Background: The majorities of statin-treated patients, in whom low-density lipoprotein cholesterol (LDL-C) targets have been achieved, have had recurrent cardiovascular events (CVE) with an absolute rate remain even higher among patients with disorders of insulin resistance, metabolic syndrome (MetS) and type2 diabetes mellitus (T2DM) as compared to patients devoid of these conditions.Objectives: Provide updated key messages of lipid and lipoprotein abnormalities as indicator for cardiovascular disease (CVD) risk in patients with T2DM and obesity, as well as the current evidence-based treatment targets and interventions to reduce this risk.Key messages: The Residual Risk Reduction Initiative (R3I) emphasized atherogenic dyslipidemia (AD) as the chief modifiable contributor to residual cardiovascular risk, especially in conditions associated with insulin-resistant,and call to improve awareness and clinical management.The probable benefit of residual CVD risk reductionsuggests a role for treatment of persistently high TGconcentration even in statin – treated patients, with TG lowering agents including fibrates, niacin, omega polyunsaturatedfatty acids, and other non statin treatment.Therapeutic lifestyle changes including; medically assistedweight loss, physical activity, and dietary changes, as well as improvement of glycemic control should be an adjunct to lipid-lowering pharmacological therapies. Therapy should be concomitantly assessed for treatment tolerance and adequacy with focused laboratory evaluations and patient follow-up. Therapy should be boosted to attain goals according to risk level, and that even more intensive therapy might be warranted in patients with CVD history.
This study aimed to know the attitudes and practice of pharmacists regarding the management of minor ailments in Iraqi community pharmacies. A cross-sectional study for 320 community pharmacists was conducted during February 2020 using a newly developed and validated questionnaire. Only 4.4% of pharmacists prefer not to deal with minor ailment cases. Minority (15.6%) of participated pharmacists refer more than half of minor ailment cases they face to the physician. Regarding the assessment of minor ailments using WWHAM technique, what are the symptoms are the most commonly asked questions by pharmacists. Only 49.1% mentioned that they ask all WWHAM questions. On the other hand, most pharmacists (90%) educate their patients about the dosi
... Show MoreSilymarin (SM) is a plant extract obtained from Silybum marianum( milk thistle) . It is class II type drug according to Biopharmaceutics Classification System with low bioavailability due to its low solubility.
Micro/nanonization during crystallization, surface modification and crystal structure modification may improve the dissolution rate of poorly water-soluble drugs.
The aim of this study was to increase the water solubility and dissolution rate of SM by in-situ micronization using solvent change either by stirring or ultrasonic method. Stabilizers like Gelatin, PVP-K30, HPMC15, Pulullan were used to stabilize the prepared ultrafine crystals. Effect of type and concentration of hydrophilic polymer, solv
... Show MoreThis research aims to analyze the impact of the United States policy of pressure and sanctions on changing Iran's conduct. Since the Islamic Revolution of Iran in 1979, the US has continuously pursued various policies towards Iran, aiming to change the regime by force or isolate it politically and economically. The main research question lies in the following: To what extent does the US pressure policy and its sanctions affect the conduct Iran?. This research discusses that the more there are economic and political alternatives to Iran, the more it will be challenging the US demands. Moreover, the more the US pursues a negotiating policy based on mutual interests, the more Iran will positively respond to American demands.
We can understand interior design as a series of interconnected human principles and goals formed by science and knowledge to build a human product that reveals or gives meaning to things، and this can be presented through ecology as a system concerned with environmental aspects and as part of interior design، seeking to achieve aesthetic and functional values، in an interactive form between spaces The interior and its occupants are within an environmental balance full of life، and the ecological interior design attaches great importance to the embodiment of spiritual aspects in the internal environment، in addition to emphasizing the importance of protecting the environment and preserving resources through saving in its use and usi
... Show MoreIn The Name of Allah Most Gracious Most Merciful
In this research, I will deal with the significance of the imperative and the disagreement of the fundamentalists in the general requirement by dividing it into an introduction and two sections. , and the appropriate indication.
Background: Laparoscopic cholecystectomy
has become the standard of care for the
elective management of cholelithiasis. Little
information exists, however, regarding the
appropriateness of this procedure in the setting
of acute symptomatology.
Objective: This study was designed to
evaluate the outcome of laparoscopic
cholecystectomy in acute and severe acute
cholecystitis based on early and late biliary
complications, their incidence and
management, and conversion rates to open
surgery.
Methods: A prospective study done between
April 2007 and November 2010, in the
department of general surgery, medical city
teaching hospital, Baghdad. Includes patients
with acute cholecystitis admitted f
Abstract
Among the things that have happened and that have emerged from the developments in society is the phenomenon of dairy banks, where institutions collect milk from donating mothers or sellers of milk and benefit from it by sterilizing and selling it.
This topic is considered one of the important topics, as Islam considers breastfeeding as a link as well as parentage, and it has the same genealogy as the spread of sanctity. Therefore, Imamate jurists addressed this topic with research despite its absence in Islamic societies.
The importance of r
... Show MoreThe current research aims to verify the relationship and impact of internal control activities as an independent variable in its dimensions (efficiency, training, independence) in making administrative decisions as a responsive variable and its dimensions (identifying and diagnosing the problem, searching for alternatives, evaluating alternatives, choosing the appropriate alternative, implementing the decision, following up Decision and evaluation) in the Kirkuk Water Directorate, as well as to identify the levels of their practices, and then try to come up with a number of recommendations contribute to the strengthening of internal control activities and the process of making administrative decisions of the researched Directorat
... Show MoreIn his opus, Ted Hughes has annexed new and fresh territories of signification to the very notion of the literary animal. Building on the earlier modernist example of the Lawrencian legacy that dwells upon the question of animalism, Hughes seems to have stepped further into the terrain of the sheer struggle when, in his hands, the grotesquerie of survival and violence energizes the topos of the literary animal in his postmodern bestiary. In Hughes’s elemental poetic process this grotesquerie and violence stages the literary animal as a vital poetic device or motif that is finally restored to the primitive power of poetry. In his “Thrushes”, he thus defamiliarizes these tiny creatures’ acts of being to bring upfront into focus thi
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