Primary and secondary response loss , often mediated by the development of anti-drug antibodies (ADAs), limit treatment efficacy. Therapeutic drug monitoring (TDM) is important in optimizing infliximab therapy by correlating drug level with clinical outcomes. This study aimed to find the relationship between infliximab level, ADA presence, and clinical activity in Iraqi Crohn's disease (CD) patients. This cross-sectional study included adult Crohn's disease patients receiving maintenance infliximab (IFX) treatment. Data on demographics and clinical characteristics were collected. Infliximab level and ADA were measured using ELISA. Forty-three patients were included. Patients in remission had significantly higher infliximab levels and lower ADA levels compared to those with active disease. The CD Activity Index (CDAI) correlated negatively with infliximab levels and positively with ADA levels . Infliximab levels correlated negatively with treatment duration and ESR , while positively correlating with the infliximab dose. ADA levels correlated positively with treatment duration. This study, which investigated IFX and ADA levels in CD patients during maintenance therapy, observed a remission rate of approximately 50% in patients. The mean IFX plasma level was 3.28±5.19, with significantly higher levels in remission group compared to active disease (4.91±6.65 vs. 1.73±2.56). This study found no significant difference in response between patients using these medications and those who weren't. Notably, active disease patients showed high ADA and low IFX levels, with a negative correlation between CDAI and IFX levels and a positive correlation between CDAI and ADA levels. These findings, consistent with other research, underscore the critical need for therapeutic drug monitoring (TDM) to personalize IFX dosing, aiming to improve patient response rates, reduce overall treatment costs, and minimize adverse events from concomitant medications, particularly in regions like Iraq where TDM implementation is currently limited. This study concluded that infliximab level was significantly linked to Crohn's disease clinical activity. Patients in remission had higher infliximab level and lower anti-drug antibody level, indicating the importance of TDM in personalize IFX treatment for better results.
World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.
Multiple sclerosis (MS) is a chronic, inflammatory, immune mediated disease of the central nervous system, mostly affecting young adults with mean age of 30 years, twice as high in women compared to men. The etiology of MS is not fully elucidated. MS symptoms are directly related to demyelination and axonal loss, along with other psychological symptoms, can result in functional limitations, disability and reduced quality of life (QoL). The QoL assessments in patients with a chronic disease may contribute to improving treatment and could even be of prognostic value. The goals of this study were to compare the QoL of Iraqi patients with relapsing remitting multiple sclerosis (RRMS),using three different diseas
... Show MoreBackground: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled i
... Show MoreThe current study aimed to isolate and diagnose the fungi associated with the inflammatory bowel disease patients with 150 samples distributed between 50 samples from Crohn's patients and 50 samples from ulcerative colitis patients, 50 control from Al-Kindy Al Teaching Hospital in Baghdad, Baghdad. Five types of yeast were isolated and identified, namely C. albicans, C.glabarta, Tropicales, C. parapsilosis, C. and C., krusi C. parapsilosis and.and Aspergillus, Penicillium, Muocer, Rhizopous, Saccharomycosis, and Cryptococcus, The results indicated the dominance of Candida spp. In crohn’s disease, the frequency of isolated Candida albicans was 24 (58.54%), Candida glabrata 11 (26.86%), Candida tropicalis 5 (12.2%) and Candida krusi was 1 (
... Show MoreThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) or 2019 novel coronavirus (2019-nCoV) is quickly spreading to the rest of the world, from its origin in Wuhan, Hubei Province, China. And becoming a global pandemic that affects the world's most powerful countries. The goal of this review is to assist scientists, researchers, and others in responding to the current Coronavirus disease (covid-19) is a worldwide public health contingency state. This review discusses current evidence based on recently published studies which is related to the origin of the virus, epidemiology, transmission, diagnosis, treatment, and all studies in Iraq for the effect of covid-19 diseases, as well as provide a reference for future research
... Show MoreBackground: A role for vitamin D deficiency in Parkinson disease (PD) has recently been suggested.
Objective:: To estimate the state of vitamin D in PD with an age-matched healthy control.
Type of the study: A case control study.
Method: The study randomly comparison of plasma 25-hydroxyvitamin D (25[OH] D) concentrations of collected samples in a clinical neurology department ward / Baghdad teaching hospital / Medical City and Parkinson disease movement disorder clinic. Participants were registered into the study from October 2015 to October 2016. We was study serum vitamin D level in 40 consecutive patients with
... Show MoreA superb demonstration of one of the wonders of technology providing the people with great aid is the employment of Artificial Intelligence in the medical field, and mainly the introduction of Clinical Decision Support Systems (CDSS). Nevertheless, non-’black-box’ AI systems have a significant problem, that is, although they are visible and understandable, there is still a considerable issue of trust by healthcare professionals. Explainable AI (XAI) technology is a means to overcome all the obstacles by unveiling more and offering the explanations of the procedures that AI performs in decision making. This study was conducted by examining various widely used approaches to XAI, which illustrate how XAI verifies the trustworthiness of CDS
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