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 Molluscum contagiosum is skin disease caused by the molluscum contagiosum virus (MCV) usually causing one or more small dome shaped umbilicated papules with symptoms that maybe self-resolve. MCV was once a disease primarily of children, but it has evolved to become a sexually transmitted disease in adults. It is believed to be a member of the pox virus family. In addition to the classic presentation of the disease; it can also come in different clinical forms that simulate large number of dermatolological disease.
Objective: To study different clinical forms of Molluscum contagiosum presentation in different age groups of Iraqi patients.
Method:This clinical descriptive study was performed in the outpatient department of
Background: Behçet’s disease (BD) is a disorder of systemic inflammatory condition. Its important features are represented by recurrent oral, genital ulcerations and eye lesions. Aims. The purpose of the current study was to evaluate and compare cytological changes using morphometric analysis of the exfoliated buccal mucosal cells in Behçet’s disease patients and healthy controls, and to evaluate the clinical characteristics of Behçet’s disease. Methods. Twenty five Behçet’s disease patients have been compared to 25 healthy volunteers as a control group. Papanicolaou stain was used for staining the smears taken from buccal epithelial cells to be analyzed cytomorphometrically. The image analysis software has been used to
... Show MoreRheumatoid arthritis is an inflammatory chronic disease with an autoimmune pathogenesis. To determine the role of Helicobacter pylori as a trigger agent, twenty five patients with rheumatoid arthritis of ages (15-47) years have been investigated and compared with twenty healthy individuals. All the studied groups were carried out to measure the rheumatoid arthritis (RA) IgM, anti-CCP antibody IgG and IgA by ELISA test and by measured anti-IgG antibody level of H. pylori by using ELISA and IFAT techniques. The present study showed significant differences (P< 0.05) of anti-H. Pylori in sera of RA patients than control group, this lead to suggest that H. pylori had a role in pathogenesis of RA.
This study investigates asset returns within the Iraq Stock Exchange by employing both the Fama-MacBeth regression model and the Fama-French three-factor model. The research involves the estimation of cross-sectional regressions wherein model parameters are subject to temporal variation, and the independent variables function as proxies. The dataset comprises information from the first quarter of 2010 to the first quarter of 2024, encompassing 22 publicly listed companies across six industrial sectors. The study explores methodological advancements through the application of the Single Index Model (SIM) and Kernel Weighted Regression (KWR) in both time series and cross-sectional analyses. The SIM outperformed the K
... Show MoreBackground: Coronary Artery Disease (CAD) is one of the largest causes of mortality worldwide. Clopidogrel, antiplatelet drug, has been widely used for management of CAD. The current study aimed to investigate the effect of clopidogrel on the oxidative stress in CAD patients. Methods: One hundred CAD patients, who were followed-up for 5 days after receiving clopidogrel, and 50 healthy volunteers were included in this study. Parameters include catalase (CAT), total antioxidant capacity (TAC), total oxidant capacity (TOC), total protein, albumin, and globulins were determined before and after treatment with clopidogrel. Results: CAT, TAC, and Tp were significantly decreased (P<0.0001) in CAD patients compared to healthy control and
... Show MoreBackground: Immediate implant placement in the maxillary anterior region was challenging, especially with the jumping gap and limited primary implant stability. Objective: To assess the autogenous dentin graft biomaterial's ability to improve the esthetic outcomes of an immediately inserted implant. Methods: Twenty patients with non-restorable retained roots in the maxillary non-molar region surrounded by natural sound teeth were included in this study after a complete clinical and radiological examination, including patient health and clinical fitness for the immediate dental implant procedure. A single dental implant was inserted for each patient, and the resulting jump distance was filled with the mineralized dentin graft and co
... Show MoreBACKGROUND: Idiopathic immune thrombocytopenia purpura is an autoimmune bleeding disorder that accounts for approximately one-third of clinical hemorrhagic diseases. Pathophysiologically, it involves a complicated imbalance in the immune system. OBJECTIVES: This study focuses on evaluating the levels of the immunomodulatory cytokines interleukin (IL)-35, interleukin-10, and transforming growth factor-β (TGF)-β in patients with refractory idiopathic immune thrombocytopenia undergoing treatment with romiplostim. MATERIALS AND METHODS: A cross-sectional study encompassed 78 individuals with idiopathic immune thrombocytopenia and conducted measurements of different immunomodulatory cytokines in response to different responses of idiopath
... Show More