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The Role of Clinical Pharmacist in Reducing Drug Related Problems in Hemodialysis Patients
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Abstract

Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient.  Identification and classification of drug related problems and discussing them with the health care providers.  Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical Care Network Europe classification, an interventional phase to increase the awareness of patients and the nephrologists about those problems and proposing a proper solution for each one.  The main drug related problems was related to the effect of drug treatment being not optimal in 58.7%, followed by no effect in 17.8%, and least for unrelated symptoms or indications in 4.8%; causes were inappropriate combination and patients taking less drug than prescribed (both 17.4%), followed by no/or incomplete drug treatment in spite of existing indication in 12.2%, drug without indication in 10.4%. Erythropoietin and calcium were the most frequently drugs with problems. Acceptance and full implementation were observed in 34.3%, while half of the drug related problems had unknown implementation (51.3%). There were significant numbers of drug related problems among Iraqi patients on hemodialysis, the use of erythropoietin, calcium carbonate and sevelamer  was responsible for most of inappropriate combinations. Physicians and clinical pharmacist cooperation was excellent.

Keywords: Drug related problems, Hemodialysis, Clinical pharmacist.

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Publication Date
Wed Dec 19 2018
Journal Name
Indian Journal Of Natural Sciences
Genotyping of Cryptosporidium Spp. Isolated from Human and Cattle in Baghdad Province, Iraq
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Cryptosporidiosis is an intestinal protozoan parasitic disease that infects human and animals, caused by apicomplexan parasite belong to the genusof Cryptosporidium. The current study was done to record the infection rate of cryptosporidiosis in human and cattle, and genotype the clinical isolates of Cryptosporidium in Baghdad Province. A total of 265 stool sample were collected (150 from human and 115 from cattle) during the period from December 2016 to the May 2017. Cryptosporidial infection was detected using modified acid fast stain. DNA of the parasite was extracted from oocysts of positive fecal samples and nested PCR method was used for partial 60 kDa glycoprotein (gp60) gene amplification then sequence analysis for selected samples.

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Publication Date
Tue Sep 11 2018
Journal Name
Iraqi Journal Of Physics
Estimation of kidney tumor volume in CT images using medical image segmentation techniques
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Kidney tumors are of different types having different characteristics and also remain challenging in the field of biomedicine. It becomes very important to detect the tumor and classify it at the early stage so that appropriate treatment can be planned. Accurate estimation of kidney tumor volume is essential for clinical diagnoses and therapeutic decisions related to renal diseases. The main objective of this research is to use the Computer-Aided Diagnosis (CAD) algorithms to help the early detection of kidney tumors that addresses the challenges of accurate kidney tumor volume estimation caused by extensive variations in kidney shape, size and orientation across subjects.
In this paper, have tried to implement an automated segmentati

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Publication Date
Fri Mar 15 2019
Journal Name
Al-khwarizmi Engineering Journal
Theoretical Prediction of Optimum Chilled Water Distribution Configuration in Air Conditioning Terminal Unit
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 The distribution of chilled water flow rate in terminal unit is a major factor used to evaluate the performance of central air conditioning unit. In this work, a theoretical chilled water distribution in the terminal units has been studied to predict the optimum heat performance of terminal unit. The central Air-conditioning unit model consists of cooling/ heating coil (three units), chilled water source (chiller), three-way and two-way valve with bypass, piping network, and pump. The term of optimization in terminal unit ingredient has two categories, the first is the uniform of the water flow rate representing in statically permanents standard deviation (minimum value) and the second category is the maximum heat transfer rate fro

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Publication Date
Sat Jun 18 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Development of novel paracetamol/naproxen co-crystals with an improvement in naproxen solubility.
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Co-crystals are new solid forms of drugs that could resolve more than one problem associated with drugs formulations like solubility, stability, bioavailability, mechanical and tableting properties. A preliminary theoretical study for estimating the possible bonding between the co-crystal components (paracetamol and naproxen) was performed using the ChemOffice program. The results revealed a high possibility for bonding between paracetamol and naproxen and indicated the ability of molecular mechanics study to predict the co-crystal design.

