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: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a bett
... Show MoreBACKGROUND: Idiopathic immune thrombocytopenia purpura is an autoimmune bleeding disorder that accounts for approximately one-third of clinical hemorrhagic diseases. Pathophysiologically, it involves a complicated imbalance in the immune system. OBJECTIVES: This study focuses on evaluating the levels of the immunomodulatory cytokines interleukin (IL)-35, interleukin-10, and transforming growth factor-β (TGF)-β in patients with refractory idiopathic immune thrombocytopenia undergoing treatment with romiplostim. MATERIALS AND METHODS: A cross-sectional study encompassed 78 individuals with idiopathic immune thrombocytopenia and conducted measurements of different immunomodulatory cytokines in response to different responses of idiopath
... Show MoreDrought is a natural phenomenon in many arid, semi-arid, or wet regions. This showed that no region worldwide is excluded from the occurrence of drought. Extreme droughts were caused by global weather warming and climate change. Therefore, it is essential to review the studies conducted on drought to use the recommendations made by the researchers on drought. The drought was classified into meteorological, agricultural, hydrological, and economic-social. In addition, researchers described the severity of the drought by using various indices which required different input data. The indices used by various researchers were the Joint Deficit Index (JDI), Effective Drought Index (EDI), Streamflow Drought Index (SDI), Sta
... Show MoreMedication safety is an important part of the comprehensive patient safety term. Medication safety is gaining more attention as the World Health Organization set the goal of decreasing medication harm by (50%) for the next 5 years when launching the third global challenge. Studying medication safety in the risk groups such as young ages, children are crucial to learn more about the effect of medicines in this risk group since they are not included in the clinical trials. Adverse drug reaction is defined as any harm resulted from the drug itself during medical process journey, while medication errors are any harm resulted from the treatment process rather than the drug or it is the result of the failure in a step of the treatment process
... Show MoreIntroduction: This study aimed to assess the color change of human teeth with artificial enamel white spot lesions (WSLs) after sandblasting with bioactive glass, resin infiltration, and microabrasion and to test color stability after pH cycling. Methods: Fifty extracted human mandibular first molars were randomly assigned into five groups: Sound, WSLs (untreated), and WSLs sandblasted with bioactive glass (Sylc), WSLs treated by resin infiltration (ICON), and WSLs treated by microabrasion (Opalustre), respectively. All specimens underwent a pH cycling procedure. The color parameters for each specimen were assessed using an Easyshade dental spectrophotometer at different time stages then the color changes (ΔE) were calculated. Results: The
... Show MoreIn Iraqi patients with acromegaly the present investigation included 40 control group and 70 patients with acromegaly divided 35 patients with Diabetic while another 35 patients without Diabetic, with ages between (29-72) years for the identification of GST activity polymorphisms by present and absent GSTM1, GSTT1, and PCR-RFLP, enzymatic digestions were carried out using BsmAI (Biolabs. England, UK) for GSTP1b and AciI (Biolabs, England, UK) for GSTP1c.the association GSTActivity with GST genotype were investigated in a cohort of Iraq acromegaly patients comparing with the healthy control group. The results show a non-significant change in GSTP1b gene in both groups, while show high significantly in GSTP1c in diabetic and non-diabetic acro
... Show MoreGallstone disease is one of the most common complications among diabetic patients especially type 2 DM. Till now, there is no specific and certain factor that explain the incidence of gallstones among type 2 diabetic patients and many risk factors are taken collectively to estimate its intensity and severity compared to non diabetic counter parts. This clinical study was designed to evaluate and report the incidence and severity of gallstones among type 2 diabetics and non diabetics regarding certain factors. 20 diabetic females and 20 diabetic males were collected as patients′ group and have had gallstones while 20 females and 20 males who have had gallstones without diabetes mellitus type 2 were collected as controls′ group
... Show MoreBackground. After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation. Materials and Methods. Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligible participants were randomly allocated into two groups
... Show MoreObjective: To study the effect of epidural spinal injection over one year in case of spinal stenosis. Methodology: This prospective study included 566 patients with spinal stenosis seen at Al-Kindy Teaching and Al-Sader, Hospitals who were treated by local epidural steroid injection. They were followed up for at least five subsequent visits after seven days, one month, three months, six months, and one year to assess efficacy. Result: Mean age of patients was 49.5 years, with a predominance of females (65%). L4/L5 was the most involved level in the spinal stenosis (70%). Grade II stenosis accounted for (45.4%) of cases. The pairwise comparison revealed that there was significant decrease in proportions of patients with pain in day
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