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.
Abstract Lateral Epicondylitis (LE) which has been referred to as the Tennis Elbow as well is a lesion affecting common tendinous origins of wrist extensors due to chronic overuse injury that results in damaging common extensor tendons which join forearm extensor muscles to humerus. The aim of the present evidence-based clinical statement is reviewing scientific evidences for efficacy of a variety of the rehabilitation methods, chronic lateral epicondylitis management. It is focused upon treating chronic lateral epicondylitis and the latest developments in physiotherapy area for managing chronic lateral epicondylitis. Due to the fact that primary physical impairments in the LE are decreased is the strength of the grip, fundamentally due to
... Show MoreBackground Immunological gene and serum level for interleukin- 9 rs 17317275 have been established to have linked to predisposition systemic lupus erythematosus (SLE) and its severity. SLE is a severe, systemic autoimmune disease characterized by autoantibody generation, complement activation, and immune complex deposition. In the pathophysiology of SLE, cytokines have a pleiotropic function. Recently, IL-9 was discovered to mediate strong anti-inflammatory effects in numerous cells or experimental autoimmune models. Objective This study aimed to determine the role of age, IL-9 serum level and genetic polymorphism, C-reactive protein (CRP), Anti-nuclear antibody (ANA) and Anti- double-stranded DNA (anti-dsDNA) to recognize SLE pathogenesis.
... Show MoreThis study aimed to determine the effect of varicocelectomy on sperm parameters, oxidant- antioxidant status and chromatin maturity percent. The current study has been conducted on 154 infertile patients complaining from varicocele and varicocelomized men in addition to 25 fertile men as control. The results revealed significant decrease (P<0.05) in sperm concentration, progressive motile sperm percent, normal sperm morphology percent, GSH, SOD1, CAT levels and chromatin maturity percent and significant increase (P<0.05) in MDA and ROS concentrations in infertile patients with varicocele when compared to fertile men. The results revealed improvement (P<0.05) of sperm parameters quality, GSH, SOD1, CAT, MDA, ROS concentration and chromatin m
... Show MoreAbstract: The researcher aims to highlight the historical frames of political development in royal regime era (1921-1949) and study its transitions on social-political aspect for the various periods during this consistent era of Iraq history. As some elements played an important role in shaping this era’s features ,as well as 2hat succeed it, which mainly affected the political progression’s configuration, such as : political culture role, social and cultural foundation, state policy essence and the unofficial institutions remarkable role in influencing public awareness and concerning it's relation to the state ,the clan and religious institutions. The researcher employed Alexis de Tocqueville’s evaluation criteria and indi
... Show MoreAbstract: The power and the size of the final spot of the laser beam reaching the target are very important requirements in most of the laser applications and fields such as medical, military, and scientific, so studying laser propagation in the atmosphere is a very important topic. The propagation of the laser beam through the atmosphere is subject to several attenuation processes that deplete the power and expand the beam. Through the simulation results of the free electron laser within the visible region of the electromagnetic spectrum (400-700nm), it was found that the attenuation increases with decreasing wavelength. Laser propagation in the presence of rain and snow leads to a very large loss of power compared to propagation i
... Show MoreThe purpose of this paper is to gain a good understanding about wake region behind the car body due to the aerodynamic effect when the air flows over the road vehicle during its movement. The main goal of this study is to discuss the effect of the geometry on the wake region and the aerodynamic drag coefficient. Results will be achieved by using two different shapes, which are the fastback and the notchback. The study will be implemented by the Computational Fluid Dynamic (CFD) by using STAR-CCM+® software for the simulation. This study investigates the steady turbulent flow using k-epsilon turbulence model. The results obtained from the simulation show that the region of the air separation behind the vehicle
... Show MoreSuffer most of the facilities of the high cost of inventory , which affects the high cost of the product and thus affects many administrative decisions , as well as suffer the facilities of the systems developed by the provisions of inventory control , and this problem is exacerbated in the construction sector where the inventory in the form of Construction spin of the Year for another it becomes difficult to control the cost effectively , and is the research problem in question follows: What are the implications of the use of the system in time inventory accounting system for the contracting company does kills Alrkaah to the provisions of the cost of inventory and what is the optimal approach to inventory control ? Find assumed
... Show MoreObjective: To identification environmental and psychological violence's components among collegians’ students of different stages, and gender throughout creating specific questionnaire, and estimating regression of environmental domain effect on psychological domain, as well as measuring powerful of the association contingency between violence's domains in admixed form with respondent characteristics, such that (Demographics, Economics, and Behaviors), and extracting model of estimates impact of studied domains in studying risks, and protective factors among collegians’ students in Baghdad city. Methodolog