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.
Spinal 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 MoreBackground: The study aim was to evaluate thermocycling effect on microleakage of occlusal and cervical margins of MOD cavity filled with bulk filled composites in comparison to incrementally placed nanohybrid composite and to evaluate the difference in microleakage between enamel and dentin margins for the three materials groups. Materials and method: Forty eight maxillary first premolars were prepared with MOD cavities. Samples were divided into three groups of sixteen teeth according to material used: Grandio: Grandio. SDR: SDR +Grandio. X-tra: X-tra base + Grandio. Each group was subdivided into two according to be thermocycled or not. After 24 hrs immersion in 2% methylene blue, samples weresectioned and microleakage was estimated. Res
... Show MoreMolar conductance (Λ) of ionizable side chains amino acids, lysine (Lys) and arginine (Arg) with dehydroascorbic acid (DHA) in water and in NaCl solutions was measured at temperatures range 298 K to 313 K. The limited molar conductance (Λo) and the constant of the ions association (KA) are calculated using the Shedlovsky techniques. The dynamic radius of the concerned ion (R) is calculated by used Stokes–Einstein relation. The heat of association, the Gibbs free energy, the change of entropy and activation energy (ΔHo/ kJ mol-1, ΔGo/ kJ mol-1, ΔSo/J K-1 mol-1, and ΔES/ kJ mol-1) respectively), also calculated. The data show increases the molar conductance with increas
... Show MoreIn this research, radon concentrations in some types of healthy drinking water samples available in Iraq's market were measured using a technique called Durridge RAD-7-H2O with closed loop. Then the rate of annual effective dose in human taken this water is determined.
It was found that, radon concentrations in studied samples ranged between 1.2 Bq.m-3 to 142 Bq.m-3. The results of the radon concentrations and the rate of annual effective dose for drinking water samples were significantly lower than the USEPA and WHO recommended limits that equal 500 Bq/m3 and 1 mSv/y resp
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This research aims to compare Bayesian Method and Full Maximum Likelihood to estimate hierarchical Poisson regression model.
The comparison was done by simulation using different sample sizes (n = 30, 60, 120) and different Frequencies (r = 1000, 5000) for the experiments as was the adoption of the Mean Square Error to compare the preference estimation methods and then choose the best way to appreciate model and concluded that hierarchical Poisson regression model that has been appreciated Full Maximum Likelihood Full Maximum Likelihood with sample size (n = 30) is the best to represent the maternal mortality data after it has been reliance value param
... Show MoreThe heavy metal cadmium is extremely harmful to both humans and animals. Zinc supplementation protects the biological system and reduces cadmium-induced toxicity. This study aimed to determine whether zinc chloride (ZnCl2) could protect male mice with the damaged liver induced by cadmium chloride (CdCl2). The protective role of zinc chloride and expression of the metallothionein (MT), Ki-67, and Bcl-2 apoptotic proteins in hepatocytes were studied after subchronic exposure of mice to cadmium chloride for 21 days. Thirty male mice were randomly categorized into 6 groups (5 mice/group) as follows: a control group that did not receive any treatment, a group given ZnCl2 at 10 mg/kg alone, and two groups received ZnCl2 (10 mg/kg) i
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The grey system model GM(1,1) is the model of the prediction of the time series and the basis of the grey theory. This research presents the methods for estimating parameters of the grey model GM(1,1) is the accumulative method (ACC), the exponential method (EXP), modified exponential method (Mod EXP) and the Particle Swarm Optimization method (PSO). These methods were compared based on the Mean square error (MSE) and the Mean Absolute percentage error (MAPE) as a basis comparator and the simulation method was adopted for the best of the four methods, The best method was obtained and then applied to real data. This data represents the consumption rate of two types of oils a he
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