Background: Osteoporosis is an extra-articular complication of rheumatoid arthritis that results in increased risk of fractures and associated morbidity, mortality, and healthcare costs. Objective: To evaluate changes in bone mineral density in a sample of rheumatoid arthritis (RA) patients on biological (anti tumor necrosis factor (TNF) alpha) and non-biological agent disease modifying antirheumatic drugs (DMARDs). Patients and Methods: A cross sectional study enrolled 60 RA patients diagnosed by rheumatologist according to the 2010 American College of Rheumatology/European League Against Rheumatism (2010 ACR/EULAR) classification criteria for RA. Thirty patient on biological agent (anti TNF alpha) and 30 patient on non-biological agent (DMARD). RA disease-related data wincluded disease duration, disease activity score index of 28 joints (DAS 28) and clinical disease activity index (CDAI), functional class, body mass index and treatment history. vitamin D level were measured in both groups. Bone mineral density was measured by dual energy x-ray absorptiometry of hip and lumber spines for patients. AT–score of equal or less than-2.5 standard deviation that of young healthy adults were taken as osteoporotic and scores between-1 to-2.5 standard deviation was taken as osteopenic. Results: Prevalence of RA patients on biological agent (anti TNF alpha) who had osteoporosis was 1 (3%) and 12 (40%) were osteopenic, and in patients on non biological (DMARD), Osteoporosis was present in 8 (26%) and osteopenia in 13 (43%, p= 0.019). Vitamin D level in patient on biological agent (anti TNF alpha) was low in 24 (80%) and normal …
Porous silicon (PS) layers were formed on n-type silicon (Si) wafers using Photo- electrochemical Etching technique (PEC) was used to produce porous silicon for n-type with orientation of (111). The effects of current density were investigated at: (10, 20, 30, 40, and50) mA/cm2 with etching time: 10min. X-ray diffraction studies showed distinct variations between the fresh silicon surface and the synthesized porous silicon. The maximum crystal size of Porous Silicon is (33.9nm) and minimum is (2.6nm) The Atomic force microscopy (AFM) analysis and Field Emission Scanning Electron Microscope (FESEM) were used to study the morphology of porous silicon layer. AFM results showed that root mean square (RMS) of roughness and the grain size of p
... Show MoreManagement Representations Letter plays a significant role as an evidence to get conclusions the Auditor is looking for. These conclusions could show the professional opinion of auditor over the fairness and integrity of financial statements for many issues and numbers that management claims, Hereby, the research aims at highlighting the importance of Management Representations Letter and the way of using as an evidence with expressing its meaning and means of application in addition to identify the Responsibility of Auditor on that Letter, This research discusses also the effect of Management Representations Letter on the credibility of financial statement and enhancing the credibility of the submitted reports, From other side, in the t
... Show MoreThe study included a statement toxicity of some heavy metals individually and collectively and the existence of plant nutrients in the center Agirenk bluish green moss growth and Askhaddm biomass as an indicator of the study, in addition to portability moss on the accumulation of the metal
Background: Health professionals have a crucial role in promotion, support and management of breastfeeding. To be effective in this effort, the clinician should focus on the issue from the preconception stage through pregnancy and delivery, and continue in subsequent infant care. Aim of the study: to assess the effectiveness of the UNICEF/WHO 40-hour of breast feeding training through the assess breastfeeding knowledge and attitudes of the health profession staff before and after training course.
Abstract
The aim of the research is to demonstrate the impact of long-term investment on profitability, and in order to achieve this goal, long-term investment was chosen, represented by (the ratio of long-term investments to total investments, the ratio of long-term investment to the total (deposits) as independent variables, and studying its impact on the dependent variable, which is profitability as measured by the rate of return on investments, the rate of return on equity. In order to reach the results, the inductive approach and the analytical descriptive approach were used, and the research found a significant impac
... Show MoreOrganizations adopt a number of procedures and instructions in their field of activities in order to aid their resources development and energies to serve their entrepreneurial orientations. This calls for preparing a range of mechanisms to mitigate the strictness and complexity of procedures. The ambiguity and severe complexity of procedures means acknowledging the loss in energy and this in turn impedes the hopes while in the same time weakens the enthusiasm in these organizations and an impedes the possibility to achieve continues innovation, thereby losing opportunities to the level of surrender to the risks and assuming them to be unconquered obstacles.
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... Show MoreIntroduction: Candida spp. has become increasingly resistant to antifungal drugs, with elevated MIC levels causing a negative medical impact and increasing the number of patients at risk of candidiasis. According to the CDC, about 7% of Candida blood samples show reduced susceptibility to fluconazole. Monitoring the antifungal resistance profile of Candida spp. is vital, as non-Albicans species may limit treatment options. Objective: Evaluate the antifungal effectiveness against clinical Candida spp. isolates of six antifungals: amphotericin B, fluconazole, voriconazole, itraconazole, caspofungin, and 5-fluorocytosine. Methods: 100 samples were collected from various clinical samples at the National Centre of Teaching Laboratories
... Show MoreAbstractBackground:Reduced glomeular filtration rate isassociated with increasedmorbidity in patientswith coronary arterydisease.Objectives :To analyze the declining eGFR andmortality risks in a patients with Chronic KidneyDisease and have had Coronary Artery Diseaseincluding risk factors .Patientsand Methods:The study included (160)patientsbetween the ages of 16 and 87years.Glomerular filtration rate was estimated (eGFR)using the Modification of Diet in Renal Diseaseequationand was categorized in the ranges<60 mL· min−1 per 1.73 m2and≥ 60 ml/min/1.73 m2.Baseline risk factors were analyzed by category ofeGFR,.The studied patients in emergencydepartment, were investigatedusing Coxproportional hazard models adjusting for traditiona
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