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.
In recent years, various methods have been developed to enhance the characteristics of asphalt pavement in order to face the continuous challenges of increasing traffic loads and changing climate conditions. One of the most popular and successful methods is modifying the asphalt mixtures or asphalt binder with the addition of polymers. Therefore, two types of Polyethylene (PE) polymer, High-Density PE (HDPE) and Low-Density PE (LDPE), are used in this research. Two methods were applied to prepare PE-modified asphalt mixtures: Semi-Wet Method (S-WM) and Dry Method (DM). The findings of the investigation indicated that the addition of PE polymer can reduce the wear loss of aggregate. In general, the experimental results revealed that asphalt
... Show MoreIn this search, Ep/SiO2 at (3, 6, 9, 12 %) composites is prepared by hand Lay-up method, to measure the change in the thermal conductivity and Impact Strength of epoxy resin before and after immersion in H2SO4 Solution with a 0.3N for 10 days. The results before immersion decreases with the increase of the weight ratios of the reinforcement material (SiO2), It changed from (82.6×10-2 to 38.7×10-2 W/m.°C) with change weight ratios from (3 to 12) % respectively, but after immersion time in the chemical solution where it was (65.6×10-2 W/m.°C) at the weight ratios (6 %) and became (46.6 × 10-2 W/m.°C) after immersion in sulfuric acid. The results of the Impact strength decreased by increasing the percentage weight ratio, it changed f
... Show MoreThree hundred and fifty five patients with hepatitis were investigated in this study all cases gave negative result with HBs Ag , IgM-anti HCV , IgM-anti HEV, IgM-anti HDV and anti-HIV tests . The frequency of IgM-anti HAV was 113 and the percentage was 32 % in all ages but when these patients divided into five groups dependent on ages. The highest percentage of IgM-anti HAV was (45%) in age <10 and the percentage declined with age increase till to 9% in age >41 year.
Since its start spreed "Severe acute respiratory syndrome coronavirus 2" was discovered in Wuhan, China.that is chargeable COVID-19, a pandemic virus, has end up a widespread fitness hassle everywhere in the global Over 2.1 million people have been affected. We analyze serum concentration of CD4 marker and CD8 marker depend in COVID-19 sufferers, and to make clear a relationship between these variables and disorder Progression and severity For those purpose, (158) sufferers with COVID-19 (showed with the aid of using polymerase chain reaction) and (22) seemingly wholesome human beings have been protected withinside the present day examine and taken into consideration as a manipulate group. All examine population (sufferers and manipulate) h
... Show MoreBackground: Diabetic mellitus (DM) is a collection of metabolic disorder identified by hyperglycemia. The heterogeneous etiology includes defects either in insulin secretion, or in insulin action, or the both. In addition to the distraction in carbohydrate, fat and protein metabolism. Inflammatory reaction that caused by many pro-inflammatory cytokines play a central role in the pathogenicity of T2DM, these cytokines can enhance insulin resistance which led to impaired glucose homeostasis. Subjects: The study included 75 patients (38 males and 37 females) suffering from T2DM with age mean ± SE 52.30 ± 1.60, and 70 individuals as healthy controls (35 males and 35 females) with age mean ± SE 48.88 ± 0.64. Evaluation of immunological marke
... Show MoreBackground: Central serous chorioretinopathy (CSCR) is an idiopathic condition aggravated by exogenous or endogenous glucocorticoids. Vascular deregulation in the choroid is a new hypothesis regarding central serous chorioretinopathy occurrence. The inhibition of choroidal mineralocorticoid receptors has a great role in shortening the duration of CSCR by inhibiting choroidal vasodilatation and leak.
Objective: To assess the effect of oral spironolactone on subretinal fluid, central macular thickness and visual acuity in patients with acute CSCR compared to observation.
Subjects and Methods: a hospital based, randomized clinical trial carried out at outpatient clinic in Ibn-Alhaitham Teaching E
... Show MoreThe effect of mental and physical health on the feelings of subject welfare is known as health-related quality of life. The chronic obstructive pulmonary disease is a common respiratory diseases. Assessment of health-related quality of life is considered important in such chronic disease. The objective of the current study was to measure health-related quality of life in a sample of chronic obstructive pulmonary patients in AL- Diwanyia city/Iraq. This study was carried out on 150 already diagnosed COPD patients who attended to the Center of Respiratory Diseases/AL-Diwaniyah Teaching Hospital during September 2019 to January 2020. The Arabic version of St George’s Respiratory Questionnaire was used to asses
... Show MorePregnancy-associated anemia is a widespread condition that can have varying impacts on both the mother and the developing fetus, depending on the level of hemoglobin in the mother’s blood and the stage of pregnancy at which the anemia occurs. In Iraq, 27% of all registered thalassemia cases are thalassemia minor. Pregnancy may aggravate mild undiagnosed thalassemia early in pregnancy. The objective of the study was to access the prevalence of undetected thalassemia minor in primigravida women who received prenatal care before 20 weeks and to compare the demographic and socioeconomic characteristic features between women with iron-deficiency anemia (IDA) and those without any anemia. A to