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.
By optimizing the efficiency of a modular simulation model of the PV module structure by genetic algorithm, under several weather conditions, as a portion of recognizing the ideal plan of a Near Zero Energy Household (NZEH), an ideal life cycle cost can be performed. The optimum design from combinations of NZEH-variable designs, are construction positioning, window-to-wall proportion, and glazing categories, which will help maximize the energy created by photovoltaic panels. Comprehensive simulation technique and modeling are utilized in the solar module I-V and for P-V output power. Both of them are constructed on the famous five-parameter model. In addition, the efficiency of the PV panel is established by the genetic algorithm
... Show MoreBackground: Polycystic ovary syndrome is a heterogeneous disorder and its etiology appears to be complex and multifactorial; characterized by hyperandrogenism, chronic anovulation and infertility. It’s associated with evidence of low-grade chronic inflammation, as indicated by the presence of elevated levels of high sensitive C- reactive protein levels, interleukin-6 and tumor necrosis factor-α. The source of excess circulating tumor necrosis factor-α in obese Polycystic ovary syndrome patient is likely to be the adipose tissues while in lean women increased visceral adiposity has been proposed as a source of excess tumor necrosis factor-α.Objectives: to evaluate the levels of high sensitive C- reactive protein, tumor necrosis facto
... Show MoreAccurate calculation of transient overvoltages and dielectric stresses from fast-front excitations is required to obtain an optimal dielectric design of power components subjected to these conditions, which are commonly due to switching and lightning, as well as utilization of power-electronic devices. Toroidal transformers are generally used at the low voltage level. However, recent investigations and developments have explored their use at the medium voltage level. This paper analyzes the model-based improvement of the insulation design of medium voltage toroidal transformers. Lumped and distributed parameter models are used and compared to predict the transient response and dielectric stress along the transformer winding. The parameters
... Show MoreObjective(s): This study aims to assess health related quality of life among Iraqi patients with chronic viral hepatitis
B and C also to find out the relationship between health related quality of life and patients demographic
characteristic and to design a new measurement scale for assessing QoL among viral hepatitis B and C patients
which can be suitable to be adopted for Iraqi patients
Methodology: A descriptive quantitative study is carried out at Gastroenterology and Hepatology Teaching
Hospital from February, 1st, 2011 to August 30th 2011, Anon probability (purposive sample) of (100) chronic viral
hepatitis B and C persons , who were clients of Gastroenterology and Hepatology Teaching Hospital / outpatient
clin
Cu X Zn1-XO films with different x content have been prepared by
pulse laser deposition technique at room temperatures (RT) and
different annealing temperatures (373 and 473) K. The effect of x
content of Cu (0, 0.2, 0.4, 0.6, 0.8) wt.% on morphology and
electrical properties of CuXZn1-XO thin films have been studied.
AFM measurements showed that the average grain size values for
CuXZn1-xO thin films at RT and different annealing temperatures
(373, 473) K decreases, while the average Roughness values increase
with increasing x content. The D.C conductivity for all films
increases as the x content increase and decreases with increasing the
annealing temperatures. Hall measurements showed that there are
two
The complete genome sequence of bacteriophage VPUSM 8 against O1 El Tor Inaba
SnS has been widely used in photoelectric devices due to its special band gap of 1.2-1.5 eV. Here, we reported on the fabrication of SnS nanosheets and the effect of synthesis condition together with heat treatment on its physical properties. The obtained band gap of the SnS nanosheets is in the rage of 1.37-1.41 eV. It was found that the photo-current density of a thin film comprised of SnS nanosheets could be enhanced significantly by annealing treatment. The maximum photo-current density of the stack structure of FTO/SnS/CdS/Pt was high as 389.5 mu A cm(-2), rendering its potential application in high efficiency solar hydrogen production.
Fluconazole was used to test the susceptibility of Candida albicans isolated from different clinical samples, and to detect mutations in ERG11 gene, and their relationship to fluconazole resistance. Forty-eight isolates of Candida albicans were tested for susceptibility using the disc diffusion method (M-44). ERG11 genes of six isolates were amplified (four resistant, two susceptible) and sequenced. The sequenced genes were analyzed to detect the mutations. Out of 48 isolates of Candida albicans, 4 (8%) were resistant to fluconazole. Sixteen-point mutations were detected included 13 silent mutations, and three missense mutations. The mutations of A945C (E266D) and G1609A (V488I) were found only in susceptible Candida albicans isolates, whil
... Show MoreBackground: tooth debonding was one of the major reasons for denture repair. With the use of recently introduced thermoplastic denture base materials the problem of tooth debonding increased due to the nature of the bond between these materials and the acrylic teeth. This study was aimed to assess the bond of the acrylic teeth to conventional heat cure acrylic resin and to thermoplastic resin denture base material and methods to enhance it. Materials and methods: acrylic resin teeth were bonded to heat cure acrylic resin with and without wetting the ridge laps of the teeth with monomer and acrylic teeth with prefabricated retentive holes, unmodified and modified, in their ridge laps were processed with Valplast thermoplastic resin denture b
... Show MoreOne of the serious problems in any wireless communication system using multi carrier modulation technique like Orthogonal Frequency Division Multiplexing (OFDM) is its Peak to Average Power Ratio (PAPR).It limits the transmission power due to the limitation of dynamic range of Analog to Digital Converter and Digital to Analog Converter (ADC/DAC) and power amplifiers at the transmitter, which in turn sets the limit over maximum achievable rate.
This issue is especially important for mobile terminals to sustain longer battery life time. Therefore reducing PAPR can be regarded as an important issue to realize efficient and affordable mobile communication services.
... Show More