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Pharmacist Intervention to Address Drug Related Problems in Patients with Decompensated Liver Cirrhosis
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Background: Patients with decompensated cirrhosis are often given therapeutic and prophylactic drugs. Polypharmacy raises both the likelihood of prescription errors and the complications associated with drugs. Clinical pharmacists are excellent at recognizing, addressing, and preventing clinically significant drug-related problems.

Objectives: Identification types of pharmacist interventions to address drug-related problems in patients with decompensated cirrhosis and assess the acceptance/implementation of these recommendations. And identify patient factors associated with accepting pharmacist recommendations.

Subjects and Methods: Prospective, interventional, clinical study for 80 hospitalized decompensated cirrhosis patients was conducted at Baghdad Teaching Hospital and lasted for four months, from the first of December 2021 until the last of March 2022. The study involved two phases, the first one was observational to identify drug-related problems and classify them according to the Pharmaceutical Care Network Europe classification version 9.1,   and the second phase was interventional to increase the awareness of patients and health care providers about those problems and to propose a proper solution for each one.

Results: The most frequent pharmacist intervention was proposed to the prescriber (54.7%), followed by speaking to the caregiver (37.7%). Acceptance and full implementation were highly observed in 71.1% of the intervention. There is a significant  association between occurring ascites and bleeding in patients and accepting/implementing pharmacist recommendations

Conclusions: Patients with decompensated liver cirrhosis have a significant prevalence of drug-related problems. Clinical pharmacists are excellent at recognizing drug-related problems and reducing their incidence, and their interventions were well accepted.

 

 

 

 

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Publication Date
Sat Dec 21 2024
Journal Name
Gastroenterology
Evaluation of global DNA methylation, homocysteine and vitamin B12 levels among patients with celiac disease
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Celiac disease (CD) is an immune-mediated disorder caused by gluten in genetically susceptible individuals characterized by chronic inflammation that essentially affects the small intestine. Objective: this study was designed to measure the potential role of some serological biomarkers including vitamin B12 and homocysteine (HCY) in the progression of CD as well as their relations to global DNA methylation (5mC). Materials and methods. Forty CD patients were enrolled in the study with an average age of (36.60 ± 2.03) years (range between 15 and 60). The diagnosis of the disease was confirmed by serological examinations and intestinal endoscopy in Gastroenterology and Liver Teaching Hospital in the Medical City Hospital in Baghdad

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Dyslipidemia among patients with type 2 diabetes mellitus visiting Specialized Center for Diabetes and Endocrinology
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Background:The most common pattern of dyslipidemia in diabetic patients is increased triglyceride (TG) and decreased HDL cholesterol level, The concentration of LDL cholesterol in diabetic patients is usually not significantly different from non diabetic individuals, Diabetic patients may have elevated levels of non-HDL cholesterol [ LDL+VLDL]. However type 2 diabetic patients typically have apreponderance of smaller ,denser LDL particles which possibly increases atherogenicity even if the absolute concentration of LDL cholesterol is not significantly increased. The Third Adult Treatment Panel of the National Cholesterol Education Program (NCEP III) and the American Heart Association (AHA ) have designate diabetes as a coronary heart dis

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Publication Date
Sun Jul 01 2018
Journal Name
The Iraqi Postgraduate Medical Journal
Molecular and Serologic Detection of HLA-B27 among Ankylosing Spondylitis Patients with Some Clinical Correlations
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BACKGROUND: HLA-B27 can effect clinical presentation and course of ankylosing spondylitis. Different detection techniques of HLA-B27 are available with variable sensitivities and specificities. OBJECTIVE: To compare serologic and molecular diagnostic techniques of detecting HLA-B27 status and to correlate it with some clinical variables among ankylosing spondylitis patients. PATIENTS AND METHODS: A cross-sectional study was conducted on 83 Iraqi patients with ankylosing spondylitis. Clinical and laboratory evaluations were reported. HLA-B27 status was determined in all patients by real-time PCR using HLA-B27 RealFast™ kit; ELISA method was used as well to detect soluble serum HLA-B27 antigens using Human Leukocyte Antigen® kit. RESULTS:

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Postoperative Nurses' Interventions for the Patients with Laparoscopic Cholecystectomy at Baghdad Teaching Hospitals
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Objective: The study aimed to assess the postoperative nurses' intervention for the patients with laparoscopic
cholecystectomy and to determine the relationship between Nurses' interventions and their demographic
characteristics.
Methodology: Quantitative design (a descriptive study) was started from 20th November 2012 up to 1st
September 2013. Non-probability (purposive sample) of (50) nurses, who were working in surgical wards, were
selected from Baghdad teaching hospitals (Baghdad Teaching Hospital, Digestives System and Liver Teaching
Hospital, AL-Kindy Teaching Hospital, and AL-Kadhimiyia Teaching Hospita). The data were collected through
the use of a constructed questionnaire, which consisted of two parts; the

