Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled in the deprescribing program. The median age was 51.5 years, 56.8% were males, and hypertension was the most common etiology for their chronic kidney disease (CKD); 78% had comorbidities. After deprescription, there was a significant reduction in the number of medications from 6.0 to 4.0 and a reduction in the number of pills from 7.0 to 5.0. Medication adherence accessed using the Arabic version of Morisky, Green, and Levine’s (MGL) adherence scale also had a significant reduction from 2.0 to 1.0. Conclusion: A pharmacist-led deprescribing program is a successful strategy for decreasing the number of medications and daily pills prescribed while simultaneously improving hemodialysis patients' adherence to their regimens without compromising the patient’s safety.
Background: Multiple sclerosis is a chronic heterogeneous demyelinating axonal and inflammatory disease involving the Central Nervous System [CNS] white matter with a possibility of gray matter involvement in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs and symptoms. Cerebral venous insufficiency theory was raised as a possible etiology for the disease at 2008 by Zamboni an Italian cardiothoracic surgeon. This theory was defeated by Multiple Sclerosis[ MS] researchers and scientists who thought that the disease is an autoimmune rather than vascular.
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... Show MoreHealth and safety problem can be described by statistics it can only be understood by knowing and feeling the pain, suffering, and depression. Health and safety has a legal responsibility to protect it for everyone who can affect in the workplace. This includes manufacturers, suppliers, designers and controllers of work places and employees. Work injury is one of the major problems in manufacturing and production systems industries; it is reduced production efficiency and affects the cost. To gain flexibility from a traditional manufacturing system and production efficiency, this paper is about the application of estimating technology to preview and synthesis of Lost Time of Work Injuries in industry systems aims to provide a safe workin
... Show MoreThe research seeks to identify the proposed scenarios to predict and ward off monetary credit risks that the bank is exposed to in the future, using the banking stress tests model, and showing their impact on capital adequacy and profitability ratio,To achieve this purpose, Sumer Commercial Bank was taken as a case study, and mathematical equations were used to extract the results. Low percentage of profits and returns, strictness in the process of granting credit and financing operations in order to reduce credit risks.
Abstract
This study aims to find the relationships between social capital (social network, social trust, shared goals) and knowledge sharing (knowledge Donating, knowledge collecting) as independent variables and their impact on improving the quality of educational services (academic staffs quality, Quality of teaching methods and study curriculums). This research is an important, because it attempts to identify the relationship between social capital and the knowledge sharing and their effect on improving the quality of educational service for universities. The study problem was determined in several questions related to the nature of the correlation relationship - the impact between the different independent variables (
... Show MoreThe aim of the current study is to identify the level of goal conflict with twelfth-grade students in South Sharqiah/ Sultanate of Oman according to gender and specialization. The study used the descriptive method. A scale of (28) items was developed and divided into six dimensions: time pressure, goal achievement, limit of power, limit of budget, incompatible strategies, and unclear task. To validate the scale, it was piloted (40) students. The scale was administered to a sample of (402) students (209) males in the Governorate of South Sharqiah. The results showed that the conflict level was high in “unclear task”, and an average conflict level in “limit of power”. Other dimensions (goal achievement, time pressure, limit of powe
... Show MoreNations are developed with education and knowledge that raise the status of society in its various segments, beyond that it leads to underdevelopment and deterioration in various sectors, whether economic, health, social, etc. If we considered the general name of The ministry of Education & Scientific Studies, then the second part seems to be not functioning, since scientific research has no material allocation and remains based on the material potential of the university professor. As for the first half of the topic, the reality of the situation reveals problems related to the Holy Trinity of Education which is (Professor - Student - the scientific method) where universities suffer at the present time from this problem, and
... Show MoreObjective: The study the association of procalcitonin (PCT) and c-reactive protein (CRP) levels in COVID-19 patients and it's role as a guide in progress and management of those patients. Methodology: This cross-sectional study analyzed 200 CIOVID-19 patients in a single privet center in Baghdad, Iraq from January 1, 2021 to January 1, 2022. Demographic data like age, sex, and clinical symptoms were recorded. High sensitivity CRP and PCT in the serum were measured via dry fluorescence immunoassay (Lansionbio-China). Results: Out of 200 patients, 50 had moderate Covid and 150 had severe disease. Mean serum PCT levels was 0.039±0.05 ng/mL in the moderate group (range 0.011-0.067) and 0.43±0.21 ng/mL in the severe group (range 0.21
... Show MoreBackground: Tooth wear is one of the most concerning problems of the current dental practice especially among older subjects. The aim of this study is to determine the severity of tooth wear and its relation with selected salivary variables (salivary pH and vitamin C level) among a group of older adults in Mosul city/Iraq. Materials and methods: All subjects (30 subjects) of both gender tookpart in the current study; sixteen of them were older adults (55-65 years) and compared with fourteen middle-aged adults (30-40 years) at Textile factory in Mosul city/Iraq. Unstimulated salivary samples were collected and salivary pH was immediately measured. Salivary vitamin C level was determined colormetrically. Severity of tooth wear was determined
... Show MoreBackground: pregnancy as a systemic condition causes changes in the functioning of human body as a whole and specifically in the oral cavity and it also is considered as a stressful condition. These changes may favor the increase of oxidative stress. Aim: The aim of this study was to estimate the level of marker of oxidative stress (malondialdehyde) and antioxidant (uric acid) in saliva of pregnant compared to non-pregnant women and to assess the gingival health condition in both groups. Additionally, unstimulated salivary flow rate was determined in both groups. Subjects, materials and methods: The study group consisted of sixty pregnant women, they were divided into three equal groups according to trimester (20 pregnant women for each
... Show MoreObjective: The present study aimed to determine the association of quality of life with the resilience of intensive care unit (ICU) nurses. Methods and Materials: A cross-sectional study was performed, including 105 ICU nurses from five hospitals in Iraq, using a convenience sample method. Data were gathered through a self-administered questionnaire that includes three sections: the demographics, the Brooks Quality of Nursing Work Life survey, and the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Findings: The QWL of the ICU nurses was moderately satisfied (mean = 161.42), and the level of resilience was moderate (mean = 26). A statistically significant positive correlation between QWL and resilience. Conclusion: Strategies
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