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 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 ,
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Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through eviden
... Show MoreAbstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. O
... 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
... Show MoreObjective(s): To determine the quality of life for adults with a chronic obstructive pulmonary disease.
Methodology: A descriptive study was carried out on (80) patients with a chronic obstructive pulmonary disease from
December 2008 through October 2009 with special inclusion criteria (adult paƟents from 18 years and above exclude
the patients who suffer complication related of disease and from psychological problems and other chronic illnesses.
The data were analyzed through the application of descriptive data analysis approach and inferential data approach.
Result: The study indicated that the determination of QoL for COPD depended on the level of effect .The grades
according to R.S are: "high" effect of disease in
Our 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 MoreThis competition between competing forces, organized into axes with conflicting objectives, is reflected in all regional affairs and the goals and interests of countries within them, including Iraq. Among the most important aspects impacted by the repercussions of international and regional competition in the region is Iraqi national security, based on its vital importance in preserving the sovereignty and entity of the Iraqi state, protecting the interests and cohesion of the state and people, ensuring and defending their present and future, and interacting with various regional and international activities. The Kurdistan Region, as an important part of Iraq with its own unique characteristics, may be one of the most important regi
... Show MoreAI in teaching English is reshaping language learning. While interest in AI-supported education is growing worldwide, research in this area is still emerging in Iraq. This review synthesizes empirical AI-based intervention studies to enhance English language learning in Iraqi higher education, and the perceptions of stakeholders regarding AI tools in language instruction. The reviewed intervention studies, comprising studies employed different AI platforms to support grammar instruction, speaking fluency, writing feedback, and pragmatic competence. These interventions yielded improvements in learners’ performance, motivation, and communicative confidence. In parallel, perception-focused studies revealed positive attitudes toward A
... Show MoreThis study aimed to measure the accounting conservatism and the lemited factors which affected on it in the annual financial reports of insurance companies which listed on the Amman Stock Exchange during the period from 2005 to 2016, these factors were represented by firm age, firm debt and firm size.
Using the market value model (MV) To book value ( BV) Beaver and Ryan (2000) The level of the accounting conservatism was measured. The study found that the insurance companies which are listed on the ASE exercise the accounting conservatism when they were preparing financial reports. And when conducting a process of the test of the affected of the factors (The age of the
... Show MoreThe results of the analysis showed that there is a correlation between ISO 9001 and the competitive advantage, which shows that the implementation of ISO 9001 in the private colleges achieves a competitive advantage through its ability to employ the entrance of quality systems management according to ISO 9001, By focusing on improving the quality of its educational services in accordance with a clear and understandable policy for all and its ability to meet the expectations, expectations and wishes of students and beneficiaries, which leads to lower costs of operations compared to other colleges and achieve a higher level of reliability and quality and value of services provided and rapid respon
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