       In this work, four different methods were used for the preparation of three different ratios 1:1, 2:1, and 1:2 of paracetamol:naproxen co-crystals. The four

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Immunohistochemical Expressions of AKT, ATM and Cyclin E in Oral Squamous Cell Carcinoma
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Background: Understanding the pathogenesis and molecular basis of Oral Squamous Cell Carcinoma (OSCC) has increased rapidly over the past few years that is essential to improve patient's prognosis and treatment modalities. The purpose of this study to evaluate the Immunohistochemical expressions of AKT, ATM, AND Cyclin E in oral squamous cell carcinoma Materials and methods: This study was performed on a forty formalin-fixed paraffin-embedded blocks which histopathologically diagnosed as Oral Squamous Cell Carcinoma. All cases were collected from the Histopathological Laboratory from patients treated surgically at Maxillofacial surgery Department at Ramadi Teaching Hospital, Iraq. Results: The immunohistochemical staining of AKT showed pos

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Publication Date
Wed Jul 03 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Bioavailability of Bilastine Oral Self-nanoemulsion: Comparative Study with Commercial Formula in Rats
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Bilastine (BL) is a novel non-sedating second-generation antihistamine, and its bioavailability is about 60%. Objective: To compare the bioavailability of prepared oral self-nanoemulsions of BL (BL-SNE) with that of pure BL and marketed tablets. Methods: Four groups of Wistar rats were used in this study, each with six rats weighing between 200 and 250 g. They were treated orally using a a gavage tube. The groups were fed either with conventional tablets ("Alerbix®") after being ground and dispersed with deionized water (DIW), treated with BL-SNE or fed with pure BL powder suspension. The fourth group did not receive any medication. The concentration of BL in the rat’s plasma was measured using HPLC. We used Trandolapril as an an interna

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Publication Date
Thu Dec 06 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effects of Vitamin E and Q10 Supplementation against Doxorubicin-Induced Neurotoxicity in Rats
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Publication Date
Wed Jul 01 2020
Journal Name
Journal Of Engineering
One and Two-Dimensional Hydraulic Simulation of a Reach in Al-Gharraf River
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One and two-dimensional hydraulic models simulations are important to specify the hydraulic characteristics of unsteady flow in Al-Gharraf River in order to define the locations that facing problems and suggesting the necessary treatments. The reach in the present study is 58200m long and lies between Kut and Hai Cities. Both numerical models were simulated using HEC-RAS software, 5.0.4, with flow rates ranging from 100 to 350 m3/s. Multi-scenarios of gates openings of Hai Regulator were applied. While the openings of Al-Gharraf Head Regulator were ranged between 60cm to fully opened. The suitable manning roughness for the unsteady state was

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Global Pharma Technology
Assessment of heavy metals in some ground water wells at Baghdad City/Iraq
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Occurrence the heavy metals in water is one of the most important concerns. may cause savior health problems. In this work we made an attempt to know the quantity of six heavy metals in groundwater in different locations of Baghdad city. Examinations were made on groundwater of the review region to assess the heavy metals. Groundwater samples were gathered and analyzed utilizing Atomic Absorption Spectrophotometer for their Manganese, Iron, Zinc, Cadmium, Copper and Lead content and their levels compared with World Health Organization (WHO) specified maximum contaminant level. In order to accomplish this, water samples were obtained from 10 randomly selected wells in the region, in February and August, 2016. The study showed that the ground

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Protective Effect of Ginger Extract Against Cisplatin-Induced Hepatotoxicity and Cardiotoxicity in Rats.
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The protective effect of ginger extract against cisplatin-induced hepatotoxicity and cardiotoxicity was evaluated in 30 albino white rats(weighing 200-300 gm ) classified into 5groups (6 rats per each group). The rats were treated with 0.5g/kg/day or         1g/kg/day ginger extract orally 5 successive days before and 5 successive days after induction of toxicity with intraperitoneal (IP) injection of (10mg/kg ) cisplatin, resulted in a significant reduction in the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) , total serum  billirubin(TSB) , lactate dehydrogenase (LDH) and creatine kinase(CK) enzymes in comparison with the cisplatin treated animals; ginger extract

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