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: Chronic periodontitis is an inflammatory disease that affects the supporting tissues of the teeth and it’s common among adults. Smoking is an important risk factor for periodontitis induces alveolar bone loss. Alkaline phosphatase enzyme is involved in the destruction of the human periodontium. It is produced by many cells such as polymorphonuclear leukocytes, osteoblasts, macrophages and fibroblasts within the area of the periodontium and gingival crevice. Osteocalcin is one of the most abundant matrix proteins found in bones and the only matrix protein synthesized exclusively there. Smaller Osteocalcin fragments are found in areas of bone remodeling and are actually degradation products of the bone matrix.The purpose of
... Show MoreObjectives: A cross sectional analytic study was carried out to identify the maternal risk factors which
contribute to occurrence of low birth weight, and to determine the statistical significant differences between low
birth weight and maternal risk factors.
Methodology: A purposive sample of (400) woman was selected from AL-Elwyia Maternity Teaching Hospital
and Fatima Al-Zaharia Maternity and Pediatric Teaching Hospital. Data was collected through the interview of
mothers. Questionnaire format was designed and consisted seven parts, demographic variables, and reproductive
variables , Reproductive health variables, complications during the current pregnancy, the mother newborn
variables nutritional status for the m
Directional Compact Geographic Forwarding (DCGF) routing protocol promises a minimal overhead generation by utilizing a smart antenna and Quality of Service (QoS) aware aggregation. However, DCGF was tested only in the attack-free scenario without involving the security elements. Therefore, an investigation was conducted to examine the routing protocol algorithm whether it is secure against attack-based networks in the presence of Denial-of-Service (DoS) attack. This analysis on DoS attack was carried out using a single optimal attacker, A1, to investigate the impact of DoS attack on DCGF in a communication link. The study showed that DCGF does not perform efficiently in terms of packet delivery ratio and energy consumption even on a sin
... Show MoreThis study investigated the impact of lime stabilization on the fate and transformation of AgNPs. It also evaluated the changes in the population and diversity of the five most relevant bacterial phyla in soil after applying lime-stabilized sludge containing AgNPs. The study was performed by spiking an environmentally relevant concentration of AgNPs (2 mg AgNPs/g TS) in sludge, applying lime stabilization to increase pH to above 12 for two hours, and applying lime-treated sludge to soil samples. Transmission electron microscopy (TEM) and energy-dispersive X-ray spectroscopy (EDS) were used to investigate the morphological and compositional changes of AgNPs during lime stabilization. After the application of lime stabilized sludge to
... Show MoreObjectives: Maxillofacial silicone is used to restore abnormalities due to congenital or acquired causes. However, the quality of silicone is far from ideal. This study was aimed at assessing the influence of the addition of cellulose nanofibers (CNFs; several nanometers wide and 2-5 micro m long) on the physical and mechanical characteristics of maxillofacial silicone elastomers. Methods: Two CNF weight percentages (0.5% and 1%) were tested, and 180 specimens were divided into one control and two experimental groups. Each group was subdivided into six subgroups. In each subgroup, ten specimens subjected to each of the following tests: tearing strength, Shore-A hardness, tensile strength, elongation percentage, surface roughness, and color
... Show MoreGiven the paucity and toxicity of available drugs for leishmaniasis, coupled with the advent of drug resistance, the discovery of new therapies for this neglected tropical disease is recognised as being of the utmost urgency. As such antimicrobial peptides (AMPs) have been proposed as promising compounds against the causative Leishmania species, insect vector-borne protozoan parasites. Here the AMP temporins A, B and 1Sa have been synthesised and screened for activity against Leishmania mexicana insect stage promastigotes and mammalian stage amastigotes, a significant cause of human cutaneous disease. In contrast to previous studies with other species the activity of these AMPs against L. mexicana amastigotes was low. This suggests that ama
... Show MoreBackground and objectives: This study aimed at testing the effect of plastic sleeve or barrier, used to cover the guide of the light cure unit to prevent cross-infection, on the shear bond strength and site of bond failure of stainless steel and ceramic orthodontic brackets. Materials and methods: Forty orthodontic brackets; twenty stainless steel and twenty ceramic brackets bonded to forty extracted human maxillary first premolars using light cure adhesive cured with and without the use of a protective plastic barrier on the guide. Comparing the effect of this barrier on the shear bond strength and adhesive remnant index was performed using an independent t-test and Chi-square test. Results: The protective barrier had decreased the shear b
... Show MoreThe significance of the research conducted in northern Iraq comes despite the expansion of afforestation projects; yet, the suffering of the forests has increased due to their lack of scientific study, unpredictability of the climate, and adverse effects on the spread and growth of plant species Therefore, the goal of the study is to understand the effects of afforestation through a statistical analysis of plant diversity in northern Iraq and its distinctivenessThe analysis revealed that natural groupings had improved qualitatively more than other groups, particularly some dwindling species that are able to compete and occupy new areas. drought-prone vegetation, vegetation, and climat