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.
In this paper the variable structure control theory is utilized to derive a discontinuous controller to the magnetic levitation system. The magnetic levitation system model is considered uncertain, which subjected to the uncertainty in system parameters, also it is open-loop unstable and strongly nonlinear. The proposed variable structure control to magnetic levitation system is proved, and the area of attraction is determined. Additionally, the chattering, which induced due to the discontinuity in control law, is attenuated by using a non-smooth approximate. With this approximation the resulted controller is a continuous variable structure controller with a determined steady state error according to the selected control
... Show MoreThere is no access to basic sanitation for half the world's population, leading to Socioeconomic issues, such as scarcity of drinking water and the spread of diseases. In this way, it is of vital importance to develop water management technologies relevant to the target population. In addition, in the separation form of water treatment, the compound often used as a coagulant in water treatment is aluminum sulfate, which provides good results for raw water turbidity and color removal. Studies show, however, that its deposition in the human body, even Alzheimer's disease, can cause serious harm to health and disease development. The study aims to improve the coagulation/flocculation stage related to the amount of flakes, i
... Show MoreThe paper proposes a methodology for predicting packet flow at the data plane in smart SDN based on the intelligent controller of spike neural networks(SNN). This methodology is applied to predict the subsequent step of the packet flow, consequently reducing the overcrowding that might happen. The centralized controller acts as a reactive controller for managing the clustering head process in the Software Defined Network data layer in the proposed model. The simulation results show the capability of Spike Neural Network controller in SDN control layer to improve the (QoS) in the whole network in terms of minimizing the packet loss ratio and increased the buffer utilization ratio.
The major objective of this study is to establish a network of Ground Control Points-GCPs which can use it as a reference for any engineering project. Total Station (type: Nikon Nivo 5.C), Optical Level and Garmin Navigator GPS were used to perform traversing. Traversing measurement was achieved by using nine points covered the selected area irregularly. Near Civil Engineering Department at Baghdad University Al-jadiriya, an attempt has been made to assess the accuracy of GPS by comparing the data obtained from the Total Station. The average error of this method is 3.326 m with the highest coefficient of determination (R2) is 0.077 m observed in Northing. While in
The Mannich reaction is one of the most important types of organic chemistry fundamental reactions. It is a crucial stage in the production of various medicines, natural goods, and industrial chemicals. Chemists' imaginations have always been piqued because of this. In general, the Mannich reactions can be used as part of a tandem reaction sequence to produce complex target molecules in an elegant and often easy manner. The following article examines and summarizes methods for synthesizing Mannich derivatives, in addition to offering a survey of recent advancements in several fields’ applications of the Mannich reaction, such as biological applications, antimicrobial activity, anticancer activity, anti-inflammation and antio
... Show MoreSpinal dysraphism is the incomplete fusion of the neural arch, which can be seen as an occult or open neural tube defect. Meningoceles are a form of open neural tube defect characterized by cystic dilatation of the meninges containing cerebrospinal fluid without the involvement of neural tissue. Neurosurgical intervention is necessary in the newborn period since survival in advancing ages is often impossible. Therefore, meningoceles are rarely reported in adulthood. Here, we discussed a case of a 23-year-old female who presented with a meningocele in the lumbosacral area since birth, which had not been operated on. Surgical management and intraoperative findings are also discussed.
Four different spectrophotometric methods are used in this study for the determination of Sulfamethoxazole and sulfanilamide drugs in pharmaceutical compounds, synthetic samples, and in their pure forms. The work comprises four chapters which are shown in the following: Chapter One: Includes a brief for Ultraviolet-Visible (UV-VIS) Absorption spectroscopy, antibacterial drugs and sulfonamides with some methods for their determination. The chapter lists two methods for optimization; univariate method and multivariate method. The later includes different types, two of these were mentioned; simplex method and design of experiment method. Chapter Two: Includes reaction of the two studied drugs with sodium nitrite and hydrochloric acid for diazo
... Show MoreAlthough renewable energy systems have become an interesting global issue, it is not continuous either daily or seasonally. Latent heat energy storage (LHES) is one of the suitable solutions for this problem. LHES becomes a basic element in renewable energy systems. LHES compensate for the energy lack when these systems are at low production conditions. The present work considered a shell and tube LHES for numerical investigation of the tube rotation influence on the melting process. The simulation and calculations were carried out using ANSYS Fluent software. Paraffin wax represents the phase change material (PCM) in this work, while water was selected to be the heat transfer fluid (HTF). The calculations were carried o
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