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.
This study focused on the synthesis of novel polymers incorporating the 1,3,4-oxadiazole ring. Four polymers were specifically prepared by blending polymers (6-9) with polyvinyl alcohol (PVA) in defined ratios, resulting in the formation of blended polymers (10-13). The synthesized polymers were characterized using Fourier Transform Infrared (FTIR) spectroscopy and proton nuclear magnetic resonance (1H-NMR). The results showed that the structure aligned with the proposed synthetic polymers. Furthermore, the physical and thermal properties were studied using scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and Differential Scanning Calorimetry (DSC). Additionally, the biological activity was examined against two s
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Comparative Analysis of Economic Policy Stability between Monarchical and Republican Systems: A Theoretical Fundamental Research
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This study examines experimentally the performance of a horizontal triple concentric tube heat exchanger TCTHE made of copper metal using water as cooling fluid and oil-40 as hot fluid. Hot fluid enters the inner annular tube of the TCTHE in a direction at a temperature of 50, 60 and 70 oC and a flow rate of 20 l/hr. On the other hand, the cooling fluid enters the inner tube and the outer annular tube in the reverse direction (counter current flow) at a temperature of 25 oC and flow rates of 10, 15, 20, 25, 30 and 35 l/hr. The TCTHE is composed of three copper tubes with outer diameters of 34.925 mm, 22.25 mm, and 9.525 mm, and thicknesses of 1.27 mm, 1.143 mm, and 0.762 mm, respectively. TCTHE tube's length was 670
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At a time when the general rules in the different legal systems require the presence of two parties to the contract, one of which is issued the first expression of the will and is called the offer, and the other is issued from the other and is called the acceptance. A special type of contracts emerged in the beginning of the last century called the “unilateral contracts”. The side sparked a major jurisprudential dispute, as well as the issuance of several contradictory judicial rulings on it. Hence, this research came to highlight this special type of contract. Key words: the definition of a unilateral contract, its distinction from other legal situations, and its effects.