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Publication Date
Fri Jun 03 2016
Journal Name
Iraqi Medical Journal
EVALUATION OF PATIENTS WITH CARPAL TUNNEL SYNDROME TREATED BY MINIMAL PALMAR INCISION (A PRELIMINARY STUDY)
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Background : Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of upper extremities and Open carpal tunnel release is the most frequent surgical procedure and the gold standard for cases that do not respond to conservative treatment. Aims :This study is used to evaluate the functional outcome of limited palmar mini-incision of carpal tunnel release. This study aims to determine the safety and symptomatic and functional efficacy of median nerve decompression with limited incision in carpal tunnel syndrome surgery. Patients and methods:Carpal tunnel release with a 1.5-2 cm limited palmar incision was performed on 20 patients. Patients were evaluated initially at one month after treatment according to symptom severity

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Publication Date
Sat Jun 03 2017
Journal Name
Journal Of Diagnostic Medical Sonography
The Diagnostic Accuracy of Sonography, With Graded Compression to Image Acute Appendicitis Compared to Histopathologic Results
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Acute appendicitis is the most common surgical abdominal emergency. Its clinical diagnosis remains a challenge to surgeons, so different imaging options were introduced to improve diagnostic accuracy. Among these imaging modality choices, diagnostic medical sonography (DMS) is a simple, easily available, and cost effective clinical tool. The purpose of this study was to assess the accuracy of DMS, in the diagnosis of acute appendicitis compared to the histopathology report, as a gold standard. Between May 2015 and May 2016, 215 patients with suspected appendicitis were examined with DMS. The DMS findings were recorded as positive and negative for acute appendicitis and compared with the histopathological results, as a gold standard

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Publication Date
Mon Jan 01 2024
Journal Name
Cytokine
Evaluation of IL-8, nitric oxide and macrophage inhibitory factor as clinical circulatory markers in patients with cutaneous leishmaniasis, before and during sodium stibogluconate treatment
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The clinical spectrum of cutaneous leishmaniasis (CL), an intracellular parasitic pathogen, ranges from a single sore healing to chronic crusty lesions with a manifestation of treatment resistance. The complicated interaction between Leishmania bodies and the early immune response, including innate and adaptive mechanisms, determines the evolution of nodules. This study examined the levels of the chemoattractant interleukin 8 (IL-8), pro-inflammatory nitric oxide (NO), and immunoregulatory macrophage inhibitory factor (MIF) in the serum of subjects recently diagnosed with cutaneous leishmaniasis, in parallel with patients being monitored during consecutive sodium stibogluconate (Pentostam) treatment. A total of 161 serum samples of newly di

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Publication Date
Sun Jan 01 2017
Journal Name
Indian Journal Of Pathology And Microbiology
Assessment of topoisomerase II-alpha gene status by dual color chromogenic in situ hybridization in a set of Iraqi patients with invasive breast carcinoma
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Abstract Background: The human epidermal growth factor receptor 2(HER2) proto-oncogene is overexpressed or amplified in approximately 15%-25% of invasive breast cancers. Approximately 35% of HER2-amplified breast cancers have coamplification of the topoisomerase II-alpha (TOP2A) gene encoding an enzyme that is a major target of anthracyclines. Hence, the determination of genetic alteration (amplification or deletion) of both genes is considered as an important predictive factor that determines the response of breast cancer patients to treatment. The aims of this study are to determinate TOP2A status gene amplification in a set of Iraqi patients with breast cancer that have had an equivocal (2+) and positive HER2/neu by immunohistochemistry

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Publication Date
Sun Jun 02 2013
Journal Name
Baghdad Science Journal
Comparison of The Effect of Aqueous Extracts of two Plants, Origanum Vulgare L. and Fenugreek Seeds with Anticancer Drug Cis-Platin on the Growth of Cancer Cell Lines
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This study involved the effect of the aqueous extracts of two plants, Origanum vulgare L.(1), Trigonella Foenum Graecum L. (Fenugreek) seeds(2) on the growth of cancer cell lines. Rhabdomyo sarcomas (RD) of human cell line and female intestine cells of Albino mice (L20B) in vitro System. These extracts were compared with the known anticancer drug Cis-platinum(Cis-Pt) as a positive control. The phytochemical tests were used for screening the active compounds in plants. The inhibition activity assay was used as a parameter of the cytotoxic effect of these extracts. Cancer cell lines were treated with four concentrations of Cis-platin, 31.25, 62.5, 125 and 250 ?g/ml for 72 hour exposure time. The same concentrations were used for the other ext

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Publication Date
Mon Feb 01 2021
Journal Name
International Medical Journal
Use of immunohistochemistry and silver in situ hybridization (Sish) in evaluation of human epidermal growth factor receptor2 (HER2/neu) status in Iraqi patients with breast cancer
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Breast cancer is the commonest cause of cancer related death in women worldwide. Amplification or over-expression of the ERBB2 (HER/neu) gene occurs in approximately 15-30% of breast cancer cases and it is strongly associated with an increased disease recurrence and a poor prognosis. Determination of HER2/neu status is crucial in the treatment plan as that positive cases will respond to trastuzumab therapy. It has been used to test for HER2/neu by immunohistochemistry as a first step and then to study only the equivocal positive cases (score 2+) by in situ hybridization technique. The aim of our study is to compare between immunohistochemistry and silver in situ hybridization (SISH) in assessment of human epidermal growth factor (HER2/neu)

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