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.
Enhancing fatigue resistance in asphalt binders and mixtures is crucial for prolonging pavement lifespan and improving road performance. Recent advancements in nanotechnology have introduced various nanomaterials such as alumina (NA), carbon nanotubes (CNTs), and silica (NS) as potential asphalt modifiers. These materials possess unique properties that address challenges related to asphalt fatigue. However, their effectiveness depends on proper dispersion and mixing techniques. This review examines the mixing methods used for each nanomaterial to ensure uniform distribution within the asphalt matrix and maximize performance benefits. Recent research findings are synthesized to elucidate how these nanomaterials and their mixing proce
... Show MoreAdsorption of Acetone and 2-Butanone on Iraqi siliceouns rocks powder have been investigated. UV technique has been used to determine the adsorption isotherms. The results showed that the adsorption isotherms obeyed Freundlich adsorption equation. The results showed that the adsorption increases with increasing acidity of solutions. The adsorption was exothermic process, increasing temperature leads to decreasing adsorption. H, S, G were calculated
This research aims to identify the role that forensic accounting plays on the transparency and quality of the financial statements in trade bank of Iraq and the Gulf Commercial Bank in Babylon. This research came to address the problem that most financial institutions suffer from, which is represented by the lack of transparency and the quality of the financial statements issued in a manner. Annual also the manipulation and fraud in the financial data, which causes a big gap between that institutions and organizational stakeholders. According to the implementation of the research hypothesis and the objectives of the research, a questionnaire was prepared consisting of three axes, the first axis dealing with the demographic distri
... Show MoreThe importance of physical and nonphysical architectural design values made architectural designers need good experience to be experts of architectural values reasonably without neglecting any value in the design process. The importance of such values made that ignoring any values and mistakes occurs in the design process. Simultaneously, architectural designers' different nature and the difference in their experiences are causing different understandings of the design values, thus causing architectural mistakes. The research problem appears from the randomly propagating of mistakes in contemporary architecture, which is about to become a phenomenon in Al Sulaymaniyah city. The research aims to find the main reason
... Show MoreRefrigerant R134a has been widely utilized in automotive air conditioning systems (AACSs); R134a has a high global warming potential (GWP) of 1430 despite having zero ozone depletion potential (ODP). Coming refrigeration systems must include refrigerants with low GWP and zero ODP. The aim of this experimental study is to evaluate the thermal performance of an (AAC) with different values of compressor speeds, i.e., (1000, 1700, and 2400 rpm) and two thermal loads, i.e., (500 and 1000 Watt) with the absence and presence of liquid suction heat exchanger (LSHX) using R134a. The results showed that adding LSHX enhanced the COP cycle by 7.18%, 10.7%, and 3.09% for the first, second, and third speed, respectively, at 500 Watt, while the en
... Show MoreThe development of new building materials, able of absorbing more energy is an active research area. Engineering Cementitious Composite (ECC) is a class of super-elastic fiberreinforced cement composites characterized by high ductility and tight crack width control. The use of bendable concrete produced from Portland Limestone Cement (PLC) may lead to an interest in new concrete mixes. Impact results of bendable concrete reinforced with steel mesh and polymer fibers will provide data for the use of this concrete in areas subject to impact loading. The experimental part consisted of compressive strength and impact resistance tests along with a result comparison with unreinforced concrete. Concrete samples, with dimensions of 100×
... Show MoreThe present study experimentally and numerically investigated the impact behavior of composite reinforced concrete (RC) beams with the pultruded I-GFRP and I-steel beams. Eight specimens of two groups were cast in different configurations. The first group consisted of four specimens and was tested under static load to provide reference results for the second group. The four specimens in the second group were tested first under impact loading and then static loading to determine the residual static strengths of the impacted specimens. The test variables considered the type of encased I-section (steel and GFRP), presence of shear connectors, and drop height during impact tests. A mass of 42.5 kg was dropped on the top surface at the m
... Show MoreBackground: In young adults, multiple sclerosis is a prevalent chronic inflammatory demyelinating condition. It is characterized by white matter affection, but many individuals also have significant gray matter involvement. A double-inversion recovery pulse (DIR) pattern was recently proposed to improve the visibility of multiple sclerosis lesions. Objective: To find out how well a DIR sequence, FLAIR, and T2-weighted pulse sequences can find MS lesions in the supratentorial and infratentorial regions. Methods: A total of 37 patients with established diagnoses of multiple sclerosis were included in this cross-sectional study. Brain MRI was done using double inversion recovery, T2, and FLAIR sequences. The number of lesions was count
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