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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
Mon Sep 15 2014
Journal Name
Journal Of Clinical And Biomedical Sciences
Detection of EGFR Mutations in Bronchial Wash from Iraqi patients with nonsmall Cell Lung Cancer (NSCLC)
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Background: Non-small cell lung cancer (NSCLC) is caused of 85% of all lung cancers. Among the most important factors for lung tumor growth and proliferation are the tyrosine kinase receptors that coded by the epidermal growth factor recep-tor (EGFR) gene. Activation of EGFR ultimately leads to developing of lung cancer. The present study was undertaken with an objective to detect EGFR mutations in bronchial wash from Iraqi patients with NSCLC before treatment. Methods: DNA was extracted from bronchial wash samples collected from 50 patients with NSCLC by using a Qiamp DNA Mini Kit (Qiagen, Hilden, Germany). Then, EGFR mutations were determined by using real-time RCR combined with two technologies, Amplification Refractory Mutation System (

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Publication Date
Sat Dec 11 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Assessment of Health Beliefs Among Iraqi Breast Cancer Patients in Baghdad using either Tamoxifen or Trastuzumab
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Breast cancer is the most diagnosed form of malignant tumour in Iraqi women. Tamoxifen and trastuzumab are highly effective adjuvant therapy for breast cancer. This study's objectives were to define the patient's belief in tamoxifen or trastuzumab when used as adjuvant therapy and to determine the variation in belief between the two medications in a sample of Iraqi breast cancer patients. The cross-section survey was conducted using the BMQ-Specific questionnaire. Ninety-seven participants (sixty-seven tamoxifen, thirty trastuzumab) participated in this study. The mean of specific-necessity scale for tamoxifen was (3.7) and for trastuzumab (4). The findings showed a high necessity for both medicines, and there were

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Effectiveness of Intra articular Injection of Platelet-Rich Plasma in Patients with Anterior Disc Displacement with Reduction
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Background: Anterior disc displacement with reduction (ADDWR) is the most common form of the internal derangement (ID) of temporomandibular joint (TMJ). It is a painful progressive dysfunction and clinically characterized by reciprocal clicking due to shift in the disc anteriorly in relation to the condyle and fossa during mandible elevation. Minimally invasive therapy such as intra-articular injection of platelet-rich plasma (PRP) has been used. PRP is a natural autologous product with a high platelet concentration obtained by centrifugation process to enhance tissue healing through several growth factors (GFs), which are released after endogenous activation. The aim of this study is to assess this technique which is increasingly used toda

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serum Level Profile and Pharmacokinetic Parameters of Single Oral Dose of Metronidazole in Type II Diabetic Patients
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Many pathophysiological processes can affect the pharmacokinetic properties of drugs in people with diabetes. The present study was deigned to evaluate the influence of diabetes mellitus (DM) on the pharmacokinetic parameters of metronidazole administered as single oral dose. Twelve healthy volunteers and twelve diabetic patients were enrolled in the present study. On day 1, a single oral dose of metronidazole 500 mg was administered orally to all participants at 9:00 am after a 10-hour fasting. Over the following 48 hours, blood samples were taken at frequent intervals and serum metronidazole concentrations were measured by a high-performance liquid chromatography method for assessment of pharmacokinetics of metronid

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Publication Date
Wed Dec 30 2020
Journal Name
Al-kindy College Medical Journal
Measurement of plasma fibrinogen and D-dimer in a sample of Iraqi patients with solid malignant tumors
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Background: Multifactor affect the pathogenesis of thrombosis in solid malignancy; however, a significant role is attributed to the cancer cells ability to interact with and activate the host hemostatic system. [1] 

Hemostasis is highly correlated to tumor growth, angiogenesis and metastasis, modulation of these pathways reflects interesting and promising treatment options in the future. [1]

Most patients with cancer frequently suffer from chronic compensated DIC and have abnormal laboratory coagulation tests without clinical manifestations of thrombosis, which is a subclinical hypercoagulable state that can be detected by varying degrees of activation of blood clotting. The results of laboratory tests in th

