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.
This paper presents the design and analysis of composite right left hand (CRLH) electromagnetic bandgap (EBG) structure. The proposed unit cell is consistent of a dielectric substrate with dimensions of 5×5×1 mm 3 made of FR4-Epoxy with εr = 4.4 underneath of a conductive patch with dimensions of 4.4×4.4mm 2 . The unit cell is structured to perform a negative permittivity (ε) and negative permeability (µ) in different bands. The proposed unit cell is developed to 5G systems in the sub-6GHz bands. In this work, a complete analysis of the unit cell in terms of Sparameters, constitutive parameters and refraction index are evaluated using HFSS simulation package based on Finite Element Method (FEM).
In this paper, the effect of wear in the fluid film journal bearings on the dynamic behavior of rotor bearing system has been studied depending on the analytical driven of dynamic stiffness and damping coefficients of worn journal bearing. The finite element method was used to modeling rotor bearing system. The unbalance response, critical speed and natural frequency of rotor bearing system have been studied to determine the changes in these parameters due to wear. MATLAB software was used to find the analytical values of dynamic coefficients of journal bearing. The results of rotor mounted on fluid film journal bearings showed that the wear in journal bearing increases the amplitude of unbalance response and decrease critical speed, sta
... Show MoreBackground: The need of the patient for a more reasonable esthetic orthodontic intervention has risen nowadays. Thus, orthodontists make use of esthetic orthodontic materials like brackets, ligature elastics, and arch wires. The esthetic brackets come as different forms of materials, such as ceramic brackets, which have their stainability remaining as the most important consideration for the patients and the orthodontists. This study aimed to compare the staining effects of various staining materials, including black tea, cigarette smoke and Pepsi, as well as the time effect on the color stability of sapphire ceramic brackets bonded with three kinds of light cure orthodontic adhesives: Transbond, Resilience and Enlight. Materials and Met
... Show MoreAmong several separation processes, the air flotation distinguish as remarkably high potential separation process related to its high separation efficiency and throughput, energy-efficient, simple process, cost-effective, applicable to a wide range of oily wastewater and no by-products. The current study aimed to investigate the effect of the type and concentration of surfactant on the stability of oil-water emulsion and efficiency of the separation process. For this purpose, three types of surfactant where used (anionic SDS, mixed nonionic Span 85/Tween 80, and cationic CTAB). The results demonstrated that the Span 85/Tween 80 surfactant has the best stability, and it increases with the surfactant concentration augmentation. The removal ef
... Show MoreAbstract:
Viral marketing has become one of the modern strategies adopted by organizations in the marketing of products and services. The idea of viral marketing focuses on the social relations between individuals and groups. As a result of the technological development, most organizations have resorted to using the Internet and its applications and social media to market and promote their products. To reach the largest number of consumers to display their products and services in many ways, including text, audio, visual or video and thus affect the behavior of the consumer.
The problem of the study was the following question (do viral marketing technologies have an impact on consumer behavior?)
... Show MoreIsolation of fungi was performed from February to July, 2019. One hundred clinical specimens were collected from King Abdullah Hospital (KAH) Bisha, Saudi Arabia. Samples were collected from twenty patients of different ages (30 - 70 years old) ten males and ten females. The samples were collected from patients with the two types of diabetics. Specimens included blood, hair, nail, oral swabs and skin. Specimens were inoculated on Sabourauds Dextrose agar containing chloramphenicol. Thirteen fungal species were isolated and identified. The isolated species were: Aspergillus flavus, A. niger, A. terrus, A. nidulans, A. fumigatus, Candida albicans, C. krusei, C. parapsilosis, C. Tropicalis, Curvularia lunata, Fusarium solani, Penicill
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