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, numerical and experimental studies on the elastic behavior of glass fiber reinforced polymer (GFRP) with stiffeners in the GFRP section's web (to prevent local buckling) are presented. The GFRP profiles were connected to the concrete deck slab by shear connectors. Two full-scale simply supported composite beams (with and without stiffeners) were tested under impact load (three-point load) to assess its structural response. The results proved that the maximum impact force, maximum deflection, damping time, and damping ratio of the composite beam were affected by the GFRP stiffeners. The experimental results indicated that the damping ratio and deflection were diminished compare
... Show MoreAlO-doped ZnO nanocrystalline thin films from with nano crystallite size in the range (19-15 nm) were fabricated by pulsed laser deposition technique. The reduction of crystallite size by increasing of doping ratio shift the bandgap to IR region the optical band gap decreases in a consistent manner, from 3.21to 2.1 eV by increasing AlO doping ratio from 0 to 7wt% but then returns to grow up to 3.21 eV by a further increase the doping ratio. The bandgap increment obtained for 9% AlO dopant concentration can be clarified in terms of the Burstein–Moss effect whereas the aluminum donor atom increased the carrier's concentration which in turn shifts the Fermi level and widened the bandgap (blue-shift). The engineering of the bandgap by
... Show MoreVariation orders are an on-going phenomenon in construction and industry projects worldwide, particularly in the province of Sulaimani, where the project's damage from cost and schedule overrun because of variation orders. However, the effect on project costs and time overrun of variation order has yet to be identified. This study evaluates the impact of variation orders on the cost and time off in the Sulaimani governorate. Two hundred twenty-eight projects from various construction sectors built between 2007-2012 were adopted to calculate the contract cost and schedule overruns due to variation orders. Data analysis was applied in the study were descriptive statistics. One-way ANOVA was also applied to determine w
... Show MoreBackground: Juvenile idiopathic arthritis (JIA) is a chronic disease of childhood. Increased prevalence of periodontal disease and dental caries in juvenile idiopathic arthritis is due to difficulties in executing good oral hygiene. This study was conducted to assess oral health status in patients with Juvenile idiopathic arthritis according to age and duration of illness. Materials and methods: A research was conducted among Juvenile idiopathic arthritis patients attending Baghdad Teaching Hospital with different age and both gender, underwent a clinical evaluation of their dental and oral condition. Diagnosis of dental caries was done according to the criteria of WHO (1997). Dental plaque, gingival condition, calculus were assessed by PI/
... Show MoreSemiconductor-based photocatalytic processes are widely applied as ecofriendly technology for degrading organic pollutants. Establishing photocatalytic heterojunctions with Z-type photocarriers transfer pathways is projected to be a superb strategy to enhance photocatalytic behavior. In this paper, novel and stable (0D/2D) heterojunctions of CoS-embedded boron-doped g-C3N4 (CoS/BCN) with a high rate of charges transfer/separation were assembled for degradation of malachite green dye (MG). The CoS/BCN photocatalyst achieves a photodegradation efficiency of 96.9 % within 1 h of LED illumination, which is 2.5 and 1.4-fold enhancement compared with bare g-C3N4 and BCN, respectively. Besides, the results of species-trapping trials exhibited that
... Show MoreBackground: The study was designed for the assessment of the knowledge of medical students regarding pandemics. In the current designed study, the level of awareness was checked and the majority of students were found aware of SARS-CoV and SARS-Cov2 (Covid-19).
Objective: To assess the awareness of SARS-CoV and SARS-Cov2 (Covid-19) among medical students of Pakistan.
Subjects and Methods: A cross-sectional survey was carried out in different universities of Pakistan from May to August 2020. A self-constructed questionnaire by Pursuing the clinical and community administration of COVID-19 given by the National Health Commission of the People's Republic of China was used am
... Show MoreForm recurrence of financial crises phenomenon disturbing and attention , and returns the reasons so that its negative effects were sharp and dangerous , because of the nature and cause of Ncaha , threatened political and economic stability of the countries in which they occur these crises , in addition to Machmlh these crises spread of contagion across multiple channels to include other countries many developed and developing , and the reason for this to the openness of the economic and financial witnessed by the countries affected by crises and other countries concerned, the financial crisis is a case of financial turmoil appears in one of the sections of the financial system one and extends to
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The current research aims to demonstrate the relationship of correlation and influence between the independent variable strategic control through its dimensions represented by (organizational structure, human resources management, commitment to specialization, defining powers and responsibilities, values and integrity) and the dependent variable the performance of the insurance company, and the degree of arrangement of these dimensions according to their importance, as well as Detection of significant differences in the sample's response to the questionnaire paragraphs in the researched company, and the research problem
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The research dealt with a studying the impact of oil price fluctuations on one of the rules of financial discipline, which is the rule of budget deficit in the Iraqi economy for the period (2003-2020) as it is one of the quarterly economies that rely mainly on volatile oil revenues that fluctuate with oil prices in global markets, and therefore the general budget suffers. from The state of instability and then the government resorts to borrowing for a long time . this deficit in the general budget and increase the debt burden in the public debt.The research aim to measure and study the impact of oil price flu
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