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.
Background: Periodontal diseases (PD) are inflammatory conditions of the tissues supporting the teeth, most often gingivitis and periodontitis. Maxillary chronic rhinosinusitis (MCRS) is the inflammation of the maxillary sinuses which is last for at least 12 consecutive weeks duration. Aims of study: Distribution of periodontal diseases among patients with Maxillary chronic rhinosinusitis according to gender and age. Materials and methods: Males and females subjects (25-45 years), divided into two groups; 150 patients suffer from MCRS and 130 subjects without MCRS. Clinical periodontal parameters; Plaque Index (PL.I), Gingival Index (G.I), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL) and Bleeding On Probing (BOP) recorded f
... Show MoreBackground: the primary objective for many researches carried out in dental implantology was to reduce the period needed for functional implant loading, simvastatin (cholesterol lowering medication) had many pleiotropic effects, one of which was increasing bone density around titanium implants (1) and subsequently establishing faster osseointegrated dental implants (2,3). This study aims to reduce the period of time needed to establish secondary stability of dental implant measured in ISQ (Implant Stability Quotient) by investigating the effect of orally administered simvastatin on bone. Materials and methods: simvastatin tablets (40mg/day for three months) were administered orally for 11 healthy women aged (40-51) years old who received 1
... Show MoreThe research aims to shed light on the financing structure, which is one of the important pillars of financial management in the commercial banking sector, which enhances its financial position through financing its various investments, which is one of the pillars of the successful economy of the commercial banking sector. in which country. The contents of the research variables, which were represented by the independent variable, financing structure, the dependent variable, and investment decisions in commercial banks, which the researcher tried to address, as the research began with a basic variable that depends on diagnosing the impact of the financin
... Show MoreA survey statistician for cholera in Iraq for 1980 and until 2003 show that cholera is endemic in Iraq and that the highest number of casualties recorded in the years 1998-1999 and increasing spread of the disease during the wars in hot climates, wet a study bacteriological used where circles selective and tests Alkouhaoah examinations serological system
Occupy public investment spending, a great deal of attention since the thirties of the last century, to play important role in economic and social development process and therefore most of the countries are trying different degree of economic development to the completion of the largest amount of public investment, especially in infrastructure, which is one of the pillars essential to economic development, and in order to maximize utilization of the completion of public investment should focus on achieving efficiency in completion.
The current reality of public projects in Iraq, indicating the absence of several key characteristics that must be provided if these proje
One of the most common public liver diseases over the world is fatty liver which contain alcoholic and non-alcoholic fatty liver. One-fourth among general population are impact Non-Alcoholic Fatty Liver Disease (NAFLD) in the worldwide.Retinol binding protein 4 (RBP4) is known as an adipokine, mainly synthesized and secreted from the liver and form adipose tissues. RBP4 acts as a transporter and specifically bound to retinol from liver to others tissues. Visfatin is an adipocytokine and mainly produced from visceral fat tissue, skeletal muscles as well as liver. Vitamin A absorbed, transported as retinyl esters to the liver then hydrolyzed to the retinol form and storage in hepatic stellate cells (HSCs) after reesterified with rigly
... Show MoreThe osseodensification (OD) drilling technique was suggested as an alveolar ridge expansion technique, so the aim of this prospective clinical study was to evaluate the amount of bone expansion obtained by the OD drilling technique and its effect on implant stability in patients with narrow alveolar ridges. The width of the alveolar ridge was measured at the crest before and after implant site preparation, whereas the implant stability was measured using Osstell Beacon implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. Twenty-three patients were included; they received 40 implants. The mean (± standard deviation [SD]) amount of expansion was 1.29 (± 0.41) mm, and the difference b
... Show MoreThis study seeks to identify the role that the leadership trend plays in the management of health institutions in Iraq and its impact on improving the quality of the health service provided by analyzing some opinions of affiliates working in the Iraqi health sector where a survey list was used as a main tool for collecting primary data, as it was subjected to this analysis ( 60) of the medical staff, of whom (40) are doctors and (20) are affiliated with the rank of assistant physician, and (60) members of the administrative cadre have undergone their various job ranks and administrative specializations (department manager, auditor, observer, accountant, statistician, secretary). Reliance on statistical software (spss) in data ana
... Show MoreOne of the most important challenges facing the development of laser weapons is represented by the attenuation of the laser beam as it passed through the layers of atmosphere.This paper presents a theoretical study to simulate the effect of turbulence attenuation and calculates the decrease of laser power in Iraq. The refractive index structure C_n^2 is very important parameter to measure the strength of the atmospheric turbulence, which is affected by microclimate conditions, propagation path, season and time in the day. The results of measurements and predictions are based on the Kolmogorov turbulence theory. It was demonstrated by simulations that the laser weapons in Iraq were severely affected due to the large change in temperatures,
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