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
Backgrounds: Jaundice occurs in most newborn due to increased bilirubin concentration. Jaundice is observed during the first week after birth in approximately 60% of term neonates. A high level of bilirubin is neurotoxic and may cause neonatal kernicterus, auditory neuropathy or death.
Objectives: to compare the Rh group compatibility, serum bilirubin (total and direct), serum albumin and several liver enzymes between physiological and pathological neonatal jaundice
Materials and Methods: A cross sectional study for one hundred neonates with jaundice divided into group 1: 50 newborns with physiological jaundice, Group 2: 50 newborns with
... Show MoreBackground: This study was performed to compare the marginal fit changes and facture resistance of metal ceramic crowns constructed from Ceramill Sintron metal coping veneered with three different porcelain veneering materials (Vita Master Koromikos VMK, Willi Geller Creation CC and GC initial MC), also to evaluate the influence of thermocycling on load at fracture. Materials and Methods: Master brass die was scanned ,then metal coping was designed and milled from Ceramill Sintron blank to get 60 metal copings, then divided randomly into three groups(20 sample), then veneered with porcelain: VITA, Creation or GC. The marginal gaps were measured before and after porcelain veneering then marginal fit changes was calculated. Fracture resist
... Show MoreWe present a simple model of charge transfer current through sensitizer N3 molecule contact to TiO2 and ZnO semiconductors to calculate the charge transfer current. The model underlying depends on the fundamental parameters of the charge transfer reaction and it is based on the quantum transition theory approach. A transition energy, driving energy and potential barrier have been taken into account charge transfer current at N3 / TiO2 and N3 / ZnO devices with wide polarity solvents Acetic acid, 2-Methoxyethanol, 1-Butanol, Methyl alcohol, chloroform, N,N-Dimethylacetamide and Ethyl alcohol via the quantum donor-acceptor system.The effects of the transition energy and potential barrier are computed and discussion on charge transfer current.
... Show MoreA qualitative chemical test was performed on functional groups extracted from fenugreek plant and its extracts (aqueous, alcoholic and volatile oil). Results revealed that fenugreek seeds contain the main functional groups, while extracts are varied accorodihg to their content of functional groups qualitatively and quantitively. Moreover, inhibition activity was tested for extracts of fenugreek seeds (aqueous, alcoholic and volatile oil). against gram negative (Salmonella typhimurium, Escherichia coli and Pseudomonas aeruginosa) and gram positive (Staphylococcus aureus) by the ager well diffusion method. Data have revealed that inhibition activity was different in accoradance with extract solvent and the tested microorgan. Oil extract (15)%
... Show MoreOne of the most significant elements influencing weather, climate, and the environment is vegetation cover. Normalized Difference Vegetation Index (NDVI) and Normalized Difference Built-up Index (NDBI) over the years 2019–2022 were estimated based on four Landsat 8 TIRS’s images covering Duhok City. Using the radiative transfer model, the city's land surface temperature (LST) during the next four years was calculated. The aim of this study is to compute the temperature at the land's surface (LST) from the years 2019-2022 and understand the link, between LST, NDVI, and NDBI and the capability for mapping by LANDSAT-8 TIRS's. The findings revealed that the NDBI and the NDVI had the strongest correlation with the
... Show MoreWell integrity is a vital feature that should be upheld into the lifespan of the well, and one constituent of which casing, necessity to be capable to endure all the interior and outside loads. The casing, through its two basic essentials: casing design and casing depth adjustment, are fundamental to a unique wellbore that plays an important role in well integrity. Casing set depths are determined based on fracturing pressure and pore pressure in the well and can usually be obtained from well-specific information. Based on the analyzes using the improved techniques in this study, the following special proposition can be projected: The selection of the first class and materials must be done correctly and accurately in accordance with
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