Background: Inflammatory bowel disease (IBD) is a collection of chronic, recurrent inflammatory illnesses of the gastrointestinal system, including Crohn's disease (CD). Infliximab is one of the biological medications used to treat CD. Therapeutic drug monitoring has evolved as a treatment in IBD, aiming to optimize benefit while meeting more demanding, objective end criteria. Objective: To determine the achievement of target trough level (TL), develop anti-drug antibodies (ADAs) to infliximab, assess response to therapy, and study TL relations with different variables. Methods: The present study was cross-sectional and conducted from May 2022 to November 2022. It included 40 CD patients allotted into 2 groups: group 1 patients achieved the TL target, and group 2 patients did not achieve the TL target. Results: Twenty-two patients achieved target TL, while 18 patients did not. Dose escalation is recommended for 11 patients, switching therapy for 15 patients, and continuing the same dosage regimen for 14 patients. In addition, erythrocyte sedimentation rate, C-reactive protein, serum calprotectin and ADAs were significantly lower in patients who achieved target infliximab TL. Only serum calprotectin can be used to predict the achievement of the target TL of infliximab. Conclusions: Therapeutic drug monitoring of infliximab to determine the TL and ADAs can help to explain why some patients do not respond to this drug. Serum calprotectin may be used as a novel marker to predict the TL and response to infliximab.
Left bundle branch block (LBBB) is a common finding in electrocardiography, there are many causes of LBBB.
The aim of this study is to discuss the true prevalence of coronary artery disease (CAD) in patients with LBBB and associated risk factors in the form of hypertension and diabetes mellitus.
Patients with LBBB were admitted to the Iraqi heart center for cardiac disea
Background : Coronary artery disease is theunderlying cause in approximately two thirds of
patients with systolic heart failure ;
Coronary artery angiogriphy may be useful to
define the presence ,
Anatomical characteristics ,and functional
significance of Coronary artery disease in
selected heart failure patients with or without signs
and aymptoms of Coronary artery disease.
Objectives: to verify the clinical usefulness of
coronary angiography (CA) in congestive heart
failure (CHF) patients with no history of ischemic
heart disease and to identify predictive factors for
performing coronary angiography to patients with
congestive heart failure with no obvious ischemia.
Methods :this is a cross-ses
The amount of protein in the serum depends on the balance between the rate of its synthesis, and that of its catabolism or loss. Abnormal metabolism may result from nutritional deficiency, enzyme deficiency, abnormal secretion of hormones, or the actions of drugs and toxins. Renal cancer is the third most common malignancy of the genitourinary system, and accounts for 3% of adult malignancies globally. Total serum proteins were measured in malignant kidney tumor, benign kidney tumors, and non tumoral kidney diseases patient groups, as well as in healthy individuals. A significant decrease (p< 0.001) of total serum protein levels in patients with malignant kidney tumors when compared with those of benign tumors, non tumoral diseases, and hea
... Show MoreForty – two elderly hypothyroidism patients and forty – two apparently healthy as control groups , divided to (21) male (M) and (21) female (F) also (21) control male C(M) and (21) control female C(F) aged > 60 years, were tested for the presence of thyroid peroxidase autoantibody (TPo – Ab) and thyroglobulin auto antibody (Tg – Ab) , also for Se and Zn levels in their sera . The results revealed a significant increase in (TPO – Ab) and (Tg – Ab) for group (M) and (F) compared to control group , also a siginificant increase in TPo – Ab and Tg – Ab for (F) compared to (M) was found. A significant decrease in Se and Zn level for (M) and (F) compared to control group, while no significant difference between (M) and (F). In conc
... Show MoreBackground : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a d
... Show MoreBackground: Diabetic patients have been reported to be more susceptible to gingivitis and periodontitis than healthy subjects. Many intracellular enzymes like (alkaline phosphatase- (ALP), aspartate aminotransferase- (AST) and alanine aminotransferase- (ALT) that are released outside cells into the gingival crevicular fluid (GCF) and saliva after destruction of periodontal tissue during periodontitis. This study was conducted to determine the periodontal health status and the levels of salivary enzymes (ALP, AST and ALT) of the study and control groups and to correlate the levels of these enzymes with clinical periodontal parameters in each study group. Subjects, Materials and Methods: One hundred subjects were enrolled in the study, with a
... Show MoreEndothelin-I (ET-I) is one of the potent vasoconstrictors secreted from endothelial cells when needed. Many studies revealed the elevation of serum ET-I with human diabetes and microangiopathies. Since insulin resistance is a case of mixed diabetic and pre-diabetic cases, many risk factors beyond obesity and inflammation are proposed. The current study aims to demonstrate the association between serum ET-I and asymmetric dimethylarginine (ADMA) and insulin resistance in type 2 diabetes mellitus (T2DM). Sera of 73 subjects were enrolled currently (control= 35 subjects, and 38 with T2DM for more than 7 years), aged (40-60) years old, with distinct body mass index (BMI) ≤ 25 for control volunteers and (BMI) ≥ 25 for obesity and diabetes
... Show MoreAnemia of chronic disease (ACD) and iron deficiency anemia (IDA) are the two most important types of anemia in rheumatoid arthritis (RA). Functional iron deficiency in ACD can be attributed to overexpression of the main iron regulatory hormone hepcidin leading to diversion of iron from the circulation into storage sites resulting in iron-restricted erythropoiesis. The aim is to investigate the role of circulating hepcidin and to uncover the frequency of IDA in RA. The study included 51 patients with RA. Complete blood counts, serum iron, total iron binding capacity, ferritin, and hepcidin- 25 were assessed. ACD was found in 37.3% of patients, IDA in 11.8%, and combined (ACD/IDA) in 17.6%. Serum hepcidin was higher in ACD than in con
... Show MoreAspartate aminotransferase was purified from urine and serum of patients with type 2 diabetes in a 2 steps procedure involving dialysis bag and sephadex G-25 gel filtration (column chromatography). The enzyme was purified 346.23 fold with 1467% yield and 3.46 fold with 142.85% yield in urine and serum of patients with type 2 diabetes respectively. The purified enzyme showed single peak. The results of this study revealed that AST activity of type 2 diabetes urine and serum increased significantly (p<0.001) compared with control group.
ZM Al-Bahrani, Medico Legal Update, 2021