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.
Form recurrence of financial crises phenomenon disturbing and attention , and returns the reasons so that its negative effects were sharp and dangerous , because of the nature and cause of Ncaha , threatened political and economic stability of the countries in which they occur these crises , in addition to Machmlh these crises spread of contagion across multiple channels to include other countries many developed and developing , and the reason for this to the openness of the economic and financial witnessed by the countries affected by crises and other countries concerned, the financial crisis is a case of financial turmoil appears in one of the sections of the financial system one and extends to
... Show MoreThe fluctuations in oil prices in world markets affect the general budget and the trade balance of the rent countries, because oil is a strategic commodity affected by economic and political factors. The fluctuations in oil prices affect the public budgets of the rent countries through the public revenue side of oil revenues. On the other hand, these fluctuations affect the balance of trade through the volume of oil exports, which lead to imbalance of trade surplus or deficit . &nbs
... Show MoreThe aim of the research is to identify the extent of the ability to ensure the integrated reports by the auditor in verifying the credibility of these reports, and their implications for the benefit of all parties dealing with the economic unit, as well as measuring the impact of the assurance procedures followed by the auditors and their role in confirming these reports.
The research methodology was designed after studying the previous literature related to the research variables, and then the relationship between these variables was tested, through the use of a questionnaire list. A questionnaire targeting the community of auditors in the local environment, and the results of the study wer
... Show MoreExtracorporeal shock wave lithotripsy (ESWL) is considered a standard treatment for nephrolith or kidney stones measuring less than 20 mm. Anatomical, machine-related, and stone factors play pivotal roles in treatment outcomes, the latter being the leading role. This paper examined the relationship between stone density on native CT scans and ESWL treatment to remove renal stones concerning several treatments. One hundred and twenty patients (64 males and 56 females) were enrolled and completed the study from April 2019 to September 2020. Inclusion criteria were a single renal pelvis stone of 5–20 mm to be treated for the first time in adult patients with no urinary or musculoskeletal anatomical abnormalities. We assessed patients
... Show MoreThe study aimed to assess the level of ANG‑2 in MM patients at diagnosis and in remission state and elaborate on its correlation with interleukin‑6 (IL‑6) and beta‑2 microglobulin (B2M) levels. Sixty MM patients; 20 newly diagnosed (ND), and 40 patients in remission were included. Twenty healthy individuals were included as a control group. Plasma levels of ANG‑2, B2M, and IL‑6 were tested by enzyme‑lin ked immunosorbent assay. There are significant statistical differences between ND patients and those in remission in hemoglobin, neutrophil count, blood urea, serum creatinine, glomerular filtration rate, B2M, IL6, and ANG‑2 (P = 0.001, 0.033, 0.005, 0.001, 0.001, 0.001, 0.004, and 0.001, respectively). ANG‑2 showed signifi
... Show MoreObjective: To assess the major anti-tuberculosis drugs available to patients at primary health care centers in Baghdad city. Methodology: A descriptive cross-sectional study design is carried out in order to achieve the objectives of the study by using the assessment technique in primary health care centers from December 29th, 2014 to July 10 th, 2015. probability sampling is select based on the study design. Eighteen primary health care centers are select according to criteria of sample to the study and for the purpose of the study, is select (6) sectors and (11) Primary Health Care Centers (PHCC) from Bagh
The research aims to verifying the tax exemptions granted in accordance with the Iraqi tax legislations, showing their suitability for basic tax rules, and identifying their role to reduce the tax evasion phenomenon and the negative effects resulting therefrom, which arerepresented by a decrease in the proceeds of tax revenue and therefore leadings to a reduction of public revenues of the state. Also, the research tries to identify the ways to reduce cases of tax evasion due to their reflection positively on the public budgetof the state. The data of the research was collected through two models of questionnaires distributed to a sample of taxpayers from some professions and a sample of the tax administration staff. The research has reac
... Show MoreBackground: H.pylori colonized gastric mucosal
epithelium will virtually develop gastritis and had the
capacity to persist for decades. Pathogenesis is
dependent upon strain, virulence host genetic
susceptibility, and environmental cofactors. Leptin is
a member of the class 1 cytokine family so altered
leptin production during ifnect and inflammation that
leptin part of the cytokine cascade ,which
orchestrates the defense mechanism.
Objective: Examin the effect of H.pylori infection
on serum leptin level.
Methods: One hundred and thirty(130) Patients
attending the Endoscopic Unit at "Gastroenterology
and Hepatology Teaching Hospital/ Baghdad Medical
City"were included in this study with ages rang
Unstable angina pectoris often leads to acute myocardial infarction. Since uric acid is thought to be risk factor for cardiovascular disease and considered a major antioxidant in human blood .The level of uric acid and lipid peroxidation in the sera of patients with unstable angina and myocardial infarction were measured and compared to the healthy individuals. Twenty-nine patients with unstable angina and twenty-nine patients with myocardial infarction were studied and compared to twenty-five healthy individuals. Uric acid was measured by using Human Kit. Malondialdelyde (MDA) a lipid peroxidation marker, was measured by thiobarbituric acid method .Significant elevation of uric acid and MDA were observed in the sera of pati
... Show MoreThe security of information represent the available protection of information and its component and guaranty the its safety and confidentiality. The absent or lack or stop of security of information and without maximum benefit may lead to lose confidence and make it burden on the company. So we must protect the company and information from the damages which may lead to the frailer of performance and loses of the company and its workers. So the security of information considered one of the potential and controlling basis to protect individuals and companies from the damages. To insure the security and confidentiality of information there are delicate, proper and trusted ways, like FIRE WALL, PASS WORD, SYPHAR
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