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.
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
... Show MoreBackground: The presence of cancer has a profound psychological impact on the quality of life of patients and their families, on family and social relationships, and on role functioning.
Aim of the study: Assess the impact of childhood cancer on patients and their families.
Subjects and methods: A Prospective questionnaire-based study, for 151 patients, had malignancy identified by tumor registry of Children Welfare Teaching Hospital. The information was taken from the parent(s) in the presence of the patient who sometimes answered some questions during the interview.
Result: There was an interview with 151 families of children with cancer in t
... Show MoreRheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition,
... Show MoreThis study included 46 patients with liver hydatid cyst diagnosed clinically and surgically. Control group consist of 22 healthy volunteers. The patients were divided according to the size of the cysts into more and less than 5 cm diameter size, 33 and 13, respectively. Also they were divided into primary and secondary hydatid cyst infection, 30 and 16, respectively. Significant increase of GOT, GPT and ALP levels were recorded due to hydatid cyst infection and had direct effect on the liver function, beside an increase in total bilirubin in patients serum compared with the control, also the same occurred in the secondary infection compared with primary infection, patients with> 5 cm showed significant increase in the above levels compared
... Show MoreThe purpose of this study is to examine the effect of human resource diversity management practices on achieving entrepreneurship in Jordanian public universities. To achieve the aims of the study, a well-designed questionnaire was used for collecting data. The population of the study was (7433) faculty members (including different ranks such as professors, associate professors, assistant professors and lecturers) in Jordanian public universities. The study sample was selected through the use of a random sample, the questionnaire is distributed to a sample (of 400 with the percentage of 5%) selected by using a random sampling (350) copies of the questionnaire were collected, reaching about (87.5%) out of the sum total of the dist
... Show MoreAbstraet
Students dropout from the Education has a negative phenomena on individual and society and even on different aspects of life especially on the economic aspect , Thus our research tries studying and analyzing the relation between the size of dropout and human development level in Iraq and as (research sample) the first decade of this century as a studying period, the study includes the dropout in Secondary schools and depending the formal records as a main source to evaluate the size of this problem in Iraq , which shows an increase in the size of dropout in this period in comparison with the last decades of the twentieth century, this produces a negative effect on human developme
... Show Moreتسعى تركيا ضمن سياساتها المائية ومنذ زمن بعيد وبأصرار على تنفيذ المزيد من بناء السدود والمشاريع التخزينية المائية على حوضي دجلة والفرات، الامر الذي يؤدي بالضرورة الى تناقص معدل الواردات المائية لنهري دجلة والفرات الداخلة للاراضي العراقية .وبالتالي التأثير على مقومات التنمية الزراعية العربية بشكل عام والتنمية الزراعية بالعراق بشكل خاص ومن ثم تهديد الامن الغذائي الوطني.
لذا فأن البحث يهد
... Show MoreThis research is aiming to analyze the impacts of the current budget in Iraq by using the Government Finance Statistics Manual (GFSM) , the research is based on hypothesis: (There is an impact on the using of the Government Finance Statistics Manual (GFSM) In public budget in Iraq) .This hypothesis was demonstrated by using the questionnaire, a number of conclusions were reached, the most important being the lack of terminology adopted in the government accounting system and the Iraqi financial and accounting manual as a result of their adoption of the monetary basis for the lack of accounting terminology that meets t
... Show Moreيهدف البحث الى أعداد بعض تمرينات الاساسية لسلاح الشيش بأستخدام المرايا في تطوير قدرة مستوى تعلم الطالبات في المبارزة ومعرفة الفروق بين المجموعتين التجريبي والضابطة بتأثير استخدام المرايا في مستوى اداء بعض مهارات سلاح الشيش لطالبات المرحلة الثالثة , وقد أستخدمت الباحثتان المنهج التجريبي على عينة من طالبات المرحلة الثالثة , وقد بلغ عددهم (45) طالبة , وقد خرجت الباحثتين بعدة أستنتاجات وهي:- - أن المنهاج التعليمي
... Show MoreBack ground: Skin grafting is the most common form
of reconstructive surgery, and regeneration of
sensations in skin grafts is a complex process
influenced by many factors such as , the thickness of
the graft, the depth of the grafted bed, meshing of the
graft, the condition of the bed and the surrounding
area. So many studies performed on this subject, some
of them clinically based on subjective type of sensation
tests, and others histological to detect the presence of
nerve fibers in the grafted skin
Objectives: To detect return of sensations to split
thickness skin grafts by clinical methods.
Methods: From Oct. 1995 to Oct. 2010, a clinical
prospective study performed in Al wasity Hospital for