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: five clinical phases were described in patients with chronic (HBV) infection: HBeAg- positive HBV infection, HBeAg- positive chronic HB, HBeAg negative HBV infection, HBeAg-negative CHB and occult HBV infection. Aim: This study aimed to determine the incidence of the unclassified phase (gray zone) in chronic hepatitis B patients and its significant in the clinical practice. Patients and methods: The study was conducted retrospectively on 109 patients' who have HBsAg positive for more than 6 months. The data recorded include; HbeAg and anti-HBe Ab, ultrasound of the abdomen, HBV DNA load and alanine aminotransferase (ALT), accordingly; we classify the patients to known clinical phases. Patients who were unfit one of these phases
... Show MoreThe research dealt with the study of choice between a range of different words between the repetitive texts in the verses of the Koran and explain the reason behind this choice, and how the context has the greatest impact in this choice, and that each word in the Koran was placed in the most appropriate place, which can not be replaced by equivalent words, whatever The degree of similarity between them in the indication of the other because it remains at the end that each of those vocabulary synonyms are indicative, the first of them especially that makes the possibility of replacing them with the equivalent vocabulary impossible, and the second general significance and this connotation makes them share with their peers In one aspect of
... Show MoreThe research aims at measuring the extent of the relationship and influence of the indicators of the Core competencies of the audit firms and offices in the Earning Quality of the private banks listed in the Iraq Stock Exchange under audit. The research community represents 38 banks. The sample of the research has been approved only 10 banks continue to issue their financial statements for the period (2007 – 2017), in addition to the audit offices assigned to audit these banks, which amounted to 14 companies and auditing offices. John's (1999) model revised by Kothari et al., (2005) was adopted to measure the Earning Quality by finding discretionary accruals and non-discretionary accruals, to measure the Core competencies indicators ,
... Show MoreOur research subject (environmental impact in the cultural output of the civilizations of ancient East) the environmental impact on human civilization and how her and adapted to serve in various cultural aspects especially in ancient cultures whether punches or sculptures and other addresses as well as tracing precious stones and raw materials. It was the environment of the civilizations of Mesopotamia and Egypt and another effective impact in drawing ancient history through human interaction and responsiveness. The Iraqi environment was marked by poverty and cruelty on the one hand and on the other cultural elements contributed to the civilization in General and research dealing with technical and product sourcing raw materi
... Show MorePurpose: This research is to identify the most important challenges for the local investment commissions and to develop solutions and proposals to encourage local and foreign investment in local governments in Iraq (the Iraqi provinces are irregular in the region). Theoretical Framework: This research suggests a conceptual framework for the local investment commissions in order to solve their problems, the most important of which was to identify the most critical challenges which are facing the Baghdad Investment Commission BIC and how to overcome them. Design/The methodology approach: Research involved a mixed-methods approach through two stages. During the first stage, the researcher gathered quantitative data from all inves
... Show MoreObjective The aim of this study was to assess whether serum cytokine levels correlate with clinical periodontal parameters in health or disease.
Materials and Methods Male subjects (40–60 years) with CP (n = 30), CP + CHD (n = 30), and healthy controls (n = 20) had plaque index (PLI), gingival index (GI), bleeding on probing, probing pocket depth (PPD), and clinical attachment level (CAL) evaluated. Serum IL-1β and IL-6 levels were quantified using enzyme-linked immunosorbent assay.
Results PLI, GI, PPD, and CAL were significantly higher in patients with CP + CHD compared to those with CP. Serum levels of IL-1β and IL-6 were also si
Background: Pleomorphic adenoma of the minor salivary gland is a rare benign tumor. It commonly occurs in the hard and soft palates. Treatment by surgical excision achieved success in improving the patient’s health. Objective: To evaluate the recurrence rate after surgical treatment of pleomorphic adenoma in minor salivary glands. Methods: This retrospective study included patients who attended the Maxillofacial Surgery Unit in Ghazi Al-Hariri Hospital, Baghdad, from 2019 to 2021, complaining of soft tissue lumps involving the soft and hard palate, buccal mucosa, and upper lip. After the provisional diagnosis of these lesions, a total surgical excision of the tumor with a safe margin of 1 mm was performed, and the biopsy was sent for hist
... Show MoreBackground: Pleomorphic adenoma of the minor salivary gland is a rare benign tumor. It commonly occurs in the hard and soft palates. Treatment by surgical excision achieved success in improving the patient’s health. Objective: To evaluate the recurrence rate after surgical treatment of pleomorphic adenoma in minor salivary glands. Methods: This retrospective study included patients who attended the Maxillofacial Surgery Unit in Ghazi Al-Hariri Hospital, Baghdad, from 2019 to 2021, complaining of soft tissue lumps involving the soft and hard palate, buccal mucosa, and upper lip. After the provisional diagnosis of these lesions, a total surgical excision of the tumor with a safe margin of 1 mm was performed, and the biopsy was sent
... Show MoreThe Objective of the research is to identify the Strategic Vigilance and effect in the Managerial Decision Quality, by knowing the interest of the organization influence the Strategic Vigilance in the Managerial Decision Quality, adopted four dimensions of the Strategic Vigilance is (Environmental Vigilance, Commercial, Competitiveness & Technology) to indicate the extent individually and collectively impact in the Managerial Decision Quality, The questionnaire was used as a main tool to survey the views of a sample of 45 managers, was named Supreme Judicial Council society for research, and the statistical program SPSS, and research found a clear positive impact dimensions Strategic Vigilance in the Manageri
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