Background: While warfarin and direct oral anticoagulants (DOACs) are used to manage thromboembolic events, they possess several features that impact adherence. Objective: To assess medication adherence and self-efficacy in patients receiving warfarin or DOAC treatment. Methods: A cross-sectional study was performed at Ibn Al-Bitar Hospital in Baghdad from December 2022 to May 2023 on patients receiving either warfarin or DOACs. The Arabic version of the Adherence to Refills and Medications Scale (ARMS) questionnaire and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C) questionnaire were used to assess adherence and self-efficacy. Results: 181 patients were enrolled in the study, of whom 56.9% received warfarin and 43.1% received DOACs. The mean ARMS score was 13.71, and 81.77% of the patients were adherent to anticoagulant therapy. There was a significant difference in adherence between the warfarin and DOAC groups. The mean SES6C score for the participants was 50.01. Patients in the DOAC group had significantly higher self-efficacy compared to those in the warfarin group. The adherence score correlated significantly with patients’ gender, education level, hospitalization and duration of anticoagulant use, while the SES6C score did not correlate with any of the independent variables. There was a significant negative correlation between self-efficacy scores and medication adherence scores. Conclusions: Patients receiving DOACs showed a higher self-efficacy to manage chronic diseases and lower medication adherence as compared to warfarin. Higher self-efficacy was associated with higher adherence to treatment.
Background: Physical exercise is essential for performance of the immune system. The integrity of immune response is dependent on the intensity and duration of the exercise performed. During exercise the metabolic and hormonal changes that occurred can induce lymphocyte apoptosis. Dehydroepiandrosteron sulphate (DHEAS) is one of the hormones that is affected by exercise, it is an androgen released from the adrenal cortex in response to adrenocortiocotropin releasing hormone (ACTH). DHEAS is regarded as an anti-aging hormone; it is primarily immune enhancing, providing some degree of counterbalance to the potentially detrimental effects of catecholamine and cortisol which are immunosuppressive if chronic
... Show MoreThe international business environment faces many challenges, including the intensity of competition, the speed of expansion, and control of the market. This leads to its shadow on the local business environment, which prompted many economic units to adopt modern strategies, including mergers and acquisitions, for expansion and prosperity. The research was conducted to verify the role of internal audit in the governance of strategy operations (Mergers and acquisitions) and its reflection on management decisions and making them efficient and effective. Internal auditing is the independent variable related to the other variable, the governance of strategic operations and its impact on management decisions for strategic operations as a depende
... Show MoreBackground: Neonatal septicemia (NNS) is the most serious complication in Neonatal Intensive Care Units (NICU) that demand urgent diagnosis and accurate treatment.
Methods: Serum was obtained from 31 neonates aged 1 hour-28 days that were diagnosed clinically and bacteriologically to have neonatal septicemia.
Results: Mean serum levels of both IL-8 and IL-1 recorded a significant increase in neonatal septicemia cases.
Conclusion: Usage of IL-8, IL-1 as diagnostic marker for NNS reduces unnecessary antibiotic therapy and therefore unnecessary costs, pain, and possible side effects of antibiotic
therapy and it may help to reduce development and spread of drug resistant bacteria.
This study was achieved to investigate the accumulation of some heavy metals included: Cadmium, Lead and Nickel in the tissues (gill, intestine, liver, muscles and skin) of Silurus triostegus Heckel, 1843 (Siluriformes, Siluridae) and its larval stage of the nematode Contracaecum sp. (Rhabditida, Anisakidae). As well as to assess the infection patterns of Contracaecum among S. triostegus specimens which were purchased fresh from the local market in Baghdad. One hundred and nine nematodes specimens in larval stage were recovered from the fish host; the overall prevalence of Contracaecum sp. was 38.6%. The sex of the host was not significantly (P ˃ 0.05) associated with the infection of this nematode. Results showed that the ov
... Show MoreSome physical and chemical characteristics of Jurf Al- Sakar drinking water plant in Babylon governorate have been studied. Seven locations for this plant were selected. These were the drinking water treatment plant source on Euphrates River before entering the plant, precipitation, filtration and collection tanks, and also after leaving the plant at distances of one meter, 4 and 8 km. The samples were collected bimonthly from October, 2002 to August, 2003. Some results match with the national and international standard characters while the other characters (Turbidity, total hardness, calcium, nitrate, phosphate and the biological oxygen demand values) were not match. The present study showed that drinking water treatment plant is undrinka
... Show MoreThis study aimed to identify the role of school administration in achieving educational and learning goals from the point of view of educational supervisors in the stage of basic education. The descriptive method was adopted. As for the sample size, it has reached (59) educational supervisors. A questionnaire consisting of 29 paragraphs divided into four areas was used. The data were statistically analyzed on the Chi-square test, the percentage, and the mono-variance analysis. The result showed that the school administration contributes to achieving educational goals. It also works to solve problems in democratic ways, and in modern methods, there are differences in the criteria for choosing the headmaster. The study recommended that sch
... Show MoreBackground: Aluminium (Al) intoxication was recognised as a causal agent in p a t i ent s undergoing haemodialysis and then was linked to Alzheimer's disease. Nevertheless, environmental pollution with Al is mainly v i a drinking water, particularly when acidic rain falls on Al containing soil and bedrock. In addition, aluminium utens i l s are widely used for cooking. Therefore, an increasing concern is emerging for the role of pH in the absorption of aluminium from ingested food.
Materials and methods: The objective of this study was to establish the effect of acidification with1 ml/dL of concentrated acetic acid on the absorption of aluminium from a 5 mM a l u mi n i u m sulphate\ solution taken orally