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.
Background: Malnutrition in human life may adversely affect various aspects of growth at different stages of life. Teeth are particularly sensitive to malnutrition. Malnutrition may affect odontometric measurement involving tooth size dimensions. The aim of this study is to estimate the effect of nutrition on teeth size dimension measurements among children aged 5 years old. Materials and methods: This study was conducted among malnourished group in comparison to well-nourished group matching with age and gender. The present study included 158 children aged 5 years (78 malnourished and 80 well-nourished). The assessment of nutritional status was done by using three nutritional indicators, namely Height-for-age, Weight-for-age and Weight-fo
... Show MoreThe compliance is considered
This study aimed to deduce the net atrioventricular compliance which is affected the trans mitral blood flow.
This study focuses on study group of 25 patients (15 males
BACKGROUND: Idiopathic immune thrombocytopenia purpura is an autoimmune bleeding disorder that accounts for approximately one-third of clinical hemorrhagic diseases. Pathophysiologically, it involves a complicated imbalance in the immune system. OBJECTIVES: This study focuses on evaluating the levels of the immunomodulatory cytokines interleukin (IL)-35, interleukin-10, and transforming growth factor-β (TGF)-β in patients with refractory idiopathic immune thrombocytopenia undergoing treatment with romiplostim. MATERIALS AND METHODS: A cross-sectional study encompassed 78 individuals with idiopathic immune thrombocytopenia and conducted measurements of different immunomodulatory cytokines in response to different responses of idiopath
... Show MoreBackground: Moral distress, as one of the most important issues in the nursing profession, can negatively affect the healthcare system. Purpose: To examine the effect of moral distress on professional quality work life. Method: A descriptive cross-sectional study a non-probability sampling method used and total sample collected was (126) of ICU nurses. Results: Moral distress, BO, STS, and, CS among ICUs nurses were moderate. Conclusion: Nurses in ICUs suffered from moderate MD which that effected their BO and STS, and the result can be negative effects on quality of care. Although MD did not affect nurses' CS, it is still an important issue that nurses may face in ICUs
It is no secret to everyone that the Arab individual suffers from poor self-awareness and political awareness, which made the state and the importance of its existence and preserving its institutions not among his interests, which made researchers wonder about the possibility of strengthening it and the extent of its impact on the future of building the contemporary Arab state. So, the study attempts to addressing the issue of community awareness and its impact on building the state through a clear intellectual vision that blended what is social and political to define the concept of community awareness and highlight its importance and role as a basic pillar in shaping and building modern Arab countries in the Arab world and ways to enha
... Show MoreThe current study is based on previous findings, where corporate governance (CG) significantly increased corporate social responsibility (CSR) to enhance transparency while reducing the tendency of corporate management to engage in earnings management (EM). A sample of 11 Iraqi banks listed on the Iraq Stock Exchange from 2010 to 2020 was selected. The CG was included in the board size and board independence apart from the variables of Chief Executive Officer (CEOs) gender, majority shareholder ownership, foreign ownership, and institutional ownership. The CSR included the wage growth rate, bank contribution growth rate for social security, training programmes, subsidies, environmental protection, and bank compliance with the law. Specifica
... Show MoreDespite the importance of sustainable development and its dimensions in developing performance and supporting competitive advantage in economic units, there is a gap and lack of coordination between Combined Assurance providers (management, internal audit, external audit) to report on sustainable development, and the research aims to propose a model for the Combined Assurance report to achieve development sustainable development in the Iraqi economic units, especially the Baghdad Municipality, enables assurance providers to coordinate efforts that lead to the achievement of Combined Assurance, The research found the proposed model for the Combined Assurance report in achieving sustainable development in the Iraqi economic units, es
... Show MoreCytokine storms are an excessive immune response triggered by severe viral infections, such as SARS-CoV2. Toll-like receptor 4 (TLR-4) is a key player in these storms. Secondary and co-infections can exacerbate the immune response, leading to amplified cytokine release and potentially severe disease outcomes. This review aims to evaluate the expression of TLR-4 in fungal and bacterial infections that are associated with and secondary to SARS-CoV2. The study collected specimens from 70 patients admitted to a Baghdad hospital’s ICUs and 35 healthy controls, aged 15-80 years, from June 2022 to April 2023. Re¬al-time RT-PCR was used for infection detection, while conventional methods were used to isolate patho¬genic microorganisms a
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