Background: Pemphigus vulgaris (PV) is an autoimmune vesiculobullous mucocutaneous disease with life-threatening consequences. Rituximab (RTX) has recently emerged as an effective treatment for PV. Objectives: This study aims to determine changes in neutrophil and platelet counts for PV patients treated with RTX or corticosteroids combined with Imuran (azathioprine). Materials and Methods: The present cross-sectional study was conducted in the Department of Dermatology at Baghdad Teaching Hospital, Baghdad, Iraq. Thirty PV patients received two types of treatment: 15 patients were administered RTX and 15 patients took corticosteroids with Imuran (azathioprine). Neutrophil and platelet counts were detected at the hospital laboratory. Results: The age range of PV patients was 27–67 years, and the mean ±SD was 44.866 ± 10.979 years for the patient group treated with RTX and 44.133 ± 11.519 for the patient group treated with corticosteroids and Imuran. In patients treated with RTX, 26.6% were males and 73.33% were females, with a female-to-male ratio of 2.75:1. In patients treated with corticosteroids with Imuran, 40% were males and 60% were females, with a female-to-male ratio of 1.5:1. The results revealed that among patients treated with RTX, 30% of them had mucocutaneous lesions, 6.66% had oral lesions, and 13.33% had cutaneous lesions. Among the other groups treated with corticosteroids and Imuran, 23.33% had mucocutaneous lesions, 13.33% had oral lesions, and 13.33% had cutaneous lesions. Among the patients treated with RTX, 53.33% had normal range of neutrophil count, while 46.6% had neutrophil count above the NR, while in patients treated with corticosteroids and Imuran, 40% had a normal range and 60% had above the normal range. Conclusion: RTX was a more effective treatment compared to corticosteroids with Imuran because no patient remained in an active state during this study. PV was prevalent in females aged 40 years with mucocutaneous lesions.
The problem of the study and its significance:
Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease
That is interested psychologists and doctors searchin
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The migration from IPv4 to IPv6 can not be achieved in a brief period, thus both protocols co-exist at certain years. IETF Next Generation Transition Working Group (NGtrans) developed IPv4/IPv6 transition mechanisms. Since Iraq infrastructure, including universities, companies and institutions still use IPv4 protocol only. This research article tries to highlight, discuss a required transition roadmap and extend the local knowledge and practice on IPv6. Also, it introduces a prototype model using Packet tracer (network simulator) deployed for the design and implementation of IPv6 migration. Finally, it compares and evaluates the performance of IPv6, IPv4 and dual stack using OPNET based on QoS metrics such as throughput, delay and point to
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