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.
Abstract
In this manuscript, a simple new method for the green synthesis of platinum nanoparticles (Pt NPs) utilizing F. carica Fig extract as reducing agent for antimicrobial activities was reported. Simultaneously, the microstructural and morphological features of the synthesized Pt NPs were thoroughly investigated. In particular, the attained Pt NPs exhibited spherical shape with diameter range of 5-30 nm and root mean square of 9.48 nm using Transmission Electron Microscopy (TEM) and Atomic Force Microscopy (AFM), respectively. Additionally, the final product (Pt NPs) was screened as antifungal and antibacterial agent against Candida and Aspergillus species as well as Gram-positive Staphyllococcus aureus and G
... Show MoreDiazotization reaction between 1-(2,4,6-Trihydroxy-phenyl)-ethanone and diazonium salts was carried out resulting in ligand 4-(3-Acetyl-2,4,6-trihydroxy-phenylazo)-N-(5-methyl-isoxazol-3-yl)-benzenesulfonamide, this in turn reacted with the next metal ions (V4+ , Cr3+ , Mn2+ and Cu2+) forming stable complexes with unique geometries such as (Octahedral for both Cr3+ , Mn2+ and Cu2+ ,squar pyramidal for V4+). The creation of such complexes was detected by employing spectroscopic means involving ultraviolet-visible which proved the obtained geometries, fourier transfer proved the formation of azo group and and the coordination with metal ion through it. Pyrolysis (TGA & DSC) studies proved the coordination of water residues with me
... Show MoreNitrogen dioxide NO2 is one of the most dangerous contaminant in the air, its toxic gas that cause disturbing respiratory effects, most of it emitted from industrial sources especially from the stack of power plants and oil refineries. In this study Gaussian equations modelled by Matlab program to state the effect of pollutant NO2 gas on area around Durra refinery, this program also evaluate some elements such as wind and stability and its effect on stacks height. Data used in this study is the amount of fuel oil and fuel gas burn inside refinery at a year 2017. Hourly April month data chosen as a case study because it’s unsteady month. After evaluate emission rate of the all fuel and calculate exit velocity from
... Show MoreIn this work we used the environmentally friendly method to prepared ZrO2 nanoparticles utilizing the extract of Thyms plant In basic medium and at pH 12, the ZrO2 NPs was characterized by different techniques such as FTIR, ultraviolet visible, Atomic force microscope, Scanning Electron Microscopy, X-ray diffraction and Energy dispersive X-ray. The average crystalline size was calculated using the Debye Scherres equation in value 7.65 nm. Atomic force microscope results showed the size values for ZrO2 NPs were 45.11nm, and there are several distortions due to the presence of some large sizes. Atomic force microscope results showed the typical size values for ZrO2 NPs were 45.11 nm, and there are several distortions due to the presence of so
... Show MoreThis study was aimed to produce AuNPs biologically using Klebsiella pneumoniae and study their synergistic effect with some antibiotics.Technologies of nanoparticles are quick and are employed in many applications in biomedicine. The potential of metallic nanoparticle as an anti-microbial agent is greatly investigated which considered as an alternative method to reduce the challenges of multi-drug resistance microbes. The present study discusses the novel approach to synthesize nanoparticles involving eco-friendly synthesis of gold nanoparticles using Klebsiella pneumoniae and study their effect as antimicrobial spectrum .Also study synergism effect of gold nanoparticles with antibiotic against Acinetobacter baumannii. These approac
... Show MoreIn this study, the potential of adsorption of amoxicillin antibiotic (AMOX) from aqueous solutions using prepared activated carbon (AC) was studied. The used AC was prepared from an inexpensive and available precursor (sunflower seed hulls (SSH)) and activated by potassium hydroxide (KOH). The prepared AC was examined for its ability to remove AMOX from aqueous contaminated solutions and characterized with the aid of N2 -adsorption/desorption isotherm Brunauer–Emmett– Teller, scanning electron microscopy, energy-dispersive X-ray spectroscopy and Fourier-transform infrared. Zeta potential of the prepared activated carbon from sunflower seed hulls (SSHAC) were studied in relation to AMOX adsorption. The physical and chemical propert
... Show MoreWater pollution as a result of contamination with dye-contaminating effluents is a severe issue for water reservoirs, which instigated the study of biodegradation of Reactive Red 195 and Reactive Blue dyes by E. coli and Bacillus sp. The effects of occupation time, solution pH, initial dyes concentrations, biomass loading, and temperature were investigated via batch-system experiments by using the Design of Experiment (DOE) for 2 levels and 5 factors response surface methodology (RSM). The operational conditions used for these factors were optimized using quadratic techniques by reducing the number of experiments. The results revealed that the two types of bacteria had a powerful effect on biodegradable dyes. The regression analysis reveale
... Show MorePolycystic ovary syndrome (PCOS) is reproductive, endocrine, and metabolic disorder affecting females. The pathology of PCOS is complicated and associated to chronic low-grade inflammation, this includes a disruption in pro-inflammatory factor production, leukocytosis, and endothelial cell dysfunction, also associated with high level of pro-inflammatory cytokines, chemokines and leukocyte count. In addition, PCOS is characterized by hormonal and immunological dysfunction. Inflammation of the ovary affects ovulation and induces or aggravates systemic inflammation. Macrophage inflammatory protein-1 (MIP-1), a pro-inflammatory chemokine, is crucial in the recruitment of inflammatory and immunological cells to the place of inflammation
... Show MoreEpithelial‐mesenchymal transition (