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.
The relationship of hyperuricemia to kidney disease, diabetes, hypertension and the risk of cardiovascular diseases remain controversial. The aim of this study is to evaluate the use of uric acid (UA) levels to find the higher risk of cardiovascular disease (CVD) in patients with end stage renal disease that have diabetic nephropathy (DN), nephropathy with hypertension (NH) and patients with both diabetic nephropathy with hypertension (DNH). This study deals with 115 patients with end-stage renal disease under hemodialysis sub-grouped into 35 patients with (DN), 40 patients with (NH), and 40 patients with (DNH). Some biochemical parameters were determined in the serum of all participants such as HbA1c, fasting blood glucose (FBG), UA, urea,
... Show MoreInternational trade in services is becoming increasingly important as it is an economic activity that deals with invisible trade, which has become increasingly important in the balance of international trade. The establishment of the WTO is a starting point in international trade relations. It is responsible for all aspects of international trade, , And in view of the continued increase in international trade in services, the need for more internationally recognized rules has become more urgent, especially as it has been increasingly proven that the traditional framework of public services is inadequate to operate some of the most dynamic and innovative sectors of the economy. (GATS) to be the regulatory framework for this sector
... Show MoreTo assess the impact of COVID‐19 on oral hygiene (OH) awareness, attitude towards dental treatment, fear of infection and economic impact in the Middle East.
This survey was performed by online distribution of questionnaires in three countries in the Middle East (Jordan, Iraq and Egypt). The questionnaire consisted of five sections: the first section was aimed at collecting demographic data and the rest sections used to assess OH awareness, attitude towards dental treatment, degree of fear and economic impact of COVID‐19. The answers were either multiple choice, closed‐end (Yes or N
Ruthenium-Ruthenium and Ruthenium–ligand interactions in the triruthenium "[Ru3(μ-H)(μ3-κ2-Hamphox-N,N)(CO)9]" cluster are studied at DFT level of theory. The topological indices are evaluated in term of QTAIM (quantum theory of atoms in molecule). The computed topological parameters are in agreement with related transition metal complexes documented in the research papers. The QTAIM analysis of the bridged core part, i.e., Ru3H, analysis shows that there is no bond path and bond critical point (chemical bonding) between Ru(2) and Ru(3). Nevertheless, a non-negligible delocalization index for this non-bonding interaction is calculated
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The current research is attempt to test the reflection of the lean management on the human resources management practices of two of the most important communication companies operating in Iraq (`Zain & Asia cell), The research aims to Determine the extent of adoption of the lean management approach in the two researched companies, as it improving human resource management practices. The research problem represented in the existence of lack of in some aspects of the application the lean management approach in service sector and neglecting the impact of its tools on the human resource management practices. For this purpose three principle research hypotheses has been formulated, first there is a correlation rel
... Show MoreThis study was conducted to test the effectiveness of Agaricus bisporus inoculums (spawn) in the ratio of (0.25, 0.5 and 1%) v/v to control Pythium aphanidermatum fungus the causal agent of damping- off disease of cucumber plant. results showed the ability of A. bisporus fungus to protect the seedlings from incidence by P. aphanidermatum . all treatments of edible fungus inoculums were significantly different from pathogen treatment after 15 day of planting and there was no significant difference found from control treatment (without pathogen) . the successful of A. bisporus was continued to protect the seedlings after 30 and 45 day after planting. The numbers of seedlings were (8, 7.25 & 7.25) respectively compared to 5.5 seedlings in con
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