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.
The adsorption of Cr (VI) from aqueous solution by spent tea leaves (STL) was studied at different initial Cr (VI) concentrations, adsorbent dose, pH and contact time under batch isotherm experiments The adsorption experiments were carried out at 30°C and the effects of the four parameters on chromium uptake to establish a mathematical model description percentage removal of Cr (VI). The
analysis results showed that the experimental data were adequately fitted to second order polynomial model with correlation coefficients for this model was (R2 = 0.9891). The optimum operating parameters of initial Cr (VI) concentrations, adsorbent dose, pH and contact time were 50 mg/l, 0.7625 g, 3 and 100 min, respectively. At these conditions, th
The insulation system of a machine coil includes several layers made of materials with different characteristics. The effective insulation design of machine coils, especially in the machine end winding, depends upon an accurate model of the stress grading system. This paper proposes a modeling approach to predict the transient overvoltage, electric field, and heat generation in machine coils with a stress grading system, considering the variation of physical properties in the insulation layers. A non-uniform line model is used to divide the coil in different segments based on material properties and lengths: overhang, stress grading and slot. The cascaded connection of chain matrices is used to connect segments for the representation of the
... Show MoreTotal quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be addressed and find ways to avoid them in the future when repeated. &n
... Show MoreCocoon of larva
Two Schiff base ligands L1 and L2 have been obtained by condensation of salicylaldehyde respectively with leucylalanine and glycylglycine then their complexes with Zn(II)were prepared and characterized by elemental analyses , conductivity measurement , IR and UV-Vis .The molar conductance measurement indicated that the Zn(II) complexes are 1:1 non-electrolytes. The IR data demonstrated that the tetradentate binding of the ligands L1 and L2 . The in vitro biological screening effect of the investigated compounds have been tested against the bacterial species Staphlococcus aureus, Escherichia coil , Klebsiella pneumaniae, Proteus vulgaris and Pseudomonas aeruginosa by the disc diffusion method . A comparative study of inhibition values of
... Show MoreBackground: Cardiovascular disease (CVD) is an important complication of type 2 diabetes mellitus (T2DM). Oxidative stress plays a major role in the development of CVD. Saliva has a diagnostic properties aiding in the detection of systemic diseases. This study aimed to assess the association between salivary oxidative stress markers and the risk of vascular disease (VD) in T2DM patients. Materials and Methods: One hundred T2DM patients and fifty apparently healthy males were enrolled in this study. Saliva sample was collected for assessment of oxidative stress markers including: lipid peroxidation plasma thiobarbituric acid-reactive substances (TBARS), uric acid (UA) and total antioxidant capacity (TAC) levels. Arterial stiffness index (ASI
... Show MoreAgility is considered an important motor ability for assistant referees and it is vital for passing modern tests issued in September 2016. The researcher used the experimental method. The subjects were (10) referees; four of them for pilot study. The experimental group followed the exercises designed by the while the controlling group used the traditional exercises followed by the refereeing committee. All referees were tested the standardized agility test issued by the FIFA. The researchers concluded that agility plays a vital role in developing some refereeing skill. Finally they recommend developing agility for improving refereeing skills.