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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
Sat Dec 01 2018
Journal Name
Ibn Al-haitham Jour. For Pure & Appl. Sci.
Estimation of Pentraxin-3(PTX3) in Rheumatoid Arthritis Males’ patients (with and without) Type II Diabetes Mellitus in Iraq
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Rheumatoid arthritis is a chronic inflammatory autoimmune disease its etiology is unknown. The classical autoimmune diseases, have adaptive immune genetic associations with autoantibodies and major histocompatibility complex (MHC) class II such as rheumatoid arthritis (RA), diabetes mellitus type two (DM II). Serum of99 males suffering from RA without DMII as group (G1), 45 males suffering from RA with DM II as group (G2) and 40 healthy males as group (G3) were enrolled in this study to estimation of alkaline phosphates (ALP), C-reactive protein (CRP) and Pentraxin-3(PTX). Results showed a highly significant increase in PTX3 levels in G1 and G2 compared to G3 and a significant decrease in G1comparing to G2. Results also revealed a significa

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Publication Date
Mon Jan 01 2024
Journal Name
International Journal Of Clinical And Diagnostic Pathology
Evaluation of transferrin saturation and serum ferritin in assessing body iron status in patients with end stage renal disease
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The study aimed to evaluate the benefits of transferrin saturation percentage (TSAT) and serum ferritin in assessing body iron status, which can influence erythropoietin treatment in patients with ESRD. Forty end-stage renal disease patients on regular hemodialysis participated in this study. Clinical data were obtained. Serum iron, total iron binding capacity, transferrin saturation, ferritin, albumin, creatinine, and C-reactive protein were investigated. Thirty healthy people were enrolled as a control group. ESRD patients had a mean age of 45.1±13.9 years, with 60% being males. They exhibited significantly lower hematocrit (25.3±6.5%), and higher platelet (285.7±148.1x10^9/L) and WBC (9.4±3.1x10^9/L) counts compared to healthy contro

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Publication Date
Sun Feb 08 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary assessment of Interleukin-6, C-reactive protein and albumin in ulcerative colitis patients in relation to oral findings
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Background: Ulcerative colitis disease is a chronic inflammatory condition that affects the gastrointestinal tract. In regulation of this inflammatory process, Interleukin-6, C-reactive proteins and albumin have a major role. Overproduction of IL-6 by immunocompetent cells contributes to activate the liver to produce CRP, transudation of plasma albumin and development of the inflammatory condition. Elevated levels of IL-6 in saliva could be expected, because the saliva-producing cells are part of the digestive system. The purpose of this study was to assess salivary IL-6, CRP and albumin in ulcerative colitis patients in relation to oral findings. Materials and methods: Forty eight saliva specimens collected from three groups of subjects (s

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Publication Date
Fri May 11 2018
Journal Name
Biomedical And Pharmacology Journal
Molecular and Phylogenetic Analysis of Human Papillomavirus Using L1 Gene in Oral Squamous Cell Carcinoma Patients in Baghdad, Iraq
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Oral squamous cell carcinoma (OSCC) is the most common malignant neoplasm of the oral mucosa. Human papillomavirus (HPV) virus cause a broad scope of diseases from benign to invasive tumors, types 16 and 18 classified as carcinogenic to humans. This study aimed to provide the first molecular characterization of HPV types in Iraq. Thirty-five unstimulated whole saliva samples were collected from histopathologically confirmed patients with oral cancer were enrolled in this study. Genomic DNA was extracted from exfoliating cells to amplify HPV-DNA using HPV-L1 gene sequence primers by polymerase chain reaction method (PCR), the viral genotyping was performed using direct sequencing method. HPV genotypes identified were deposited in Gen

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Publication Date
Sun Feb 08 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary C- reactive protein in relation to periodontal health among a group of patients with rheumatoid arthritis in Iraq
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Background: Rheumatoid arthritis is a chronic destructive inflammatory disease associated with destruction of joint connective tissues and bones, affecting 0.5%–1% of the population worldwide reporting higher prevalence of periodontitis among rheumatoid arthritis patients. The purpose of this study is to estimate level of salivary C-reactive protein in relation to the occurrence and severity of the periodontal disease and other oral parameters among group of patients with rheumatoid arthritis Material and methods: Fifty women patients with rheumatoid arthritis; twenty five on Methotrexate treatment and twenty five on combination treatment of Methotrexate and Etanercept selected as study groups with an age range (30-40) years old and

