Objective: The Najaf Cancer Center conducted a study to evaluate the effectiveness of oncologist strategies in the
prevention and treatment of cancer-associated venous thromboembolism (VTE). The primary objective was to measure
the adherence of VTE patients to anticoagulant therapy recommended by the NCCN guidelines.
Method: Conducting a one-of-a-kind investigation from the period of November 2022 to March 2023, the Middle
Euphrates Cancer Center in Najaf Governorate, Iraq, is embarking on an extraordinary endeavor. Split into two distinct
phases, an observation phase and an intervention prospective phase with a focus on an educational program, this
groundbreaking study will involve a group of 100 patients. These patients, who have undergone treatment in hospitals
and outpatient clinics and are over the age of 18, consist of both post-educational and pre-school individuals. Adopting
the renowned NCCN guidelines and the Khorana risk score, this study aims to evaluate the risk score of patients with
different types of cancer by implementing a well-established questionnaire.
Result: After completing the educational program, the prescription of anticoagulants for patients experienced a notable
boost, increasing from a mere 6%e13%. The assessment of adherence to the Cancer-associated VTE prophylaxis or treatment
guideline categories revealed an interesting alteration in four of the categories following the program, while the other three
categories showed no meaningful change. Nonetheless, when taking into account all seven categories, the overall adherence
score saw a substantial improvement from 1.42 points prior to the program to 3.86 points afterwards (P < 0.05).
Conclusion: According to the final evaluation, an improvement is observed in the Adherence of oncologists to NCCN
guideline recommendations after the educational program.

Beta thalassemia major (b TM) is one of the more prevalent hereditary diseases in the globe due to a deficiency of
globin chains. It is associated with lipid abnormalities, electrolytes, and oxidative stress that can lead to potentially fatal
complications. The current study included 100 patients diagnosed with b TM in an age group of 2e18 years compared to
80 healthy subjects. The current study included evaluating Complete blood count (CBC), iron status, lipid profile, potassium, and magnesium. Also, Oxidative status represented by Superoxide dismutase (SOD), Catalase (CAT), and Nitric
oxide (NO) were investigated. The finding of this study included a significant increase of triglycerdes (Tg), very lowdensity lipoprotin (VLDL), and Potassium levels of the patients with b TM compared to the healthy control group, while
a significant decrease in total cholsterol (TC), high-density lipoprotin (HDL), low-density, lipoprotin (LDL), SOD, CAT,
NO, and magnesium levels. Moreover, Pearson\'s correlation coefficient (r) was also found between the oxidative status
parameters, Potassium, and magnesium studied for b-thalassemia patients vs ferritin levels that were found a negative
correlation with SOD, CAT, NO, and magnesium levels whereas positive correlation with Potassium level. The finding
of the current study showed a clinical predictor of dyslipidemia, state of oxidative stress, and high risk each of
Hyperkalemia and hypomagnesemia, which portends the use of more efficient treatment protocols to remove excess iron
from b TM patients.

The use of vesicular structures as a drug delivery method has many advantages, including extending the duration of
the drug's action in circulation, enhancing drug targeting, minimizing adverse effects, and boosting the bioavailability of
a variety of medications. Spanlastics, which are elastic and can transport a range of pharmaceutical substances, are
thought to be a subset of nanovesicles. They have drawn interest as a potentially effective medicine delivery method.
They are a preferred choice for many administration routes because of their pliable and elastic nature, which allows
them to pass through various cellular membranes. Non-ionic surfactants or a mixture of surfactants and a nanoscale edge
activator make up these nanovesicles. Researchers have established that SPs improve drug bioavailability. The structure,
composition, special qualities, and applicability as a cutting-edge drug delivery system for encapsulating a range of
medications to treat various ailments are all covered in this review paper.