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.
Generally fossil based fuels are used in internal combustion engines as an energy source.
Excessive use of fossil based fuels diminishes present reserves and increases the air pollution in
urban areas. This enhances the importance of the effective use of present reserves and/or to develop
new alternative fuels, which are environment friendly. Use of alternative fuel is a way of emission
control. The term “Alternative Gaseous Fuels” relates to a wide range of fuels that are in the
gaseous state at ambient conditions, whether when used on their own or as components of mixtures
with other fuels.
In this study, a single cylinder diesel engine was modified to use LPG in dual fuel mode to study
the performance, emis
The need for renewable energy sources is higher than ever due to rising global warming, climate change, and ozone depletion. For refrigeration and air conditioning applications, adsorption refrigeration systems are viable alternatives cooling techniques. This study is a topic and part of the M.Sc. thesis. A field solar-powered ice maker unit was created, studied, tested, and evaluated on the 13th and 30th of May, 2022. Activated carbon and methanol pair was used to set up a refrigeration system in Baghdad (Al Dora). Experimental tests were carried out outdoors to determine the coefficient of performance COP and specific cooling power SCP of the system. The results showed that the lowest temperature
... Show MoreThe local authority represented by the Provincial Council and the administrative units thereof has legislative and supervisory functions which are in the administration and supervision of the local public utilities as provided for by the laws in force. The subject of the interactive relationship between the federal authority and the provincial councils not organized in one of the main problems that accompanied the emergence and application of decentralized system Iraq after 2003, which began since the writing of the Constitution in force for the year 2005 and the law of the provinces No. 21 of 2008 This law has been subjected to political recordings that eventually led to the appearance of this consensus image. The weakness of the legisl
... Show MoreThis study examines experimentally the performance of a horizontal triple concentric tube heat exchanger TCTHE made of copper metal using water as cooling fluid and oil-40 as hot fluid. Hot fluid enters the inner annular tube of the TCTHE in a direction at a temperature of 50, 60 and 70 oC and a flow rate of 20 l/hr. On the other hand, the cooling fluid enters the inner tube and the outer annular tube in the reverse direction (counter current flow) at a temperature of 25 oC and flow rates of 10, 15, 20, 25, 30 and 35 l/hr. The TCTHE is composed of three copper tubes with outer diameters of 34.925 mm, 22.25 mm, and 9.525 mm, and thicknesses of 1.27 mm, 1.143 mm, and 0.762 mm, respectively. TCTHE tube's length was 670
... Show MoreThe necessary optimality conditions with Lagrange multipliers are studied and derived for a new class that includes the system of Caputo–Katugampola fractional derivatives to the optimal control problems with considering the end time free. The formula for the integral by parts has been proven for the left Caputo–Katugampola fractional derivative that contributes to the finding and deriving the necessary optimality conditions. Also, three special cases are obtained, including the study of the necessary optimality conditions when both the final time and the final state are fixed. According to convexity assumptions prove that necessary optimality conditions are sufficient optimality conditions.
... Show MoreIn this paper, variable gain nonlinear PD and PI fuzzy logic controllers are designed and the effect of the variable gain characteristic of these controllers is analyzed to show its contribution in enhancing the performance of the closed loop system over a conventional linear PID controller. Simulation results and time domain performance characteristics show how these fuzzy controllers outperform the conventional PID controller when used to control a nonlinear plant and a plant that has time delay.
Introduction: Diabetic foot infections are one of the most severe complications of diabetes. This study was aimed to determine the common bacterial isolates of diabetic foot infections and the in vitro antibiotic susceptibility then treatment.
Methods: A swab was taken from the foot ulcer, and the aerobic bacteria were isolated and identified by cultural, microscopic and biochemical test, then by api-20E system. After that their antibiotic susceptibility pattern was determined. Then local and systemic treatment was used to treat the diabetic foot patients.
Results: Bacterial isolates belonging to twelve species were obtained from diabetic foot patients. Gram (-) bacteria were the predominant pathogens in the diabetic foot infection