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 aims to assess the adoption of TQM in the Middle East Bank for Investment, and diagnosis means and techniques of technological innovation that applied in, as well as to determine the nature of the relationship between total quality management practices (operations management, employment relations, customer relations) and technological innovation (the incremental innovation of the service, incremental innovation process, a radical innovation of the service, a radical innovation of the operation), through use the checklists, derived from a study (Kim et al, 2012) the many styles of mathematical and statistical tools was adopted like the percentage, mean, duplicates, as well as the adoption of the Z test th
... Show MoreA total of (25) stool samples were collected from children and adults (2- 4) years old suffering from diarrhea to isolate E. coli strains that produce heat-stable enterotoxin a (STa), and after performing microscopic examination, cultural characterization and biochemical identification only (11) isolates showed positive E. coli. STa activity was estimated by using suckling mouse assay (SMA) and from these (11) isolates only (5) showed STa activity and the one with the highest STa activity was selected for large scale production of STa, which was followed by partial purification using ion-exchange chromatography (normal phase) using DEAE sephadex A-50 column. After purification and determination of protein concentration by using the standard
... Show MoreA fluorescence microscopy considered as a powerful imaging tool in biology and medicine. In addition to useful signal obtained from fluorescence microscopy, there are some defects in its images such as random variation in brightness, noise that caused by photon detection and some background pixels in the acquired fluorescence microscopic images appear wrongly auto-fluorescence property. All these practical limitations have a negative impact on the correct vision and analysis of the fluorescent microscope users. Our research enters the field of automation of image processing and image analysis using image processing techniques and applying this processing and analysis on one of the very important experiments in biology science. This research
... Show MoreA simple and accurate method to determinate furosemide (FUR) based on converting the secondary amine to primary amine with acidic hydrolysis then azotization by nitrous acid and coupled with resorcinol as a coupling agent in aqueous medium at pH 13. The optical characteristic like beers law limit found to be (0.25-2.5) μg.ml−1, detection and quantification limits (0.0196) (0.0654) μg.ml−1respectivly and Sandel sensitivity was 0.006738 μg.cm−2. The least-square method was used to evaluate the regression equation and the correlation coefficient. The resulted azo dye has a maximum absorbance at 430 nm with light oran
This study aims at describing the identity crisis of Diaspora people (Arab -American) in "Laila Halaby's" novel "Once in A promise Land". Halaby tackles the issues of racism, exclusion, and instability of identity that affect the Arab American community after the terrorist event of eleventh of September. She sheds light on the experiences of her significant characters Salwa and Jassim in America, clarifying how this event weakened their social position and turns their presence in America questionable. "Halaby" describes the bitterness of her characters who are induced into a dream of belonging to a land that transcends their original culture and religious values as well as their language. "Halaby" explains the subsistence in America involvi
... Show MoreIn recent years, the field of research around the congestion problem of 4G and 5G networks has grown, especially those based on artificial intelligence (AI). Although 4G with LTE is seen as a mature technology, there is a continuous improvement in the infrastructure that led to the emergence of 5G networks. As a result of the large services provided in industries, Internet of Things (IoT) applications and smart cities, which have a large amount of exchanged data, a large number of connected devices per area, and high data rates, have brought their own problems and challenges, especially the problem of congestion. In this context, artificial intelligence (AI) models can be considered as one of the main techniques that can be used to solve ne
... Show MoreThe current study was conducted in the environment of the Martyr Monument Lake in the city center of Baghdad during 2019 to monitor the impact of climatic conditions such as drought, water shortage, high temperatures in the environment of the city and the lack of water flow during the years 2015 to 2018 and their effects on some of the physical and chemical factors of water and the dynamics of the phytoplankton community in the lake environment. Heterogeneity of some studied environmental factors, including air and water temperature, permeability, water depth, pH, DO, BOD5, nutrients, nitrate, NO3, and phosphates were found. The results showed the effect of climate change and the pres
This study confirms the ubiquitin conjugating enzyme 2B (Rad6) plays a significant role in the DNA repair pathway also because the ubiquitin-conjugating pathway. The DNA repair pathway could be a variety of bypass repair mechanism where the broken base pair is bypassed by permitting the replication fork to labor under the site of injury. This is often done by a shift mechanism wherever deoxyribonucleic acid enzyme - δ is switched with DNA enzyme - η (DNAP - η). Site of DNAP - η is massive enough to permit the broken ester to labor under, and so bypass the broken nucleotide. However, this is often potential solely through the involvement of Proliferating cell nuclear antigen (PCNA) that could be a processivity issue and it acts as a plat
... Show MoreThe research summarizes the knowledge of the dimensions and denotations of T.V advertisement; and its constituents for building it through the semiotic approach of an ad sample represented by the announcement of Zain Kuwait Telecom Company which carries the title "Mr. President" using Roland Barth's approach, starting with the designation, implicit, and linguistic reading to reach the narrative features and their denotations. That makes television advertising as a semiotic and pragmatic discourse in view of the still and motion picture with its efficiency and strength to inform and communicate. And what lies in it of aesthetic, artistic elements; informational and effective power in influencing the recipients by focusing on narratives and a
... Show MoreUtilizing phase change materials in thermal energy storage systems is commonly considered as an alternative solution for the effective use of energy. This study presents numerical simulations of the charging process for a multitube latent heat thermal energy storage system. A thermal energy storage model, consisting of five tubes of heat transfer fluids, was investigated using Rubitherm phase change material (RT35) as the. The locations of the tubes were optimized by applying the Taguchi method. The thermal behavior of the unit was evaluated by considering the liquid fraction graphs, streamlines, and isotherm contours. The numerical model was first verified compared with existed experimental data from the literature. The outcomes re
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