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.
Abstract
In this paper presents two dimensional turbulent flow of different nanofluids and ribs configuration in a circular tube have been numerically investigation using FLUENT 6.3.26. Two samples of CuO and, ZnO nanoparticles with 2% v/v concentration and 40 nm as nanoparticle diameter combined with trapezoidalribs with aspect ratio of p/d=5.72 in a constant tube surface heat flux were conducted for simulation. The results showed that heat flow as Nusselt number for all cases raises with Reynolds number and volume fraction of nanofluid, likewise the results also reveal that ZnO with volume fractions of 2% in trapezoidal ribs offered highest Nusselt number at Reynolds number of Re= 30000.
Key
... Show MoreThe presence of residual antibiotics in water results in the development of antibiotics resistant genes. The available wastewater treatment systems are not capable of removing such antibiotics from sewage. Thus, antibiotics need to be removed before the discharge of wastewater. Adsorption is among the promising techniques for the wastewater treatment to aid the removal of a wide range of organic and inorganic pollutants. The present work is a contribution to the search for an economical method for the removal of low concentrations of amoxicillin (AMX) from water by adsorption on water treatment residue, WTR, taken from a local drinking water facility. The chemical composition and the adsorptive characteristics of the material were first
... Show MoreP. aeruginosa is a famous bacterium that causes several diseases and has a high ability to be a multidrug resistant organism that is linked with the formation of biofilm. This study aimed to investigate tssC1 gene role in the resistance of different antibiotics in the presence of biofilm. We constructed biofilm for the isolates under the study and showed the effect of different antibiotics on biofilm formation and maturation. The presence of the gene was detected through achieving PCR reaction. Finally, tssC1 gene variation was determined through sequencing and aligning the sequencing products. The results showed that most of the isolates (80%) formed biofilm that played a role in the resistance of different antibiotics which could
... Show MoreThis study aimed to investigate the effect of oral administration of pomegranate seed oil on diabetic in male rabbits. A total of 32 adult male rabbits.6 months old weighting 1-2kg were divided in to four equal groups. G- Control (negative) Rabbits were received olive oil, G2- (control positive) Rabbits were received (30 mg/kg B.W/daily of the Pomegranate seed oil orally and daily for 45 day. G3-Rabbits were received (150mg/kg of Alloxan injected Intraperitonealy, G4-Rabbits were received the same dose orally of the Pomegranate seed oil four 45 days. There is significant increase (Insulin, Insulin resistance) and decreased glucose in group received Pomegranate seed oil (G4) as compared with G3 (diabetic group). On conclusion, the administra
... Show MoreThe present art icle discusses the prob lems of understanding and translating the lingu istic and cult ural aspect of a foreign lite rary text. The article considers the trans lation process through the pr ism of cult ural orientation. In the process of transl ation, the nati onal cultural iden tity should be expressed to the max imum extent, through all me ans of expre ssion that include imagery and inton ation. In addi tion to the author's sty le, special atte ntion should al so be pa id to tro pes, phraseological uni ts, colloquial wo rds and dial&n
... Show MoreThe internet of medical things (IoMT), which is expected the lead to the biggest technology in worldwide distribution. Using 5th generation (5G) transmission, market possibilities and hazards related to IoMT are improved and detected. This framework describes a strategy for proactively addressing worries and offering a forum to promote development, alter attitudes and maintain people's confidence in the broader healthcare system without compromising security. It is combined with a data offloading system to speed up the transmission of medical data and improved the quality of service (QoS). As a result of this development, we suggested the enriched energy efficient fuzzy (EEEF) data offloading technique to enhance the delivery of dat
... Show More