End Stage Renal Disease is a well-known global public health problem. Maintenance hemodialysis is considered a life-saving treatment for patients with such disease. This treatment method that requires patients to be adherent to hemodialysis attendance, dietary and fluid recommendations as well as adherence to prescribed medications to ensure success. The aim of the current study was to assess adherence, perception, and counseling among hemodialysis patients to different modalities of treatment (fluid restriction, dietary recommendations, medications, and hemodialysis schedules). A cross-sectional study carried out on hemodialysis patients who attended to the dialysis centers at al- Karama teaching hospital and Madinat Al- Imamain Al- Kadhimain teaching hospital. The Arabic version of the “ end stage renal disease-adherence questionnaire ” was used in assessing adherence, perception, and counseling. The number of recruited patients were 200 adult patients (113 men and 87 women). The average of the total adherence score lies within the moderate adherence (984.9 ±174.2). Patients adherence to the hemodialysis session was good as representing by high scores of adherence for (hemodialysis-attendance, episode of hemodialysis-shortening and duration of hemodialysis-shortening) while the lowest adherence score (126.0 out of 200) was for following the fluid restriction. In terms of adherence categories, the majority (61%) of the patients had good adherence, 33.0% had moderate adherence with 6% had poor adherence. Age had significant positive association with the total adherence score. All patients perceived their hemodialysis management as highly/very important. On the other hand, some patients perceived their adherence to the recommended diet as moderately (7%) or less important (7%). Regarding the frequency of counseling received by patients for different treatment modalities. The negative answers represented 58.5% of answers about the how important is to follow a proper diet, and 25.0% of answers about the importance of taking prescribed medications as ordered. Accordingly, the overall adherence of hemodialysis patients to different treatment modalities was less than optimum with fluid and diet adherence representing most challenging tasks in the health care of hemodialysis patients.
Background: The relation between insulin resistance ,leptin levels and other hormones in women with polycystic ovary syndrome(PCOS) is still controversial.Metformin therapy is proved effective in reducing insulin resistance and also in some studies it was seen to be effective in reducing leptin levels.
Al- Kindy Col Med J 2012 ; Vol .8 No. (2) p: 65
Objective: to study the effect of metformin on reducing leptin levels and enhancing ovulation in PCOS women.
Methods:metformin 500mg 3 times daily for 3 months was was given to 36 women
with proved PCOS, in addition to that, other parameters were included.
Results:28 women out of 36(77.78%) showed an evidence of ovulation ovulation after 3 months of metformin therapy(p<0.01)
Vapor-liquid equilibrium data are presented for the binary systems n-hexane - 1-propanol, benzene - 1-propanol and n-hexane – benzene at 760 mm of mercury pressure. In addition ternary data are presented at selected compositions with respect to the 1-propanol in the 1-propanol, benzene, n-hexane system at 760 mmHg. The results indicate the relative volatility of n-hexane relative to benzene increases appreciably with addition of 1-propanol.
A discussion about the repercussions of the exchange rate on the behavior of stock markets became one of the basic principles of financial economics. The Istanbul Stock Exchange , considered one of the fastest financial markets growing in the region, driven by solid economic activity, for a diversified economy which classified as one of the the fastest growing economies in the world. However, the aforementioned market witnessed sharp fluctuations in the past few months, coinciding with the continuous fluctuations in the exchange rate of the Turkish lira, posing a serious challenge to the economic and investment environment in a c
... Show MoreBiomass has been extensively investigated, because of its presence as clean energy source. Tars and particulates formation problems are still the major challenges in development especially in the implementation of gasification technologies into nowadays energy supply systems. Laser Induced Fluorescence spectroscopy (LIF) method is incorporated for determining aromatic and Polycyclic Aromatic Hydrocarbons (PAH) produced at high temperature gasification technology. The effect of tars deposition when the gases are cooled has been highly reduced by introducing a new concept of measurement cell. The samples of PAH components have been prepared with the standard constrictions of measured PAHs by using gas chromatograph (GC). OPO laser with tun
... Show MoreThe objective of the research is to determine the nature of the strategic direction of the institution and its impact on enhancing the indicators of institutional performance. The strategic direction is the main purpose for which it was found. Therefore, it is the main engine for all activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. The promotion of corporate performance indicators is one of the major challenges that senior management must address in order to help the organization invest its human resources in the best possible way.
The research problem was determined by means of the intentional sample, consisting of (33) members
... Show MoreThe degree of the woman’s satisfaction on clothing depends, to a large extent, on the body measurements. If clothing is very wide, it shows her enormous and if it is too tight it may draw attention to the defects of the body. It may also lead to the compatibility or incompatibility of clothing with fashion. Whatever the quality of the garment in terms of sewing and design, the costume which is not suitable for body size may affect the physical style negatively and may give the wearer an improper look. Clothing was carried out without measurements and did not use models (templates). The method of preparation affected the overall appearance because it often did not fit the shape of the body completely. Therefore, people thought in many w
... Show MoreThe support qualitative information regards as an additional step in the process of decision-making where the method following by companies to provide information help in the creation of value because it is very important to deliver information to investors about their stratigies and what happen truly inside the companies i.e. every case relating with the expectations of stockhotslder and the prices of markets depending on those expectation ,and if the matter isn’t that there will be lack of confidence thate couldn’t be backed again. The decisions of the investors effected by security ,economic ,political, psychological, emotional ,and financial factors .
... Show MoreA Laced Reinforced Concrete (LRC) structural element comprises continuously inclined shear reinforcement in the form of lacing that connects the longitudinal reinforcements on both faces of the structural element. This study conducted a theoretical investigation of LRC deep beams to predict their behavior after exposure to fire and high temperatures. Four simply supported reinforced concrete beams of 1500 mm, 200 mm, and 240 mm length, width, and depth, respectively, were considered. The specimens were identical in terms of compressive strength ( 40 MPa) and steel reinforcement details. The same laced steel reinforcement ratio of 0.0035 was used. Three specimens were burned at variable durations and steady-state temperatures (one
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