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 Strait of Malacca is one of the waterways of strategic, political, and economic importance. This strait has an increasing importance to its neighboring countries. The Strait of Malacca is very important for China, especially in the field of energy supply security, as the vast ma jority of energy supplies come to China through this strait. China seeks to ensure its security, especially in light of the cooperation of countries that look forward to this strait as well as the United States, and what the United States may cause to China, as many of them are at war with China over the China Sea, not to mention the countries that overlook it. The importance of the research emerges from the basic idea that the strategic importance of the Strait
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The aim of the research is to demonstrate the impact of the salary localization service in enhancing banking competitive advantage. In order to achieve this goal, salary localization was chosen as an independent variable and its impact was studied on the dependent variable, which is the competitive advantage. The research problem lies in the fluctuation of the salary localization service from one bank to another and the impact of this on the competitive advantage. The study sample included five private Iraqi banks, namely (the National Bank of Iraq, the International Development Bank, Assyria International Bank, Al Khaleej Commercial Ban
... Show MoreThe aim of this research is to diagnose the impact of competitive dimensions represented by quality, cost, time, flexibility on the efficiency of e-learning, The research adopted the descriptive analytical method by identifying the impact of these dimensions on the efficiency of e-learning, as well as the use of the statistical method for the purpose of eliciting results. The research concluded that there is an impact of the competitive dimensions on the efficiency of e-learning, as it has been proven that the special models for each of the research hypotheses are statistically significant and at a level of significance of 5%, and that each of these dimensions has a positive impact on the dependent variable, and the research recommended
... Show MoreTo find out the impact of maternal risk factors on the outcome of pregnancy in Baghdad city. A descriptive purposive study was carried out on 100 postpartum women who had delivered for 1 hr. to 24 hrs. ago . the study sample was selected from three hospitals in Baghdad city ( Baghdad teaching hospital ,Fatima Al-Zahra'a maternity and pediatric teaching hospital and Al-Yarmook teaching hospital),during the period from 25 Jan. to 25 Feb. 2006. The data were collected through the use of questionnaire format reviewing pregnants' records and personal interview and were analyzed by using descriptive and inferential statistical approaches. The finding revealed that maternal pregnancy complications had weak effects on pregnancy outcome , while mate
... Show MoreToxoplasmosis is the most common, widespread disease in the world which is caused by Toxoplasma gondii.The objective of the current study is to determine the effect of the Toxoplasma gondii infection on male sperm, especially on the mitochondria of sperm for men who suffer infertility and the possibility of a hereditary mutation. Sixty seminal fluid and serum samples were taken from sub- fertile patients who attended Teba center for in vitro fertilization / Babylon and similarly samples were also obtained from healthy individuals as a control group, their ages ranged from 20 to 60 years old during the period from 1st may /2016 till 25th January/2017. All samples subjected to the tests included Macroscopic and microscopic examination, molecu
... Show MoreThis manuscript investigated the effect of anchorage CFRP wrapping sheets, bolts, and laminate interlock on increasing the efficiency of flexural strengthening for the post-tension girder using CFRP composites techniques longitudinal laminates at the soffit for partially damaged loss of about 14.3% from its area of prestressed concrete beams, and the impact on restoring the original flexural capacity of PC girder. Mitigating delamination of the soffit of horizontal laminates (CFRP). The texture of the laminate and anchorages influenced the stress of the laminate carbon fiber, the mode of crack propagation and failure, and consequently, the beam's attitude has been investigated in this manuscript. The experimental findi
... Show MoreThis research aims to examine the effectiveness of a teaching strategy based on the cognitive model of Daniel in the development of achievement and the motivation of learning the school mathematics among the third intermediate grade students in the light of their study of "Systems of Linear Equations”. The research was conducted in the first semester (1439/1440AH), at Saeed Ibn Almosaieb Intermediate School, in Arar, Saudi Arabia. A quasi-experimental design has been used. In addition, a (pre & post) achievement test (20 Questions) and a (pre & post) scale of learning motivation to the school mathematics (25 Items) have been applied on two groups: a control group (31Students), and an experimental group (29 Students). The resear
... Show MoreBackground: A diverse group of bacteria live in biofilms in the oral cavity. On dental surfaces biofilms form plaque that is potentially involved in caries and periodontal diseases. Periodic studying of plaque microflora and their antimicrobial sensitivity patterns strongly affects the clinical practice in plaque-induced oral diseases. Materials and methods: Dental plaque samples were collected from 22 patients having ages ranged between 33 and 49 years with gingivitis that met the study criteria. Plaque, gingival and gingival bleeding indices (PI, GI, GBI) were measured for each patient. Laboratory procedures included microbiological examination of plaque samples followed by antibiotic sensitivity testing using disc diffusion method were
... Show MoreNow-a-days the Flexible AC Transmission Systems (FACTS) technology is very effective in improving the power flow along the transmission lines and makes the power system more flexible and controllable. This paper deals with the most robust type of FACTS devices; it’s a Unified Power Flow Controller (UPFC). Many cases have been taken to study how the system behaves in the presence and absence of the UPFC under normal and contingency conditions. The UPFC is a device that can be used to improve the bus voltage, increasing the loadability of the line and reduce the active and reactive power losses in the transmission lines, through controlling the flow of real and reactive power. Both the magnitude and the phase angle of th
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