Patients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen. Prospective, interventional, clinical study for 80 hospitalized decompensated liver cirrhosis patients was designed in two phases, an observational phase to identify drug related problems and classify them according to the Pharmaceutical Care Network Europe classification version 9.1, and an interventional phase to increase the awareness of patients and the health care providers about those problems and to propose a proper solution for each one. The majority of drug-related problems were attributable to the Effect of drug treatment not optimal in 41.5%, Adverse drug events (possibly) occurring in 41.5 %, and Untreated symptoms or indications in 17%. Causes were Drug dose too high in 30.2%, Patient unintentionally using the drug in the wrong way in 22.6%, and Prescribed drug not available in 13.2%. Omeprazole and lactulose were the most common medications causing problems. Acceptance and full implementation were high and observed in 71.7% of pharmacist interventions while 15.1% of the intervention have no agreement. Significant numbers of Iraqi patients with decompensated liver cirrhosis have drug-related problems, and the use of proton pump inhibitors in too high dose was accountable for a large number of problems. Physicians and clinical pharmacists collaborated exceptionally well
Background: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratc
... Show MoreBackground: Immediate implant placement in the maxillary anterior region was challenging, especially with the jumping gap and limited primary implant stability. Objective: To assess the autogenous dentin graft biomaterial's ability to improve the esthetic outcomes of an immediately inserted implant. Methods: Twenty patients with non-restorable retained roots in the maxillary non-molar region surrounded by natural sound teeth were included in this study after a complete clinical and radiological examination, including patient health and clinical fitness for the immediate dental implant procedure. A single dental implant was inserted for each patient, and the resulting jump distance was filled with the mineralized dentin graft and co
... Show MoreThis study tries to examine a model involving human resources management practices, employees’ outcomes, governmental support, and organizational performance of small businesses in Malaysia. It was hypothesized that HRM practices will be positively related to the organizational performance (financial and operational), and that employees’ outcomes would serve as a mediator in the relationship between HRM practices and performance. Also it was hypothesized that the governmental support will be positively related to organizational performance. The statistical results on data gathered from a sample of 265 small manufacturing businesses will demonstrate the nature of relationships among the study variables. Theoretical and practical
... Show MoreIntroduction: Since the hallmark of gestational trophoblastic disease is trophoblastic proliferation, Ki67 is regarded as the best marker in studying hydatidiform mole.This study was conducted to evaluate the role of this proliferative marker in distinguishing among hydropic abortion, partial and complete hydatidiform mole. Materials and methods: This is a cross sectional study involving the application of Ki67 on a total of 90 histological samples of curetting materials from molar (partial and complete mole) and non molar hydropic abortion belong to Iraqi females, so three study groups were created. Immunohistochemical expression in villous cytotrophoblasts, syncytiotrophoblasts and stromal cells were recorded separately by three i
... Show MoreBac kground: The transfer of the tibialis posterior tendon to the anterior aspect
of the ankle not only replaces the function of the paralyzed muscles, but also
removes the deforming force on the medial aspect of the foot.
Objec t i ves : In this study, we evaluated patients who underwent tibialis
posterior tendon transfer for the treatment of foot drop, and comparison through
interosseous membrane route versus anterior to lower tibia route of tibialis
posterior tendon transfer, with evaluation of the results according to carayon
criteria
Methods: Nine patients with foot drop secondary to different causes treated with
tibialis posterior tendon transfer from January 2011 to January 2012 were
followed up for a
The organizational structure of relations between states is among the main features that distinguished the twentieth century as the era of international organization, especially after the increase in the number of political units after World War II in which regionalism was crystallized as a phenomenon. It is not modern, as there are many blocs such as the European Union that have developed in it, the idea of regional bloc is prominent, especially in Europe, as it emerged after a controversy revolved around what was called globalism in the face of Globalism vs. Regionalism. Regional, as the proponents of the global orientation saw the establishment of a global organization that includes all countries, as the best way to achieve inte
... Show MoreBackgr ound: The transfer of the tibialis posterior tendon to the anterior aspect of the ankle not only replaces the function of the paralyzed muscles, but also removes the deforming force on the medial aspect of the foot. Objecti ves: In this study, we evaluated patients who underwent tibialis posterior tendon transfer for the treatment of foot drop, and comparison through interosseous membrane route versus anterior to lower tibia route of tibialis posterior tendon transfer, with evaluation of the results according to carayon criteria Methods: Nine patients with foot drop secondary to different causes treated with tibialis posterior tendon transfer from January 2011 to January 2012 were followed up for a mean of 12 months in Al Kindy Teach
... Show MorePulsatile drug delivery systems (PDDS) are developed to deliver drug according to circadian behavior of diseases. They deliver the drug at the right time, action and in the right amount, which provides more benefit than conventional dosages and increased patient compliance. The drug is released rapidly and completely as a pulse after a lag time. These systems are beneficial for drugs with chrono-pharmacological behavior, where nighttime dosing is required and for the drugs having a high first-pass effect and having specific site of absorption in the gastrointestinal tract. This article covers methods and marketed technologies that have been developed to achieve pulsatile delivery. Diseases wherein PDDS are promising include asthma, peptic u
... Show MoreTransdermal drug delivery has made an important contribution to medical practice but has yet to fully achieve its potential as an alternative to oral delivery and hypodermic injections. Transdermal therapeutic systems have been designed to provide controlled continuous delivery of drugs through the skin to the systemic circulation. A transdermal patch is an adhesive patch that has a coating of drug; the patch is placed on the skin to deliver particular amount of drug into the systemic circulation over a period of time. The transdermal drug delivery systems (TDDS) review articles provide information regarding the transdermal drug delivery systems and its evaluation process as a ready reference for the research scientist who is involved
... Show MoreThis study was conducted to determine the relationship between two most common diseases in Iraqis patients , which are Diabetic mellitus (DM) and Rheumatoid Arthritis (RA); seeking rheumatoid factor in hyperglycemic sera. The results revealed that ; 62.5% of hyperglycemic (HG) patients had positive rheumatoid factor (RF) . No difference in number between both gender of HG patients (20 males and 20 females ) , RF reaction was nearly similar in males and females of HG patients ( 12 &13 respectively ) . Only 40% out of patient controls had positive RF . None of the apparently healthy subjects had positive RF .