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 article presents the results of an experimental investigation of using carbon fiber–reinforced polymer sheets to enhance the behavior of reinforced concrete deep beams with large web openings in shear spans. A set of 18 specimens were fabricated and tested up to a failure to evaluate the structural performance in terms of cracking, deformation, and load-carrying capacity. All tested specimens were with 1500-mm length, 500-mm cross-sectional deep, and 150-mm wide. Parameters that studied were opening size, opening location, and the strengthening factor. Two deep beams were implemented as control specimens without opening and without strengthening. Eight deep beams were fabricated with openings but without strengthening, while
... Show MoreEco-friendly concrete is produced using the waste of many industries. It reduces the fears concerning energy utilization, raw materials, and mass-produced cost of common concrete. Several stress-strain models documented in the literature can be utilized to estimate the ultimate strength of concrete components reinforced with fibers. Unfortunately, there is a lack of data on how non-metallic fibers, such as polypropylene (PP), affect the properties of concrete, especially eco-friendly concrete. This study presents a novel approach to modeling the stress-strain behavior of eco-friendly polypropylene fiber-reinforced concrete (PFRC) using meta-heuristic particle swarm optimization (PSO) employing 26 PFRC various mixtures. The cement was partia
... Show MorePultruded materials made of Fiber-Reinforced Polymer (FRP) come in a broad range of shapes, such as bars, I-sections, C-sections, etc. FRP materials are starting to compete with steel as structural materials owing to their great resistance, low self-weight, and cheap maintenance costs, especially in corrosive conditions. This study aims to evaluate the effectiveness of a novel concrete Composite Column (CC) using Encased I-Section (EIS) as a reinforcement in contrast to traditional steel bars by using Glass Fiber-Reinforced Polymer (GFRP) as I-section (CC-EIS) to evaluate the effectiveness of the hybrid columns which have been built by combining GFRP profiles with concrete columns. To achieve the aims of this study, nine circular co
... Show MoreKlebsiella pneumoniae has been found in the urinary tract of some bladder cancer patients. Bacterial presence within tumor tissue may affect the tumor-microenvironment and consequently influence cancer behavior, development, and treatment response. This study investigated mesenchymal and stemness transdifferentiation of bladder cancer cell line due to environmental stress of K. pneumoniae. Cultures of urothelial bladder cancer cell line (T24) were infected with K. pneumoniae with different multiplicity of infection (MOI) for two and four days. Transdifferentiation-associated features were morphologically assessed.
Moreover, transdifferentiation markers were estimated using Q-PCR and immunohistoc
... Show MoreObjective : The study was carried out to construct an initial assessment documentation tool for nursing
recording system in Coronary Care Unit.
Methodology : A descriptive, purposive sample of (65) nurses was selected from CCU of main
teaching hospitals (Al Karama, Al Kindy, Al Kadimia, Al Yarmmok, Baghdad teaching hospital, Ibn
Al Naffis hospital) and Ibn-Al betar hospital in Baghdad city from the 15th of April 2004 to the 15th of
April 2006.
The instrument was constructed and comprised of two sections: section one included the
nurses' demographic characteristic; section two was the initial assessment documentation tool that
contained (2) parts including: General information form and the initial assessment form.
In this work, pure and Ag-doped nickel oxide (NiO) thin films were deposited on glass substrates with different dopant concentrations (0.1, 0.2, 0.3 and 0.4 wt.%) by pulsed-laser deposition (PLD) technique at room temperature. These films were annealed at temperature of 450 °C. The structural and optical properties of the prepared thin films were studied. It was found that annealing process has lead to increase the transmittance of the deposited films. Also, the transmittance was found to increase with doping concentration of silver in the deposited NiO films. The optical energy gap was decreased from 3.5 to 3.2 eV as the doping concentration was increased to 0.4 %.
In the present study, the effectiveness of a procedure of electrocoagulation for removing chemical oxygen demand (COD) from the wastewater of petroleum refinery has been evaluated. Aluminum and stainless steel electrodes were used as a sacrificial anode and cathode respectively. The effect of current density (4-20mAcm−2), pH (3-11), and NaCl concentration (0-4g/l) on efficiency of removal of chemical oxygen demand was investigated. The results have shown that increasing of current density led to increase the efficiency of COD removal while increasing NaCl concentration resulted in decreasing of COD removal efficiency. Effect of pH was found to be lowering COD re
A comparative study was done on the adsorption of methyl orange dye (MO) using non-activated and activated corn leaves with hydrochloric acid as an adsorbent material. Scanning electron microscopy (SEM) and Fourier Transform Infrared spectroscopy (FTIR) were utilized to specify the properties of adsorbent material. The effect of several variables (pH, initial dye concentration, temperature, amount of adsorbent and contact time) on the removal efficiency was studied and the results indicated that the adsorption efficiency increases with the increase in the concentration of dye, adsorbent dosage and contact time, while inversely proportional to the increase in pH and temperature for both the treated and untreated corn leaves. The equi
... Show MoreDandruff and seborrheic dermatitis (SD) are common skin disorders affecting the scalp and extending to other body sites in the case of SD. They are associated with pruritus and scaling, causing an esthetical disturbance in the population affected. Treatment of such conditions involves using a variety of drugs for long terms, thus optimizing drug formulation is essential to improve therapeutic efficacy and patient compliance. Conventional topical formulations like shampoos and creams have been widely used but their use is associated with disadvantages. To overcome such effects, novel topical nanotechnology-based formulations are currently under investigation. In the following article, we highlight recently published formulatio
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