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.
This research dealt with the impact of internal control on tax performance using balanced scorecard indicators because of its special importance in improving tax performance and reform. The internal control system is a safety valve for senior management in all organizations, it plays an important role in the regularity and development of work and the fight against corruption To provide reliable and accurate data and information, follow up on compliance with laws, regulations and instructions. The aim of this research is to demonstrate how control affects tax performance and how to adapt internal control components to improve tax performance. In the General Authority for taxes and its branches,. The research resulted in a number of conclu
... Show MoreAnaemia is a crucial issue among cancer patients and need to be treated properly. High incidence of anaemia in patients with cancer have been associated with several physiological manifestations, leading to decreased quality of life (QOL).
The current study aimed to assess the severity of anaemia, evaluate the current treatment guideline of anaemia, and to determine the association between the level of anaemia and its treatment on quality of life of breast cancer patients in Malaysia. This prospective study conducted among breast cancer patients in multicancer centers in Malaysia including three follow ups after receiving their chemotherapy. Clinical data were collected from their medical records and at each follow up, they asked
... Show MoreThat the structural changes in the environment, business and finance and the spread of business and the diversity of transactions between economic organizations and breadth of a commercial scale in the world have left their clear on the need to keep up with the accounting for these variables as one of the social sciences affect and are affected by the surrounding environment because of the various economic and social factors, technical, legal and others.
As a result of these variables emerged a new field of accounting called Forensic Accounting, which involves the use of expertise of multiple pour in the end to the accounting profession, where the Forensic Accounting cover a large area of disciplines including strengthening
... Show MoreClinical index is needed to predict the outcome of pregnancy after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) for infertile patients. Growth differentiation factor-8 (GDF-8), also known as myostatin, is one of transforming growth factor-â superfamily localized in antral follicles in normal and PCOS ovaries but its function in female reproductive system is still unknown. Aim of the study is to assess the correlation between levels of GDF8 in follicular fluid (FF) with outcomes of in vitro fertilization (IVF/ICSI) in women with and without PCOS. A prospective case control study was performed enrolling (40) patients with PCOS and (40) non-PCOS women (male infertility) undergoing IVF/ICSI. The collect
... Show MoreThe aim of this research is to employ the roundhouse strategy to study its impact on the students achievement of the 10th grade in physics and their core thinking. After the application of the research experience and gaining data, which was processed statistically using the statistical packages program (SPSS). The results of the researcher revealed the superiority of the students of the experimental group who studied using the roundhouse strategy on the students of the control group who studied the usual method in the achievement test. As results showed that there were statistically significant differences between the average scores of the experimental group and the average scores of the control group students in the core thinking test and
... Show MoreThe research aims to identify the degree of the availability of knowledge, skill and ability as components of human capital, in addition to stand at the level of strategic agility upon tourism and travel agencies company of Jordan, the impact of human capital on strategic agility has been tested through distribution of a questionnaire on a Randomly Sample from Workers in Jordan tourist Companies of (349),a number of statistics techinces have been used simple liner Regrision and Multiplayer regession, it has shown that the degree of knowledge, ability and skill availability was high, and the same applies on strategic agility components, and shown out that there is a statistically significant impact between human capital and strate
... Show MoreOne of the most effective systems for managing water is subsurface trickle irrigation. Finding empirical formulas and studying the effect of soil texture are the main purposes of this paper. In order to reach an ideal irrigation system as a modern technique to save water, especially in arid regions, soil textures of loam, silt, and silt loam were studied on a subsurface trickle irrigation system by utilizing HYDRUS/2D. The trickle system is usually operated at low pressure, in this paper the used pressure is 30 cm with an emitter buried at 10, 15, and 20 cm at different diameters. Patterns of wetting fronts in both directions at various times depending on soil texture are gathered to
Background: Celiac disease is an autoimmune chronic disease that affects the human’s intestine and subsequently reflects its effect on the entire body health by retardation the absorption and immune mediated complications cause the involvement of oral health. The present study intended to evaluate the impact of the histopathological disease activity upon dental enamel defects and dental caries.
Subjects and methods: Forty celiac-diseased patients aged 7-11 years were collected from 3 different teaching hospitals in Baghdad classified by means of the histopathological activity of the intestinal disease according to modified Marsh-Ros
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