Systemic lupus erythematosus (SLE) is an autoimmune disease with polymorphic expression. B cells have an essential contribution in immune system activation via the production of different cytokines and functioning as potent antigen-presenting cells. Therefore, a drug that particularly targets B cells may represent an ideal therapeutic approach for SLE. Rituximab (RTX), an anti-CD20 monoclonal antibody causing transient B-cell depletion, has been used to manage SLE. This study aims to assess Rituximab effects on lupus nephritis (LN) patients when added to conventional immunosuppressants. Twenty four patients, 15-32 years old, with class III/IV/V LN were involved in this study. All were on steroids before lupus nephritis occurrence. They were given rituximab induction therapy and mycophenolate mofetil (MMF) maintenance therapy. RTX was indicated for refractory and relapsing SLE. Several investigations done before and after RTX treatment and in the last follow up (done one year after starting Rituximab). Those included protein in urine, serum creatinine, double stranded DNA, C3, C4, and Estimated Glomerular Filtration Rate (eGFR). Proteinuria decreased significantly after RTX treatment and in the last measurement (P=0.01 and P=0.001, respectively). Serum creatinine significantly decreased only in the last measurement (P=0.02). Double stranded DNA decreased remarkably after treatment (P=0.01) with a further decrease in the last measurement (P=0.006). C3 and C4 increased after treatment but the increase was significant only for C3 (P=0.002) and this increase continues till the last measurement (P=0.0006). Active urine sediments found in fifteen patients and disappeared after RTX treatment. Rituximab can be promising in treating lupus nephritis when used along with traditional immunosuppressants. It can reduce disease activity and improve renal function in such patients.
We used to think of grammar as the bones of the language and vocabulary as the flesh to be added given that language consisted largely of life generated chunks of lexis. This “skeleton image” has been proverbially used to refer to that central feature of lexis named collocation- an idea that for the first 15 years of language study and analysis gave a moment‟s thought to English classroom material and methodology.
The work of John Sinclair, Dave Willis, Ron Carter, Michael McCarthy, Michael Lewis, and many others have all contributed to the way teachers today approach the area of lexis and what it means in the teaching/learning process of the language. This also seems to have incorporated lexical ideas into the teaching mechanis
Labor movement is considered important in Britain because it is an international phenomenon of the feudal system and one of the flowerings of the era of the capitalist machine. At the beginning of the 18th century, the world witnessed a change and progress in many aspects of the industrial fields such as the different means of production .this era is called the industrial revolution which especially appeared in Britain and extended to other areas of the world .it leads to many changes in Europe and participated in different economic, political and cultural and social fields. and it has a very important role in progress and development but its disadvantage is that it is exploited by the capitalists to achieve their special rights .in othe
... Show MoreThrough research and research in the creative composition in the poetry of Zafer-Alhaddad it turned out to be superior in its systems, especially that he chose a linguistic and verbal texture accompanied by a cultural dictionary full of creativity and beauty helped this culture arrangement reflects the poetically wonderful and beautiful custom led to the harmony of colors and bodies painted by the poet brush the creative artist evaluates the metaphorical and metaphorical relations that would explain the poets idea, most of which were inspired by the wonderful spirit of nature, its beautiful landscapes and bright colors, especially that we do not forget the beautiful colors and the aesthetic touch that created a fascinating musical intera
... Show MoreBackground: The apical seal is the single most important factor in determining the success of surgical endodontics, the aim of this study was to compare the sealing ability of Mineral Trioxide Aggregate in three different cavity designs. Materials and Methods: Thirty extracted human single-rooted teeth were divided into three groups of ten teeth per group, a retrograde cavity preparation was carried out using a low speed handpiece and round bur with parallel walls in the first group, ultrasonic retrotip and unit in the second group and a low speed handpiece with a carbide inverted cone bur with undercuts in the third group, all the cavities were filled with MTA. microleakage was measured by dye penetration technique using methylene blue. Re
... Show MoreThe evolution in the field of Artificial Intelligent (AI) with its training algorithms make AI very important in different aspect of the life. The prediction problem of behavior of dynamical control system is one of the most important issue that the AI can be employed to solve it. In this paper, a Convolutional Multi-Spike Neural Network (CMSNN) is proposed as smart system to predict the response of nonlinear dynamical systems. The proposed structure mixed the advantages of Convolutional Neural Network (CNN) with Multi -Spike Neural Network (MSNN) to generate the smart structure. The CMSNN has the capability of training weights based on a proposed training algorithm. The simulation results demonstrated that the proposed
... Show MoreNotwithstanding the importance of international cooperation as the other facet of international interactions, a strategy of conflict resolution, a maintainer of international peace and security, its provision in the United Nations conventions, as an objective of the United Nations after the international peace and security, however, the recognition of international cooperation has not been underlined by global, intellectual think tanks. While realism emphasized on the state's role in achieving international cooperation to ensure mutual and multilateral interests, liberalism focused on the role of international organizations in building such cooperation. Additionally, constructivist approaches developed other sub-variables to contribute to t
... Show MoreRecently, several concepts and expressions have emerged that have often preoccupied the world . around the concept of environment and sustainability. This is due to the negative and irresponsible impact of man and his innovations in various industrial and technological fieldsthat have damaged the natural environment. Architecture and cities at the broader level are some of the man made components that caused these negative impacts and in the same time affected by them. What distinguishes architectural and urban projects is the consumption of large . quantities of natural resources and production larger amounts of waste and pollution, along the life of these projects. At the end of the twentieth century and the beginning of the twenty-fir
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