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.
Mercury is a heavy metal that is extremely toxic. There are three types of it: inorganic, organic, and elemental. Mercury in all its forms has been shown to have harmful effects on living things. It can multiply its concentration from lower to higher trophic levels and accumulate in the body's various tissues. Aquatic organisms bodies have been exposed to mercury mostly through various human activities. The largest source of mercury pollution in the air is thermal power plants that mostly use coal as fuel. It is carried to a body of water after being deposited on the ground surface from the air. The way it enters the food chain is through aquatic plants and animals. Mercury accumulations in the kidney, liver, gills, or gonadal tissu
... Show MorePraise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
We see human societies differ from one society to another in organizing social life, and each according to the foundations and rules prepared by the main thing in the welfare and prosperity.
That is why we see eastern societies differ from western societies in many patterns and various ways of reaching that sophistication, until Islam came and gave the proper model in raising society at that time to the best and highest social levels, because it is based on heavenly rules and foundations and not status as in previous civilizations.
And when the Islamic community has
Assessment of the in service behavior of asphalt stabilized subgrade soil under environmental impact has got little attention by the research workers. However, the sustainability of the roadway depends mainly on the welfare of its subgrade soil condition. In this work, Gypseous soil was stabilized with asphalt emulsion for subgrade usage, the durability of the mixture has been assessed in term of its ability to maintain the compressive strength when practicing the environmental impacts. Specimens of 38 mm in diameter , and 76 mm in height have been prepared with various water-asphalt percentages, and subjected to 30 cycles of (freezing-thawing), (heating-cooling) and (wetting-drying) processes. Specimens have been tested for unconfined comp
... Show More. The concepts of structural flexibility became one of the important goals in the design phases to reach high performance in architecture. The pioneering projects and ideas that linked architecture with technologies and scientific innovations appeared, with the aim of reaching projects that mix the concepts of flexibility with the development of machine thought and modern technology to meet the functional, environmental, and aesthetic requirements for human wellbeing. The aim of this paper is to identify the mechanisms used in order to reach flexible structural systems capable of accommodating technological changes and developments. The research hypothesizes that the structural design according to the concepts of flexibility achieves high s
... Show Moreكان لنهاية الحرب الباردة وعولمة العالم على وفق رؤية كونية تتجاوز حدود ومفاهيم السيادة الوطنية والقومية الاثر الواضح في ترتيب العلاقات الدولية , واصبحت تلك العلاقات تدور حول محورين الاول .. هو الاعتماد المتبادل بين الدول من اجل الوصول الى خطوط مشتركة للمصالح المختلفة بين هذه الدول . والآخر.. هو تبعية الدول الضعيفة للدول القوية لافتقار الاولى توفير الحاجيات الى مواطنيها . هذا يشير الى نشأة علا
... Show MoreUrban wetlands are one of the complex systems that provide many economic, social and environmental services to the city. In this research, the most important services provided by urban wetlands from the point of view of the urban planner were reviewed, and the types of these lands and their divisions according to the type of services provided by each type were presented. Environmental is represented in its ability to reduce the dangers of floods, mitigate the climate and reduce its negative impacts, purify water and deplete a lot of suspended impurities and pollutants, and social services such as recreational areas and beautiful landscapes that inspire joy and reassurance in the soul, as well as cultural areas and sports activities for m
... Show MoreAntibiotic resistance is a problem of deep scientific concern both in hospital and community settings. Rapid detection in clinical laboratories is essential for the judicious recognition of antimicrobial resistant organisms. So, the growth of Uropathgenic Escherichia coli (UPEC) isolates with Multidrug-resistant (MDR) and Extensively Drug-resistant (XDR) profiles that thwart therapy for (UTIs) has been detected and has straight squeezed costs and extended hospital stays. This study aims to detect MDR- and XDR-UPEC isolates. Out of 42 UPEC clinical isolates were composed from UTI patients. The bacterial strains were recognized by standard laboratory protocols. Susceptibility to antibiotic was measured by the standard disk diffusi
... Show MoreThis research aims to identify the effectiveness of counseling by using the technique of self-talkin developing the habits of mind among middle school students by testing important hypotheses, and choosing the experimental design for the two groups (experimental - control). The classification of "Costa & Kallick" was adopted to measure the habits of the mind, and the scale consisted of (64) items, and after confirming the psychometric properties of the scale, the researcher applied it to the research sample (487) students from middle school students. One of the students who got the lowest marks after answering the scale. purpose of applying the experiment. He divided them into two groups, one of them is experimental (10) students, as
... Show MoreIndia is today the largest democratic state in the Third World and has been able to maintain its national unity in the near future. The history of Indian civilization is more than 5,000 years old. It has achieved its heritage, culture, philosophy, traditions, national unity and unity and has taken its place among nations seeking progress and progress. Which are still visible to the present day, because of their history of civilization and achievements, and the fusion of cultures of invading peoples over the centuries with the culture of diverse Indian society, but despite being a secular state, Has put into place through its governments various forms of exclusion and marginalization towards the people of India, especially Muslims, and th
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