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Publication Date
Sat Sep 30 2023
Journal Name
Romanian Journal Of Rheumatology
Association between genetic polymorphism in tumor necrosis factor-alpha gene and adverse effects of etanercept in rheumatoid arthritis patients
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Background. Gene polymorphisms affect etanercept’s pharmacokinetics, pharmacodynamics, and side effects. This effect is evidenced by the extensive genetic variation in the drug’s targets. Objectives. This study aims to find the association between different genotypes of the promoter region of the TNF-α gene at -308G/A(rs1800629), -857C/T(rs1799724), -863 C/A(rs1800630), -1031 T/C (rs1799964), -806 C/T (rs4248158) and -376 G/A (rs1800750) and the side effects of ETN that occurred to Iraqi RA patients. Method. The trial included patients with rheumatoid arthritis who had been using ETN for at least six months. The participants were from the Baghdad Teaching Hospital Rheumatology Unit. The PCR was sequenced to determine the polymo

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of International Oral Health
Endothelin-1 is a surrogate biomarker link severe periodontitis and endothelial dysfunction in hypertensive patients: The potential nexus
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Aim and Objectives: The objective of this study was to illustrate the link between periodontitis (PO) and endothelial dysfunction in hypertensive patients. Materials and Methods: This cross‑sectional study involved 53 hypertensive patients with or without PO compared with 28 healthy controls. On the basis of the study protocol, the participants were divided into three groups: Group (1): 24 patients with hypertension only, Group (2): 29 patients with hypertension and PO, and Group (3): 28 healthy controls. Lipid profile, endothelin‑1 (ET‑1), and high‑sensitivity C‑reactive protein (hs‑CRP) were measured. Blood pressure and body mass index (BMI) were evaluated. Diagnostic criteria of severe PO periodontal indices including plaque

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Publication Date
Mon Jan 01 2024
Journal Name
Medical Research Archives
Genetic Polymorphism for the Gene Encoding Endoplasmic Reticulum Aminopeptidase-1 (ERAP-1) in Iraqi Patients with Ankylosing Spondylitis
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Ankylosing spondylitis (AS) is a common, highly heritable inflammatory arthritis affecting primarily the spine and pelvis. This study was aimed to investigate the relationship between the rs27044 polymorphism in Endoplasmic reticulum aminopeptidase-1 (ERAP-1) with the susceptibility and severity of AS correlated with some biochemical markers such as hematological parameter (Erythrocytes sedimentation rate (ESR)) and immunological parameters (C-reactive protein (CRP), Human leukocyte antigen-B27 (HLA-B27), Interlukin-6 (IL-6) and Interlukin-23 (IL-23)), and oxidative stress parameters (Glutathione (GSH) and Malondialdehyde (MDA)) in a sample of Iraqi population. A total of 60 blood samples were collected from AS patients requited Rhe

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Publication Date
Thu May 28 2020
Journal Name
Iraqi Journal Of Science
The Association Between IL-2 Gene (RS2069763 (Single Nucleotide Polymorphism and Type 2 Diabetes Mellitus in Iraqi Patients
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This research attempts to find the association between single nucleotide polymorphism (SNP) of IL2+166 gene (rs2069763) and type 2 diabetes mellitus (T2DM) in a sample of Iraqi patients. A total of 44 patients and 55 apparently healthy volunteers were genotyped for the SNP using polymerase chain reaction test. Three genotypes (GG, GT, and TT) corresponding to two alleles (G and T) were found to have SNP. Both study groups’ genotypes had a good agreement for the analysis of Hardy-Weinberg Equilibrium. The results revealed increased frequencies between the observed and expected GG and TT genotypes and IL2+166 SNP T allele in T2DM  patients (40.9 vs. 40.0 %; OR = 1.04; 95% CI, 0.47 - 2.31), whereas the values in the control group were

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Publication Date
Thu Jul 06 2023
Journal Name
Iraqi Journal Of Biotechnology
Impact of Helicobacter pylori in some Blood Parameters Change of Iraqi Patients with Gastritis Disease
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In order to find the relationship between Helicobacter pylori infection and hematological disease are disorders which primarily affect the blood and blood-forming organs. One hundred and three blood samples were taken for people aged (20-68) years for the period from 10/1/2021 to 1/3/2022, divided into three groups. The first group included 44-person H. pylori-infected with symptoms of infection, the second group had 19-person H. pylori-infected but without symptoms, and the third group included 40 people without H. pylori infection. All studied groups were carried out to measure anti-IgG Ab, Vac A and Ferritin by Enzyme Linked Immunosorbent Assay (ELISA) technique. The statistical analysis indicates a non-significant difference in Vac A (p

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