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 given rituximab induction therapy and mycophenolate mofetil (MMF) maintenance therapy. RTX was indicated for refractory and relapsing SLE. Several investigations done before and after RTX treatment and in the last follow up (done one year after starting Rituximab). Those included protein in urine, serum creatinine, double stranded DNA, C3, C4, and Estimated Glomerular Filtration Rate (eGFR). Proteinuria decreased significantly after RTX treatment and in the last measurement (P=0.01 and P=0.001, respectively). Serum creatinine significantly decreased only in the last measurement (P=0.02). Double stranded DNA decreased remarkably after treatment (P=0.01) with a further decrease in the last measurement (P=0.006). C3 and C4 increased after treatment but the increase was significant only for C3 (P=0.002) and this increase continues till the last measurement (P=0.0006). Active urine sediments found in fifteen patients and disappeared after RTX treatment. Rituximab can be promising in treating lupus nephritis when used along with traditional immunosuppressants. It can reduce disease activity and improve renal function in such patients.
The provided research paper offers a thorough analysis of the semiotic analysis present in tobacco-free initiative advertisements from the year 2021. The study delves into the intricate process of decoding the diverse signs, symbols, and visual components integrated into these anti-smoking campaigns. The core aim of this investigation is to comprehend and explore the semiotic tactics that underlie these advertisements, with a particular emphasis on visual communication as a pivotal tool in shaping the public's attitudes and behaviors towards tobacco usage. The research introduces a significant theoretical framework, the "Taxonomy of Image-Text Relations and Functions" theory, as proposed by Emily E. Marsh and Marilyn Dom
... Show MoreAs a kind of linguistic study, the study of presupposition in drama is one of captivating topic to explore, because of the capability of this topic to make people perceive the presupposition differently. Presupposition is one of the most important concepts in linguistics. It refers to the implicit inferences made in communication between people. These inferences are necessary to understand the utterances correctly. The research particularly endeavors to focus on the linguistic constructions that activate presupposition.
Sub-threshold operation has received a lot of attention in limited performance applications.However, energy optimization of sub-threshold circuits should be performed with the concern of the performance limitation of such circuit. In this paper, a dual size design is proposed for energy minimization of sub-threshold CMOS circuits. The optimal downsizing factor is determined and assigned for some gates on the off-critical paths to minimize the energy at the maximum allowable performance. This assignment is performed using the proposed slack based genetic algorithm which is a heuristic-mixed evolutionary algorithm. Some gates are heuristically assigned to the original and the downsized design based on their slack time determined by static tim
... Show MoreReverse shoulder arthroplasty is an increasingly common surgical intervention. However there are concerns and known limitations in relation to such joint replacement, while novel designs of reverse shoulder prostheses continue to appear on the market. Many claim to offer improvements over older designs but such assertions are difficult to validate when there is no consensus as to how such implants should be tested in vitro or even if such testing is necessary. In order to permit appropriate in vitro testing of reverse shoulder prostheses a unique, multi-station test rig was designed which was capable of applying motion in three axes to test prostheses. The shoulder simulator can apply up to 110° of motion in the flexion–extension and abd
... Show Morepatterns of utterance stress in discourse direct attention to specific themes and reactions, controlling the flow and coherence of conversation. this study examines the utterance stress in Steve Harvey's selected episodes from a phono-stylistic perspective. this study is hoped to improve understanding of linguistic mechanism in talk show communication, highlighting the importance of phonetic features in transmitting meaning and increasing broadcast conversation participation. the researcher concentrates on the types of focus functions of utterance stress of some episodes available on YouTube. to conduct the analysis, the researcher adopts (Carr, 2013; Davenport& Hannahs 2005) to analyze utterance stress and Leech and Short (2007
... Show MoreBackground: Injuries to blood vessels are among the most dramatic challenges facing trauma surgeons because repair is often urgent, the surgeon has to decide between management options (open or endovascular), and gaining control and reconstructing a major arterial injury can be technically demanding .
Objective:,To analyze the cause of injury, surgical approach, outcome and complications of axillary artery injuries.
Methods A descriptive cross-sectional study on fifty patients at Ibn-Alnafees hospital in Baghdad from January 2005 to December 2010
Results Males were more commonly affected than female with ratio of 6.1:1. Most injuries were caused by bullet and shell (84%), followed by stab wounds (10%) and blunt trauma (6%). Pati
Negotiations are distinguished in that they are an easy and simple means between the conflicting parties, and it is an effective means at the same time as the conflicting parties seek understanding on the most effective way to solve their dispute, but negotiations are not always appropriate to resolve international disputes, especially when there is a disparity in power between the negotiating countries, or when it is missing Goodwill, or even when one of the parties is absent or less flexible, and the internal circumstances of one of the conflicting countries may play a negative or positive role in the success of the negotiations, away from the influence of the role of external variables in that, a
... Show MoreThe aim: To examine the efficiency of different concentrations of Dimethyl sulfoxide (DMSO) and glycerol as a cytoprotectants in protection of human sperms during cryopres¬ervation in this technique. Materials and methods: Thirty oligozoospermic semen samples were used in this study. Samples diagnosed according to WHO 2010 criteria. Sheep’s ovarian follicles obtained from local slaughterhouse and prepared by slicing the ovaries and evacuating the follicular fluid and oocyte. Each semen sample divided into six equal parts, and diluted 1:1 with cryosolution contains 5%, 10%, 15% DMSO or glycerol and injected within the emptied follicles. After freezing and thawing, the semen mixture aspired outside the follicles and sperm concentr
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