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 past decades of the last century and until now have witnessed many crises in the housing sector, and these crises were the result of many problems that led to a weak quality and quantity of housing stock, especially for lowincome people, and Goal 11 of the Sustainable Development Goals states, "Make cities and human settlements inclusive, safe, and capable of enduring and being sustainable, we have prepared this research that attempts to answer the following question: Is the current empowerment in the housing sector real and efficient support for people with limited income? The research assumes that empowerment in the housing sector has an important and effective role in reducing housing problems, the research aims to reach the most imp
... Show MoreThe relationship of hyperuricemia to kidney disease, diabetes, hypertension and the risk of cardiovascular diseases remain controversial. The aim of this study is to evaluate the use of uric acid (UA) levels to find the higher risk of cardiovascular disease (CVD) in patients with end stage renal disease that have diabetic nephropathy (DN), nephropathy with hypertension (NH) and patients with both diabetic nephropathy with hypertension (DNH). This study deals with 115 patients with end-stage renal disease under hemodialysis sub-grouped into 35 patients with (DN), 40 patients with (NH), and 40 patients with (DNH). Some biochemical parameters were determined in the serum of all participants such as HbA1c, fasting blood glucose (FBG), UA, urea,
... Show MoreIn light of crises, the need for efficient and flexible public administrations to make quick and decisive decisions, also institutions capable of directing the internal elements and components of them and adapting them to the requirements of rapid change due to crises and disasters, which led to scarce resources becoming scarcer and economic, political and social problems becomes more prominent. For the majority of developing countries, including Iraq, the increasing need for the importance of moving towards enhancing the efficiency of the performance of public institutions while trying to predict their future, can only be achieved. Through solid mechanisms and principles of governance that enhance the ability of institutions and make them
... Show MoreTo determine the important pathogenic role of celiac disease in triggering several autoimmune disease, thirty patients with Multiple Sclerosis of ages (22-55) years have been investigated and compared with 25 healthy individuals. All the studied groups were carried out to measure anti-tissue transglutaminase antibodies IgA IgG by ELISA test, anti-reticulin antibodies IgA and IgG, and anti-endomysial antibodies IgA and IgG by IFAT. There was a significant elevation in the concentration of anti-tissue transglutaminase antibodies IgA and IgG compared to control groups (P≤0.05), there was 4(13.33%) positive results for anti-reticulin antibodies IgA and IgG , 3(10%) positive results for anti-endomysial antibodies IgA and IgG . There were 4 pos
... Show MoreImposed on foreign oil companies from important sources in the financing of the general budget in most countries of the world income tax is considered as well as be used to achieve political, economic and social goals, and has developed the concept of the tax until it became play an important role in influencing the economic conditions of a country, and the aim of this research is to statement imposed on foreign oil companies operating in Iraq in the financing of the state budget income tax contribution, as well as clarify the contracts type contracts with these companies, which is in favor of Iraq, together with the Income Tax Law No. (19) for the year / 2010, and instructed No. (5) for the year / 2011, which organized the tax process s
... Show MoreObjective: To determine the impact of personal hygiene on woman who complain pelvic inflammatory disease Methodology: A quasi experimental study in the High Institute Infertility Diagnostic and A.R.T.(assistance reproductive technology) in AL-Kadimya city and al-Emamian al Kadmain medical city hospital. The sample collected during (26th ) January – (30th ) April 2014. A purposive sample of (60) women, (30) of them regard as study group and (30) regard as a control group whom they take routine care in the institute and hospital. The questionnaire consisted of socio-demographic data, reproductive heal
Background: Sialosis described as a specific consequence of diabetes. In diabetic sialosis, the increased volume of the glands is due to the infiltration of adipose in the parenchyma. The B-scan ultrasonography is a generally accepted tool for determining parotid gland enlargement. Oral health is, to a greater extent, dependent on quality and quantity of saliva, both of which may be altered in diabetics. This study was established to detect the enlargement of parotid gland in diabetic patient and study the changes in physical properties of saliva and its relation with the salivary gland enlargement. Subjects, Materials and Methods: A cross-sectional study with highly specified criteria with ages ranged (20-65) years, male and female subject
... Show MoreAnaemia is a common extra-articular manifestation of rheumatoid arthritis (RA) where anaemia of chronic disease (ACD) and iron deficiency anaemia (IDA) are the two most frequent types. The distinction between these two types of anaemia has always been challenging requiring sophisticated techniques. Serum transferrin receptor (sTfR) a truncated soluble form of the transferrin receptor is one of the parameters that is influenced by the Iron content and supply to the erythrons and is not affected by inflammatory status and therefore the use of the sTfR/log ferritin (sTfR-F) index can be a reliable indicator of functional iron deficiency.