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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 Jul 25 2022
Journal Name
International Journal Of Health Sciences
Ca242 as a potential prognostic marker in colorectal cancer Iraqi patients
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Background: Colorectal cancer is the third most common cancer-related mortality worldwide, and its prevalence is increasing among many nations.  Aim of the study: Investigate the predictive value of carbohydrate antigen 242 (CA242) in comparison to the CEA biomarker and to estimate the significance of CA242 as prognosis maker in colorectal cancer patients. Methods: a case-control study with a total of 150 individuals, 100 patients (59 males, 41 females) and 50 healthy controls (26 males, 24 females). using an enzyme-linked immunosorbent (ELISA) to determine the serum levels of CA242 and CEA. The study was carried out at the gastroenterology consultation clinic of the oncology teaching hospital between November 2020 and February

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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Hypomagnesemia in Iraqi Diabetic Patients and Healthy Controls: An Exploratory study
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Background: Diabetes mellitus has been suggested
to be the most common metabolic disorder
associated with magnesium deficiency, and because
available data suggest that adverse outcomes are
associated with hypomagnesemia, it is prudent that
routine surveillance for hypomagnesemia be done
and the condition be treated whenever possible.
Aim of the study:To explore the serum Mg
concentrations of diabetic patients and healthy
controls in our locality.
Mehtods: One hundred and forty four diabetic
patients (22 with type I and 122 with type II diabetes
mellitus) recruited from the outpatient diabetes clinic
at the Specialized Center For Endocrine DiseasesBaghdad (62 patients), National Diabetes Center-Al

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Publication Date
Mon Mar 06 2023
Journal Name
Rheumatology (bulgaria)
Tenascin-C and Interleukin-17 Up-regulation in Axial Spondyloarthritis Patients
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Background: Axial spondyloarthritis (axSpA) is an inflammatory, systemic rheumatic condition that mostly affects the axial skeleton. Tenascin-C (TN-C) is a hexameric glycoprotein of considerable size, upregulated in many inflammatory conditions, while Interleukin-17 (IL-17) a cytokine that plays an important role in SpA symptoms. Objective: to investigate the upregulation between the serum levels of TN-C and IL-17 in Iraqi axSpA patients and the disease characteristics. Patients and Methods: Seventy-four axSpA patients and 28 matched controls were studied. Fifty-four patients received a tumor necrosis factor inhibitor (TNFi) and 20 did not. Serum TN-C and IL-17 concentrations were determined using the ELISA technique. The Bath Ankyl

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Exfoliative Cytological Changes in Peritoneal Fluid from Patients on Peritoneal Dialysis
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Background: Ambulatory peritoneal dialysis
introduced by Popvich et al (13) in 1978 , consists of a
four to five hours lavage of peritoneal cavity with 2000
ml of glucose solution .It remains a useful method for
treating patients with end stage renal failure till renal
transplantation becomes possible.
Objectives: The aim of the study is to evaluate the
value of cytological changes of mesothelial cells in
dialysate patients.
Methods: Within one year period, 32 cytological
peritoneal fluid samples were collected from patients
with end stage renal failure regardless of the underlying
causes, admitted to the dialyzing unit in Kadimya
Teaching Hospital. Smears were prepared and fixed in
95 % ethyl al

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Publication Date
Mon Mar 27 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Lipid Profile and Fasting Blood Sugar Analysis in Patients with Cholelithiasis
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Cholelithiasis is one of the commonest surgical problems and one of the most common gastrointestinal diseases throughout the world but its pathogenesis remains unclear. Many theories have been proposed forward to explain the mechanism of stone formation. It is not fully clear if symptomatic gallstone disease is associated with a specific pattern of some biochemical abnormalities, as lipid profile and fasting blood sugar in serum of patients.

This study was designed to estimate lipid profile and fasting blood sugar in the sera of patients with cholelithiasis in comparison with normal individuals (control).

