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.
Soil water retention curves (SWRCs) are crucial for characterizing soil moisture dynamics and are particularly relevant in the context of irrigation management. A study was carried out to obtain the SWRC, inflection point, S index, pore size distribution curve, macro porosity, and air capacity from samples submitted to saturation and re-saturation processes. Five different-texture disturbed soil samples Sandy Loam, Loam, Sandy Clay Loam, Silt Loam, and Clay were collected. After obtaining SWRC, each air-dried soil samples were submitted to particle size distribution and clay dispersed in water analyses to verify the soil lost clay. The experimental design was completely randomized with three replications using two processes of SWRC (saturat
... Show MoreThe serum protein test includes measurement of the level of total protein(albumin, globulin). Fetuin-A is a blood protein made in liver. It can inhibit insulin receptor, enhance insulin sensitivity and make the individuals more likely to develop type 2 diabetes, then disorder in lipid profile (Total cholesterol(TC), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), Triglyceride(TG) and very low density lipoprotein cholesterol (VLDL-c) . To evaluate Fetuin-A, total protein, albumin, globulin, HbAlc and lipid profile in 200 adult and elderly Iraqi patients with type 2 Diabetes Mellitus were taken and compare them with 200 subjects as a healthy control. The laboratory analysis(for patients and
... Show MoreBackground: Health professionals have a crucial role in promotion, support and management of breastfeeding. To be effective in this effort, the clinician should focus on the issue from the preconception stage through pregnancy and delivery, and continue in subsequent infant care. Aim of the study: to assess the effectiveness of the UNICEF/WHO 40-hour of breast feeding training through the assess breastfeeding knowledge and attitudes of the health profession staff before and after training course.
This research aims to identify the role of external environment factors on the quality of educational services, from the academic point of view, where the distribution of a questionnaire to a random sample of (100) university professors, and then analyzing a model, and test the validity of this model using structural modeling (SEM) (Structural Equation Modeling).
And then test the relationships between variables using the software of Statistical Package for Social Sciences (SPSS V.18), the research found a number of conclusions, the most important conclusion is: the external environment factors has significant impact on the quality of educational services.
Break in the bond and its impact on the difference of scholars
Iraq has the second largest proven oil reserves in the world. According to oil experts, it is expected that the Iraq's reserves to rise to 200+ billion barrels of high-grade crude.
Oil is a strategic commodity for producing and exporting countries in general, and Iraq in particular, as demonstrated by the international experience that oil is an important means to achieve economic growth, an important tool in the overall economic, social and political development. It is also an important source of hard currency for any national economy and a means to connect the local economy and the global economy. In this paper we focus our attention on selecting the best regression model that explain the effect of human capita
... Show MoreThe purpose of this research is to demonstrate the effectiveness of a program to address the problem of mixing similar letters in the Arabic language for students in the second grade of primary and to achieve the goal of the research. The researcher followed the experimental method to suit the nature of this research and found that there are statistically significant differences between the tribal and remote tests, The effectiveness of the proposed educational program. At the end of the research, the researcher recommends several recommendations, the most important of which are: 1 - Training students to correct pronunciation of the outlets, especially in the first three stages of primary education (primary) and the use of direct training
... Show MoreOver the course of six decades, Iraq exposed to many events that have affected the Iraqi people from the social, physical and mental aspects. In this study, two groups of people (2369), from Iraq (G1) and the Michigan, United States (U.S) of America (G2) selected to compare the prevalence rate and effects of trauma factors such as mental illness (anxiety, depression and PTS), somatic diseases (heart disease, hypertension, and diabetes), substances abuse (illicit drugs, alcohol and tobacco), and chemicals pollution), and self-rated health among the two groups. The study results reveals a significant different between the two groups in the all indicators for trauma. The study conclude that Iraqi in U.S. (G2) suffer from factors completely dif
... Show MoreLecture method is still need to a part of PBL in order to explain the difficult and abstract concepts in all fields of physics particularly thermodynamics. Introducing and promoting PBL in the lecture method is wise step for innovation in teaching and learning. The objective of this study is to compare the effects of using three methods: problem-based learning (PBL), PBL with lecture method, and conventional teaching on undergraduate physics students’ understanding of thermodynamics. The actual sample size comprises of 122 students, who were selected randomly from the Physics Department, College of Education in Iraq in the academic year 2011-2012. In this study, the pre- and post-test were done and the instruments were administered to the
... Show MoreThe general assumption of linear variation of earth pressures with depth on retaining structures is still controversial; investigations are yet required to determine those distributions of the passive earth pressure (PEP) accurately and deduce the corresponding centroid location. In particular, for rigid retaining walls, the calculation of PEP is strongly dependent on the type of wall movement. This paper presents a numerical analysis for studying the influence of wall movement on the PEP distribution on a rigid retaining wall and the passive earth thrust location. The numerical predictions are remarkably similar to existing experimental works as recorded on scaled test models and ful