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.
Long-term use of sulfonylureas including chlorpropamide, is known to potentiate the antidiuretic action of arginine vasopressin (AVP), predisposing to hyponatremia.The present study was designed to evaluate the effect of long term use of glibenclamide on serum and urinary levels of sodium and potassium in Type 2 DM patients in Iraqi DM centers. Ninety eight patients with Type 2 DM who were maintained on different doses of glibenclamide for at least 1 year, attending the centre for Diabetes and Endocrinology in Al-Rusafa, Baghdad, were enrolled in the study, in addition to 15 normal healthy subjects. Patients were allocated into three groups according to the dose of glibenc
... Show MoreBackground Direct-acting antivirals (DAAs) combination therapies from various mechanisms of action and families have been revolutionized the management landscape of chronic hepatitis C virus (HCV). Ombitasvir, paritaprevir with ritonavir (OBV/PTV/r) ± ribavirin (RBV) is approved to treat HCV genotype 4 (GT4) infection. Here, our objective was to delineate the efficacy and safety of OBV/PTV/r plus RBV in treating of Egyptian naïve patients infected with HCV GT4.
Methods a cohort of 100 Egyptian patients infected with HCV GT4 was allocated and administered orally OBV/PTV/r with RBV. The primary endpoint of our study was a sustained virological response (HCV RNA < 12 IU/mL) 12 weeks after the c
... Show MoreRheumatoid arthritis is an autoimmune diseasecharacterized by chronic inflammationthat affects joints and cartilage. Bone complications such asRA-relatedosteoporosis are one of the most extra-articular manifestations. Many inflammatory mediators are released during RA disease pathophysiology; these mediators stimulate osteoclast genesis of bone by direct effects on RANKL and OPG. The study aimedto measure RANKL, OPG in RA patients treated with Etanercept only and other groups treated with Methotrexate onlyat baseline and after three months to evaluate bone state. An observational case-control prospective study was done on 30 RA patients who received MTX, 30 RA patients who received ETN, and 30 healthy,age-matched control groups. The
... Show MoreBackground: Insulin resistance is present in 50% or more of patients with primary hypothyroidism. Metformin can decrease TSH levels in these patients by a complex matter, this can be of great help in clinical practice.
Objective: This study was designed to evaluate the effect of metformin in reducing TSH levels in patients with primary hypothyroidism.
Methods: Hundred patients with primary hypothyroidism, 82 females, 18 males were included in this study, everyone was followed up for two months after adding metformin 850 mg twice daily in addition to thyroxin.
Results: 36 patients (36%) have a normal baseline TSH and no change after 2 months, 64 pa
... Show MoreIdentify the effect of an educational design according to the repulsive (allosteric) learning model on the achievement of chemistry and lateral thinking. The sample consisted of (59) students from third-grade intermediate students. They were randomly distributed into two groups (experimental and control), and the equivalence was done in (chronological age, previous achievement in chemistry, intelligence, lateral thinking). The (30) students from experimental group were taught according to the instructional design, other 29 students from the (control) group were taught according to the usual method. Two tests done, one of them is an achievement test consisted of (30) items of the type of multiple choice, the other was a lateral think
... Show MoreThis research deals with leverage and its impact on the profitability of Islamic banks in Iraq for the years (2015-2018), the research variables of leverage have been analyzed and measured as an independent variable, profitability as a dependent variable, and the research is based on a main hypothesis: there is a moral relationship of statistical significance. Between leverage and profitability at The Islamic Cooperation Bank for the period (2015-2018). The results of the research showed that there are moral (exorcist) relationships between the ratio of leverage and profitability indicators, as the higher the leverage ratio, the higher the profitability indicators. In addition, The Islamic Cooperation Bank has adopted a conservative poli
... Show MoreThe research has deal with the relationship between organizational justice and empowerment and their impact on the achievement of organizational commitment in the office of Labour and Vocational Training. To study the research problem which is represented a sense that employees with low levels of organizational justice and empowerment and the reflection on the organizational commitment of the employees, so that Has been collecting data and information relating to research by designing a questionnaire, were distributed to a sample of (50) people in the office mentioned, and the results of the study to confirm the research hypotheses. and the key results of the research was the presence of correlation relationships and the effect o
... Show MoreThis research aims to know the effect of the strategy of map bubbles on developing the skills of science operations among 5th grade literary students in the subject of rhetoric and application, and the design of the experimental and control groups with the pre and post-tests was used. The research sample consisted of (50) students divided into two groups, an experimental group of which reached the number of its members is (25) students and studied using the strategy of map bubbles, and a control group of its members reached (25) students and studied in the traditional (standard) method. The researchers prepared a multiple-choice achievement test with several (30) paragraphs, and its validity and consistency were extracted. Then the test was
... Show MoreThe agricultural lands that depend on supplementary irrigation methods for winter wheat cultivating in wide areas of the Nineveh province are most vulnerable to climate change concerns. Due to frequent rainfall shortages and the temperature increase recently noticed and predicted by the climate scenarios. Hence important to assess the climate effect on the crop response in terms of water consumption during the periods (2021-2040) and (2041-2060) by using high-resolution data extracted from 6 global climate data GCMs under SSP5-8.5 fossil fuel emission scenarios in changing and fixed CO2 concentration. And validate the Aqua-Crop model to estimate the yield and water productivity. And gives the RRSME of 7.1- 4.1
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