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.
Warfarin dosing is challenging due to a multitude of factors affecting its pharmacokinetics (PK) and pharmacodynamics (PD). A novel personalised dosing algorithm predicated on a warfarin PK/PD model and incorporating CYP2C9 and VKORC1 genotype information has been developed for children. The present prospective, observational study aimed to compare the model with conventional weight-based dosing. The study involved two groups of children post-cardiac surgery: Group 1 were warfarin naïve, in whom loading and maintenance doses were estimated using the model over a 6-month duration and compared to historical case-matched controls. Group 2 were already established on maintenance therapy a
Background: It is well known that oral carriage
of Candida species increase in many situations, like
obesity, debility, leukemia, viral infection, use of
certain drugs in addition to diabetes mellitus.
Objective: find the relation between diabetes and
its control on oral carriage of Candida.
Methods: Thirty four hundred oral swabs from
diabetic patients 67% are females and 33% are
males, 41.7% are type 1 diabetes and 58.3% are type
2.different culture media are used.
Results: we found that 37.9% of diabetics had oral
carriage, older age group had more but the
difference is not significant statistically P>0.05, in
addition females carry more Candida than males
P<0.05, while type of diabetes
الذات والتحصيل الدراسي . وقد استخدمت الباحثة المنهج الوصفي التحليلي، وبلغت عينة الدراسة (500) طالبًا وطالبة، تم اختيارهم بالطريقة الطبقية العشوائية وهي تمثل (15%) من مجتمع الدراسة البالغ (3328) طالباً وطالبة من طلبة المرحلة الإعدادية واستخدمت الباحثة مقياسين تم بناء مقياس لقياس الجوهر والمظهر وتبني مقياس فاعلية الذات بعد إن قامت بترجمته وتعريبه وجعله ملائم للبيئة العراقية، كم تم استخراج درجات التحصيل الدراسي للع
... Show MoreThe general trend in Iraqi banks is focused towards the application of international financial reporting standards, especially the international financial reporting standard IFRS 9 “Financial Instruments”, in addition to the directives issued on the Central Bank of Iraq’s instructions for the year 2018 regarding the development of expected credit losses models, and not to adhere to a specific method for calculating these losses and authorizing the banks’ departments to adopt the method of calculating losses that suits the nature of the bank’s activity and to be consistent in its use from time to time. The research problem revolves around the different methodologies for calculatin
... Show MoreObjective: To Evaluate the Roley of Cytotoxic T-Lymphocytek antigen 4 Polymorphism and soluble immune checkpoint level (PD-1,PDL-1 and CTLA-4 ) in SARS-Cov-2 patients. Methods: Fromt October 2020 to April 2021, the currentk study was conducted in Baghdad-Iraq. Ninety patients with Confirmatory SARS-Cov-2 by PCR were inclusion in the study, and they were seeking treatment at Medical City in Baghdad's Teaching Hospital (BTH). Patients with SARS-Cov-2 were divided into two groups: those with Sever SARS-Cov-2 symptom and those with mild - moderate SARS-Cov-2 symptoms (cross sectional study. Patients with another form of autoimmune illness, malignant, diabetes, under the age of 18 and pregnant women were excluded. Results: Data rega
... Show MoreThe objective of this study is to evaluate the effect of aspirin, clopidogrel or their combination on different parameters in hypertensive patients.Platelets adhesion, activation, and aggregation are central to thrombus formation, which follows atherosclerotic plaque disruption and causes acute coronary syndromes. Aspirin and clopidogrel exert their antiplatelet effects by inhibiting thromboxane A2 production and adenosine diphosphate–induced platelet aggregation pathways, respectively. This study was designed to evaluate the possible effects of aspirin and clopidogrel given either alone or in combination in patients with essential hypertension on blood pressure and other parameters in addition to lipid profile using a randomized
... Show MoreThe aim of this study is to identify the effectiveness of a rational, emotional, behavioral program in developing self-efficacy to reduce the level of Burnout in 20 teachers of students with autism disorder in Jazan, Saudi Arabia. The proposed program included 12 training sessions. The researcher found that the proposed program has contributed significantly to the development of self-efficacy and reduce the level of Burnout for the targeted subject in this study.
In the present study, the aim was made to identify the relationship between thyroid autoimmunity (TAI) and female infertility. The study was performed on 30 infertile women and 22 age-matched healthy fertile control age (33 ± 5 years). Overall, serum prolactin (PRL), thyroid stimulating hormone (TSH) assay is the key test for the diagnosis and management of hypo and hyperthyroidism. Anti-TPO Ab and anti-TG Ab were measured. The mean ± SE of serum PRL (31.080 ± 3.06) ng/ml was significantly (P<0.05) higher in infertile group compared with control (16.191±1.36) ng/ml. Serum TSH was significantly (P<0.05) higher in infertile group (5.689 ± 1.12) µIU/ml compared to control group (2.282 ± 0.18) µIU/ml. The prevalence of positive
... Show MoreThere is a suggestion that an antidiuretic hormone-induced decrease in diuresis might contribute to the rapid relief of the acute pain in renal colic. This study was designed to evaluate the efficacy of desmopressin nasal spray compared with diclofenac given intramuscularly in patients with acute renal colic. The study included 75 patients randomized into three different groups; group A received desmopressin (40 μg, nasal spray), group B diclofenac (75 mg) intramuscularly and group C, both desmopressin and diclofenac. Pain was assessed using a visual analogue scale (a 10-cm horizontal scale ranging from `no pain' to `unbearable pain') at baseline, 10, 20 and 30 min after administering t
... Show MoreThere are numerous bidirectional interactions between the reproductive system and the liver. Sex steroids regulate metabolic health through signaling effects in both peripheral and central metabolic tissues, including adipose tissue, liver, skeletal muscle, and brain, and have a role in the etiology of structural and functional liver diseases. Blood samples were obtained from 90 healthy women (control group) and 90 women that have hormonal changes (patients’ group). The levels of reproductive hormones (follicle stimulation hormone/FSH, luteinizing hormone/LH, estradiol/E2, progesterone/P4) were measured by using fully automated Cobas E411, whereas those of liver enzymes (alanine transaminase /ALT, aspartate aminotransferase/AST, a
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