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.
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
... Show MoreBackground: The rapid integration of Artificial Intelligence (AI) into healthcare necessitates that nursing education evolves to equip students with essential technological competencies. Objectives: To explore pediatric nursing students' perceptions of AI in nursing and analyze associations with sociodemographic factors and prior AI knowledge. Methods: A descriptive cross-sectional study was conducted from December 2024 to March 2025 across five universities in Baghdad. A non-probability sample of 500 pediatric nursing students completed the Shinners Artificial Intelligence Perception (SAIP) tool. Data were analyzed using descriptive statistics and inferential comparisons (t-tests/ANOVA) via SPSS. Results: Participants had a mean ag
... Show MoreBackground Parkinson’s disease (PD) is currently the fastest-growing neurological disorder in the world. Patients with PD face numerous challenges in managing their chronic condition, particularly in countries with scarce healthcare infrastructure. Objective This qualitative study aimed to delve into neurologists’ perspectives on challenges and gaps in the Iraqi healthcare system that influence the management of PD, as well as strategies to mitigate these obstacles. Method Semi-structured interviews were conducted with neurologists from five different Iraqi provinces, working in both hospitals and private neurology clinics, between November 2024 and January 2025. A thematic analysis approach was employed to identify the main challenge
... Show MoreThe objective of this study is to evaluate the level of cytokines IL-1?, IL-10 and IL-17A in the serum of patients with Alzheimer's disease (AD), vascular dementia (VD) and down syndrome (DS). The results showed that Serum level of IL-1? was significantly increased in AD patients (3.79 ± 0.26 pg/ml) as compared with DS patients (2.78 ± 0.39 pg/ml) or controls (2.78 ± 0.22 pg/ml), while no significant difference was observed between AD and VD (3.25 ± 0.20 pg/ml) patients or between VD patients, DS patients and controls. The serum level of IL-10 was approximated in VD and DS patients and controls (3.39 ± 0.24, 2.77 ± 0.39 and 3.41 ± 0.35 pg/ml, respectively), but was significantly (P ? 0.05) increased in AD patients (5.73 ± 0.55 pg/ml
... Show MoreBackground: Immune thrombocytopenia is an immune-related disorder that causes an impairment in platelet production and stimulates platelet destruction, causing variable bleeding symptoms. Objective: This study focuses on refractory immune thrombocytopenic purpura patients on romiplostim treatment and their level of illness perception related to treatment response. Method: A cross-sectional study was conducted from May 1st, 2025, to August 1st, 2025. Brief Illness Perception Questionnaires were administered to 84 patients with ITP to collect the data. The study took place at the Hematology and Bone Marrow Transplant Center, Medical City, Baghdad, Iraq. Results: The romiplostim response rate is 21 (25.0%), while the partial response rate is 4
... Show MoreAmpullary carcinomas are uncommon malignant tumours of the digestive system, they usually are adenocarcinomas presenting histologically as three types: intestinal, pancreaticobiliary and mixed. β-catenin is a multifunctional protein involved in physiological homoeostasis and intracellular adhesion. Abnormal nuclear accumulation of β-catenin has been described in many malignancies such as colon, breast, liver and others. The relationships between the immunohistochemical expression of β-catenin and the subtype, the grade and the stage of ampullary carcinoma are studied.
Mental disorders (MDs) are a common problem in Primary Health Care Centers (PHCCs). Many people with serious MDs are challenged by symptoms and disabilities that result from the disease and by stereotypes and prejudice due to misconceptions about mental illness. This study aims at evaluating the knowledge, and attitude toward mental health concepts and services and causes of the reluctance to seek those services among people attending PHCCs. A descriptive cross-sectional study was conducted. The random sampling technique was used to include (10) of Directorates of Health (DoHs) coverage north, middle, and south of Iraq. The study was executed in (50) selected PHCs, (5) PHCCs in each DoH involved randomly selected (30) people attending th
... Show MoreBACKGROUND: Vaccine hesitancy and reluctant had an important obstacle in achieving protection and population immunity against coronavirus disease 19 (COVID-19). It is essential to achieve high COVID-19 vaccination acceptance rates among medical students and health care workers to provide recommendations and counseling vaccine hesitant population. AIM: This study aims to identify level of COVID-19 hesitancy, attitude, knowledge, and factors that affect vaccination decision. MATERIALS AND METHODS: A cross-sectional study was done among medical students in Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq. Data collection was done through an online Google Forms questionnaire during 2021 from 810 medical students.
... Show MoreOsteoporosis is a prevalent systemic metabolic disorder characterized by a reduction in bone mass and bone density, damage in microstructure of bone tissue, and raised bone fragility causing of fracture susceptibility. This study included 189 Iraqi adults aged 45–75 years, evaluating serum levels TGF-β3 and WNT5A across three groups: healthy individuals (n = 31) as control, those with primary osteoporosis/osteopenia (n = 61), and with comorbidity-related osteoporosis (linked to β-thalassemia, parathyroid disorders or diabetes; n = 97). Among those, β-thalassemia-associated osteoporosis patients showed the most distinct decrease in bone mineral density (0.57 ± 0.078 g/cm², p < 0.0001) along with marked increases in WNT5A (0.89 ± 0.68
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