In this study, 104(male=16, female=88) were symptomatic gallstone patients (aged 42.79± 12.18 years), and 38(male=6

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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
Correlation between malondialdehyde and metanephrine in patients with acute lymphoblastic leukemia
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Acute lymphoblastic leukemia (ALL) is one of the most common diseases , so in this study the serum level of malondialdehyde and its relationship with metanephrine was investigated in acute lymphoblastic leukemia patients over one month of treatment. Some biochemical parameters (serum glucose , total serum protein , malondialdehyde ,vitamin C, and metanephrine) changed as well as white blood cell count and blood hemoglobinlevelswere analyzed in sixty patients diagnosed with acute lymphoblastic leukemia over one month of treatment compared to healthy control group.Statistically significant increases (p<0.01) in white blood cell (WBC) count, mean concentrations of malondialdehyde (MDA) (p< 0.05) and metanephrine (p< 0.001) were observed in

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Oral Tumors; Clinicopathological Study among Patients Attending ENT Clinic in Baghdad
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Background: Oral tumors are one of the most challenging
tumors regarding their good prognosis in early diagnosis and
very difficult control in advancing stages.
Objectives: To study the prevalence, types and clinical
presentation of oral tumors in comparison to other oral
lesions among patients attending ENT clinic.
Al-Kindy Col Med J 2008 Vol.5(1) Original Article 11
Methods: This study included 534 patients with different
oral complains attending ENT clinics in AI-Yarmouk
Teaching Hospital, and AI-Kindy Teaching Hospital -
Baghdad, in the period from 1st jan1999 till 31th des 2006 (8
years interval).
Results: The results of this study showed that the prevalence
of malignant lesions was 13.5% (72 o

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
Human Leukocyte Antigens Assosiation with Systemic Lupus Arythematosus In Iraqi Patients
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Background: The etiology of Systemic lupus erythematosus seems to be multifactorial including environmental as well as genetic factors. The genetic predisposition was supported by the occurrence of Systemic lupus erythematosus in more than one member of a family as well as in identical twins.
Aim of the study: To determine the human leukocyte antigen typing class I (A and B) in patients with Systemic Lupus Erythematousus disease.
Methods: Patients group consisted of 44 Iraqi Arab Muslims patients with Systemic lupus erythematosus disease who presented to Baghdad Medical City from January 2010 to January 2012 from Baghdad Province. The second control group consisted from 80 Iraqi Arab Muslims volunteers from hospital employees and t

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Publication Date
Wed Jun 01 2022
Journal Name
Baghdad Science Journal
Correlation between Serum and Tissue Markers in Breast Cancer Iraqi Patients
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Breast cancer is the most prevalent malignancy among women worldwide, in Iraq it ranks the first among the population and the leading cause of cancer related female mortality. This study is designed to investigate the correlations between serum and tissue markers in order to clarify their role in progression or regression breast cancer. Tumor Markers are groups of substances, mainly proteins, produced from cancer cell or from other cells in the body in response to tumor.  The study was carried out from April 2018 to April 2019 with total number of 60 breast cancer women. The blood samples were collected from breast cancer women in postoperative and pretherapeutic who attended teaching oncology hospital of the medical city in Baghdad and

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Publication Date
Sun Jul 07 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Chromogenic in Situ Hybridization Technique versus Immunohistochemistry in Assessment of HER2/neu Status in 448 Iraqi Patients with Invasive Breast Carcinoma
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BACKGROUND: The rapidly growing knowledge regarding factors controlling tumour growth, with the new modalities of therapy acting on the biological activity of the tumours draw the attention of most cancer researches nowadays and represent a major focus for clinical oncology practice. For the detection of HER2/neu protein overexpression and gene amplification, immunohistochemistry (IHC) and in-situ hybridisation (ISH) is the recommended techniques, respectively, with high concordance between the two techniques. The current United Kingdom recommendations for HER2/neu testing are either for a two-tier system using IHC with reflex ISH testing in equivocal positive cases, or a one-tier ISH strategy. AIM: To compare the results of HER2/neu gene s

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