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.
It is well known that monotherapy does not provide therapeutic response in all hypertensive. Somepatients show an excellent response, while in others there is a poor response. Combinationantihypertensive therapy is administered when blood pressure is inadequately controlled bymonotherapy to achieve a balanced and additive antihypertensive effect with minimum adverse effects.Both angiotensin converting enzyme (ACE) inhibitors and dihydropyridine type of calcium antagonistsare well established and widely used in monotherapy. An understanding of differences in themechanism of action of these agents allows a logical approach for the use of these agents as acombination therapy. This study was designed to evaluate the possible beneficial
... Show MoreA cross-sectional study was conducted on 80 type 2 diabetic patients aged 20-60 years in Baghdad and 20 non diabetic persons as controls. Laboratory assessment of glucose related parameters; Fasting blood sugar (FBS), Glycated hemoglobin (HbA1c), Insulin and Insulin resistance (IR), renal function test; Blood urea, serum creatinine, Calcium (Ca) and Phosphorus (P), Calcium regulating hormones; Parathyroid hormone (PTH), calcitonin and vitamin D, cytokines, Adiponectin and Tumor necrosis factor (TNF-α) and comparison these parameters between patients and controls. The results: a high significant (p˂0.01) increase in FBG level in the patients (211.34 ± 11.20 mg/dl) as compared with control (85.89 ± 3.07 mg/dl). A high significant (p˂0.01
... Show MoreResearch Summary The aim of the search for knowledge of the effect generative learning strategy in: 1 - Achievement of the second grade. 2 - Systemic thinking for the second grade students when studying the biology. The study sample increased (60) students distributed into two equal experimental and control groups. Prepare the test of 40 pieces of multiple choice type and prepare a test for systematic thinking according to three skills 1. Understand the relationships between the parts of the systemic form and complement the sentences given 2 - complement the relationships between parts of the systemic form 3. Building the systemic form. It was a search result 1- There is a difference of statistical significance (at level 0.05) between th
... Show MoreResearch aims to know the impact beyond the defined in the collection. The research community is the second school students at Baghdad University and a research sample (63) students, the number of experimental group (27) students and a control group (30) students. The researcher was rewarded in variable lifetime for students and educational attainment and educational level of the parents and the educational level of mothers. The researcher has developed a test took the number of paragraphs (20). A test was true after it has been submitted to the Group of arbitrators. The test was consistent with test method used and the reliability coefficient (0, 88). Either the statistical methods used by the researcher are: Pearson correla
... Show MoreThe Urban Residential has developed and changed in different periods of time with successive and gradual shifts, as it cast a shadow over the characterization of modern urbanism in Iraq. The semi-total absence of the governing legislation of urbanization as well as the weakness of the State's role of supervisory in addition to neglecting urban heritage contributed in offering a strange environment in relation to its traditional identity. That was increased by the pressure of the using urban environment as a result of the increasing of population as well as the growth of people’s needs. The research aims to provide an objective view for a mechanism of the application of urban legislation to monitor the implementation o
... Show MoreThe research aims to measure the impact of the quality of the audit on the Earnings Quality, for a sample of private joint stock companies listed on the Iraq Stock Exchange, as the research sample included (14) private and listed joint stock companies in issuing their financial statements for the period from (2010-2018), as well as companies The audit offices in charge of auditing these companies, which number (18) companies or an audit office, and the research relied on two main models for measurement, as the first model reflects the assumed relationship between independent variables represented in the characteristics of external audit quality and measuring the extent of its impact on the dependent variable represented in the Ea
... Show MoreBackground: Chronic periodontitis is an inflammatory disease that affects the supporting tissues of the teeth and it’s common among adults. Smoking is an important risk factor for periodontitis induces alveolar bone loss. Alkaline phosphatase enzyme is involved in the destruction of the human periodontium. It is produced by many cells such as polymorphonuclear leukocytes, osteoblasts, macrophages and fibroblasts within the area of the periodontium and gingival crevice. Osteocalcin is one of the most abundant matrix proteins found in bones and the only matrix protein synthesized exclusively there. Smaller Osteocalcin fragments are found in areas of bone remodeling and are actually degradation products of the bone matrix.The purpose of
... Show MoreHR Al-Hamami, AA Noaimi, MM Al-Waiz, AS Al-Kabraty, Iraqi Postgraduate Medical Journal, 2010 - Cited by 4
All - Mighty Allah is beautiful and loves beauty and Man is the only living that is given by the gift of Almighty Allah the ability to awareness of beauty and the taste of everything which recognized by him around all aspects of life.
So the children have more ability than others towards feeling the sense of beauty and the distinction between the beautiful and the ugly understanding , as they are attracted to the beauty , so we should promote and encourage their sense of beauty in future the beauty in behavior , in psychology and in the community, as well.
This is definitely be done through all of
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