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: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a bett
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Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient. Identification and classification of drug related problems and discussing them with the health care providers. Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical
... Show MoreBackground: It was stated in scientific literatures that the entire craniofacial complex is influenced by the growth of the cranial base structures. Nevertheless, many times this is not the case, and this point is subject to great controversy so the aim of this study is to evaluate the possible differences in cranial base shape and flexure between different skeletal classes for both genders and to investigate any possible correlation between cranial base variables and other skeletal base variables. Materials and Methods: The sample include 75 lateral cephalometric radiographs of Iraqi adults aged between 18-25 years (39 males, 36 females), collected from patients and undergraduate students in the orthodontic department of College of Dentist
... Show MoreDespite their critical role in child care, emergency department (ED) nurses’ empathy and their attachment style toward children have not been thoroughly studied.
This research is conducted to explore the reciprocal dynamic relationship between nurses’ empathetical orientation and their level of attachment style in the pediatric emergency departments.
A descriptive cross-sectional survey was conducted across 132 pediatric emerg
Background: Community pharmacists endure significantly elevated levels of work-related stress and depression, posing a threat to their overall well-being and possibly affecting the quality of patient care. Objectives: To explore workplace-associated stress and depression in Iraqi community pharmacists. Methods: This observational study was conducted using a cross-sectional design. Information was gathered through the utilization of an internet-based survey. The study involved a community pharmacist with a minimum of one year of experience working at community pharmacies. The survey utilized pre-validated questionnaires. The level of stress experienced was assessed using the Perceived Stress Scale (PSS)-10, while the level of depression was
... Show MoreSystemic 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: Colorectal cancer (CRC) is one of the top ten most common cancers worldwide. There are multiple risk factors for CRC, one of which is aging. However, in recent years, CRC has been reported in children. Objective: To describe the main characteristics and symptoms of CRC as well as highlight pathologic data for early-onset CRC. Methods: 79 CRC patients were recruited from the Oncology Teaching Hospital in the period February–December 2022. A questionnaire was used to collect demographic and clinical data. Results: 25 (31.6%) of patients were below 50 years of age. 52 (65.8%) patients had tumors in the colon. The most common symptom is bleeding per rectum in both age groups. There was no significant difference in patholog
... Show Moreackground An autoimmune and inflammatory illness called rheumatoid arthritis (RA) occurs when your immune system mistakenly attacks normal cells in your body. Interleukin-35 is a brand-new cytokine that belongs to the immunosuppressive and anti-inflammatory IL-12 family. β -herpesvirus that produces inflammation and stays dormant in its host for life is the human cytomegalovirus. Human herpesvirus (HCMV) has been at the core of several RA-related theories. Objective The current study looked at the association between RA and serum IL-35 levels as well as the association between RA and CMV. Patients and methods Blood samples were taken in the Baghdad Teaching Hospital and Typical Rheumatology Unit from January 2022 to Mars 2022 for the curre
... Show MoreBackground: since December 2019, China and in particularly Wuhan, faced an unprecedented an outbreak challenge of coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2. Clinical characteristics of Iraqi patients with COVID-19 and risk factors for mortality needed to be shared with the health care providers to improve the overall disease experience. Methods: prospective, single-center study recruited patients with confirmed SARS-CoV-2 infection who were admitted to Al-Shifaa Isolation Center / Baghdad Medical City between the mid of March and the end of April 2020 until had been discharged or had died. Demographic data, information on clinical signs, symptoms, at presentation, treatment, have been collected
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