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.
Background: Prolonged use of low-dose estrogen ''20 micrograms or less" Combined oral contraceptive pill (that have estrogen and progesterone steroid hormone) had an effect on bone turnover .Bone mineral density is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk. The aim of the study: The aim of this study was to investigate the effect of low dose oral contraceptive pill on the cortical thickness (in millimeter) and bone mineral density at the mandibular cortex of mental and gonial regions in Hounsfield unit(HU) using spiral computed tomography. Material and method: This prospective study was conducted on computed tomographic image of 100 women aged between (20-40) years .The collected sample includes
... Show MoreThe aim of this study is to assess nurse's knowledge and role in the management of thalassemic patients in the Sulaimania Thalassemia Centre. Methodology: This study utilized a qualitative approach to explore nurses’ knowledge about thalassemia through semi structured group interviews. Questionnaire was synthesized through a comprehensive review of literature. Results: The results show that nurses in Kurdistan region of Iraq have a limited role in terms of decision making and there is lack of nursing documentation other than that of recording abnormal events, and a lack of knowledge about and engageme
Breast cancer is the second most common cancer in women world. Multiple Cytokines appear to have a dominant role in human breast cancer formation. Estimation of the in situ expression of IL-6 and IL-1β in breast cancer patients. A sixty patients with breast cancer BC were divided into two clinical subgroups, (30) with malignant breast cancer MBC and (30) with benign breast tumor as a control group according to histological examination. In situ hybridization technique used for detection of IL-6 and IL-1β mRNA sequence in two groups. The results showed that percentages of mRNA expression of IL-6 and IL-1β were in (≥ 11-50%) for malignant breast cancer. This research also investigated that (73.3%) of beni
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The research has discussed the public relations as dependent variable of its branch dimensions( confidence , commitment, control and satisfaction ) and the governmental service quality as independent variable of its branch dimensions (response, dependency, emphasis, tangibility and sympathy), and the research problem has represented by weakness of service quality presented to the customers dealing with company, which is observed via field co-existence of the researcher, where he observe that the quality presented in the company services, are inappropriate with the customers expectations level, also there is weakness of attention and recognition by the
Climate change is a global environmental issue and a common concern for humanity, and it is an inevitable result of civilization development, especially after the industrial revolution All areas of life At the level of the Iraqi situation , Iraq faces several challenges posed by Climate change , Such as high temperature, lack of rain, water scarcity , land salinity , and the increase in the proportion of sand and dust storms and the resulting disasters, which impedes development and hinders efforts to reduce poverty , enhance livelihoods , and reduce conflict to obtain natural resources.
... Show MoreThe civil engineering field currently focus on sustainable development. It is important to develop new sustainable and economic generations of concrete, using eco-friendly materials in the construction industry with a fair amount of costs and minimizing the impact upon the environment by reducing CO2 emissions from the cement industry as a whole while still obtaining high cement quality and strength. The main objective of this research is to clarify the mechanical behavior and ability to use Portland limestone cement in producing self compacted concrete, due to the beneficious effec of the limestone cement economically and enviromently. The research investigates the effect of using steel and polymer meshs as reinforcement, where the results
... Show MoreSelf- curing is the potential of lightweight aggregate to absorption great amount of water thru mixing which prominently can moves to the paste during hydration process. Self- curing empowers a water to be distributes more evenly act out the cross section. Whereas, the external curing water is only able to penetrate several millimetres into concrete with low water cement ratio. Brick dust accumulates in the demolish site creates serious environmental contamination. This study investigates the effect of brick dust recovered from construction site on the Properties of mortar cured in three curing conditions. Mortar in this study produced using BD as cement additive with (2, 4, 6, and 8) % by weight of cement. BD was used a
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