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: The appointment system is a common practice in primary health care clinics in developed countries. The patients and health care providers in the primary health care setting perceived the appointment system as an indicator of good quality service.
Objective: The aim of this study was to survey patients’ and health care providers’ attitudes towards the introduction of an appointment system and their satisfaction with the existing ‘walk-in’ system in the primary health care setting.
Subjects and Methods: A questionnaire survey was conducted included a convenient sample of 234 patients as well as 76 health care providers from two primary health care center
... Show MoreLong-term use of non-steroidal anti-inflammatory drugs (NSAIDs) mostly associated with renal and hepatic adverse effects, and the adjunct use of compounds with potent protective effects, like silymarin, may be one of the choices to avoid these effects. This project was designed to evaluate the protective effect of silymarin against the suspected renal and hepatic injury induced with long term use of NSAIDs; 220 patients with osteoarthritis were randomized into 5 groups and treated with either silymarin 300mg/day alone, piroxicam 20mg/day alone, meloxicam 15mg/day alone or the combination of each of them with silymarin for 8 weeks. The renal and hepatic functions were evaluated before starting treatment and after 8 weeks including assessm
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At any moment, the continuous usage of medications can accompanied by DNA damage and the accumulation of such damages can cause serious consequences. Antidepressants are long-term used drugs and the incidence of their genotoxic impacts cannot be excluded. Therefore, this work was designed to investigate the possible genotoxic effects of the commonly used antidepressants (fluoxetine and amitriptyline) in adult male rats.
Detection of DNA damage in individual cells was assessed by comet and micronucleus assays in three different cell populations i.e. liver, testis and bone marrow tissues of 24 swiss albino adult male rats. The animals were randomly allocated into three groups of 8 rats ea
... Show MoreGroundwater is an important resource that can be used for various purposes. Various factors can change the chemistry of the GW, such as the chemical composition of an aquifer as well as the leaching of human waste into groundwater. The study area is a barren land covered by some sabkhas, in addition to some agricultural fields. The study aims to assess groundwater quality for drinking purposes using the Water Quality Index. The groundwater is chemically heterogeneous and has a wide quality range from very poor to excellent. Evaporation appears to be the controlling factor among the other shallow waters, while relatively deep water is related to rock-soil dominance. Rocks, land use and land cover have helped control the groundwater q
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This study aimed to identify the business risks using the approach of the client strategy analysis in order to improve the efficiency and effectiveness of the audit process. A study of business risks and their impact on the efficiency and effectiveness of the audit process has been performed to establish a cognitive framework of the main objective of this study, in which the descriptive analytical method has been adopted. A survey questionnaire has been developed and distributed to the targeted group of audit firms which have profession license from the Auditors Association in the Gaza Strip (63 offices). A hundred questionnaires have been distributed to the study sample of which, a total of 84 where answered and
... Show MoreBackground: This study aimed to apply a high-power pulsed alexandrite laser in vitro, the researchers tested different exposure periods, pulse lengths, and laser fluencies to see which dosage was most successful against S. aureus bacteria, which had developed resistance to many antibiotics. Method: Three bacteria samples were exposed to laser beams for 30 seconds with a 5ms pulse duration and a laser fluency of 5J/cm2. The process was repeated with laser fluencies of 10, 15, and 20. Results: The study was carried out by using different doses of Alexandrite laser. Results: There are significant differences (p = 0.05) in the mean number of bacteria colonies exposed for 30 and 60 seconds at any laser fluencies utilized in the present i
... Show MoreTo determine the relationship between Helicobacter pylori infection and skin disorders, sixty six patients who suffering from skin diseases include chronic urticarial (CU) and atopic dermatitis (AD) who attended at Dermatological Clinic/ Al-Numan Teaching Hospital from the beginning of October 2015 to the end of January 2016 with age (6-62) have been investigated and compared to twenty two samples of apparently healthy individuals were studied as control group. All the studied groups were subjected to measurement of antiHelicobacter pylori IgG antibodies by enzyme linked immuno sorbent assay (ELISA) and detection of 16S rRNA and CagA genes by using singleplex and multiplex PCR methods. The results of current study revealed that there was a
... Show MoreThe agricultural lands that depend on supplementary irrigation methods for winter wheat cultivating in wide areas of the Nineveh province are most vulnerable to climate change concerns. Due to frequent rainfall shortages and the temperature increase recently noticed and predicted by the climate scenarios. Hence important to assess the climate effect on the crop response in terms of water consumption during the periods (2021-2040) and (2041-2060) by using high-resolution data extracted from 6 global climate data GCMs under SSP5-8.5 fossil fuel emission scenarios in changing and fixed CO2 concentration. And validate the Aqua-Crop model to estimate the yield and water productivity. And gives the RRSME of 7.1- 4.1
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