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Publication Date
Sat Jan 01 2011
Journal Name
Iraqi J Pharm Sci,
Serum Level Profile and Pharmacokinetic Parameters of Single Oral Dose of Metronidazole in Type II Diabetic Patients
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Many pathophysiological processes can affect the pharmacokinetic properties of drugs in people with diabetes. The present study was deigned to evaluate the influence of diabetes mellitus (DM) on the pharmacokinetic parameters of metronidazole administered as single oral dose. Twelve healthy volunteers and twelve diabetic patients were enrolled in the present study. On day 1, a single oral dose of metronidazole 500 mg was administered orally to all participants at 9:00 am after a 10-hour fasting. Over the following 48 hours, blood samples were taken at frequent intervals and serum metronidazole concentrations were measured by a high-performance liquid chromatography method for assessment of pharmacokinetics of metronidazole. The data

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Publication Date
Mon Oct 17 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Focus Assessment of Transthoracic Echocardiography post septostomy Procedure in Patients Undergoing Ablation of Left Atrial Supraventricular Tachycardia
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Background: Echocardiography has an important role to follow up patients with Iatrogenic atrial septaldefect (IASD) and after Catheter ablation during electro-physiological study.Objectives: evaluating the impact of non-invasive Transthoracic Echocardiography (TTE) parameters(LAVI, LVEF, ASD size and E/e`) post radiofrequency ablation of left atrial arrhythmia.Patients and methods: for the evaluation of the atrial septal defect, a transthoracic echocardiography(TTE) was used in patients who underwent left atrial arrhythmia ablation, enrolled in prospective studyin the Iraqi center for cardiac diseases, in cooperation with university of Baghdad /college of medicineResults: The outcomes of the present study were assessed according to

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Publication Date
Mon Mar 01 2021
Journal Name
Journal Of Physics: Conference Series
Evaluation of total oxidant status and antioxidant capacity in sera of acute-and chronic-renal failure patients
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Abstract<p>Renal failure is a disease of the kidney, in which the renal excretory function is failed to process due to depression of the GFR. Renal failure is divided into acute and chronic depending on the period of the disease. The study was designed to investigate the level of oxidative stress in RF patients. Seventy-five subjects had enrolled in the study, who divided into three groups equally, in which they are healthy control, ARF patients, and CRF patients. The results had shown a significant <italic>(P<0.01)</italic> increase in the level of TOS for RF patients when compared with control. Also, a significant difference in the level of TOS has been observed between ARF and CR</p> ... Show More
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Publication Date
Mon Dec 01 2014
Journal Name
Iraqi Journal Of Science
Detection of human leukocyte antigen and celiac disease auto antibodies in serum of patients with multiple sclerosis
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To determine the important pathogenic role of celiac disease in triggering several autoimmune disease, thirty patients with Multiple Sclerosis of ages (22-55) years have been investigated and compared with 25 healthy individuals. All the studied groups were carried out to measure anti-tissue transglutaminase antibodies IgA IgG by ELISA test, anti-reticulin antibodies IgA and IgG, and anti-endomysial antibodies IgA and IgG by IFAT. There was a significant elevation in the concentration of anti-tissue transglutaminase antibodies IgA and IgG compared to control groups (P≤0.05), there was 4(13.33%) positive results for anti-reticulin antibodies IgA and IgG , 3(10%) positive results for anti-endomysial antibodies IgA and IgG . There were 4 pos

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Publication Date
Tue Oct 01 2019
Journal Name
Biochemical & Cellular Archives
PREDICTIVE VALUES OF DHEAS, TT AND IGF1 IN SUCCESSFUL PREGNANCY OUTCOME OF PATIENTS UNDERGOING IVF/ICSI-ET
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vitrofertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) for infertile patients. Insulin like growth factor 1 (IGF1), Dehydroepiandrosterone sulfate (DHEAS) and Total Testosterone (TT) may have a role on follicle growth, oocyte quality, embryo quality and subsequent pregnancy in patients undergoing IVF cycles. To explore the possibility of using DHEAS, TT and IGF1 as predictive indicator for successful pregnancy in patients undergoing (IVF/ICSI-ET). A prospective study was performed enrolling (12) non pregnant control group,(7) pregnant control group,(18) non-pregnant PCOS group and (12) pregnant PCOS group. The collection of blood and follicular fluid (FF) samples was done at the day of oocyte aspiration. Electroch

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