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.
One of the most important problems in the oil production process and when its continuous flow, is emulsified oil (w/o emulsion), which in turn causes many problems, from the production line to the extended pipelines that are then transported to the oil refining process. It was observed that the nanomaterial (SiO2) supported the separation process by adding it to the emulsion sample and showed a high separation rate with the demulsifiers (RB6000) and (sebamax) where the percentage of separation was greater than (90 and 80 )% respectively, and less than that when dealing with (Sodium dodecyl sulfate and Diethylene glycol), the percentage of separation was (60% and 50%) respectively.
The high proportion
... 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 the
... Show MoreThis paper develops a nonlinear transient three-dimensional heat transfer finite element model and a rate independent three-dimensional deformation model, developed for the CO2 laser welding simulations in Al-6061-T6 alloy. Simulations are performed using an indirect coupled thermal-structural method for the process of welding. Temperature-dependent thermal properties of Al-6061-T6, effect of latent heat of fusion, and the convective and radiative boundary conditions are included in the model. The heat input to the model is assumed to be a Gaussian heat source. The finite element code ANSYS12, along with a few FORTRAN subroutines, are employed to obtain the numerical results. The benefit of the proposed methodology is that it
... Show MoreThis study included 50 blood serum samples that collected from children with age ranged between 7-12 years. Thirty five samples collected from children with Type 1 Diabetes Mellitus (T1D), and 15 blood serum samples collected from healthy children as a control sample. The polymorphism of IL-4 -590 (C>T) gene, which amplified by using amplification refractory mutation system (ARMS-PCR) was showed high percentage of C allele frequency in T1D patients sample in comparison with T allele frequency, and the C allele revealed as etiological faction with risk by having T1D disease, whereas the T allele showed high frequency from the C allele frequency in control sample, and the T allele revealed as preventive faction from infection by this disease.
... Show MoreThe present study dealt with the morphological, anatomical,trichomespollen grains,and ecological characteristics of Caroxylon jordanicola (EigAkhani & Roalson (Amaranthaceae) in Al-Tar Caves, Karbala, Iraq which belongs to the Amaranthaceae family. The results of the present study demonstrated that There are distinctive characteristics of the studied species distinguish it from other species and facilitate its diagnosis. The sample was diagnosed using the taxonomic keys of the Iraqi flora and the flora of neighboring countriesIn addition to some available research. The results of the morphological and anatomical features investigation provide really significant taxonomical value to distinguish the species. The results that showe
... Show MoreThis study is a numerical investigation of the performance of reinforced concrete (RC) columns after fire exposure. This study aims to investigate the effect of introducing lateral ties and using the RC jacket on improving post-fire behavior of these columns, the effect of the duration of the fire on ultimate load of columns. The analysis was performed through ABAQUS, a 3D – non-linear finite element program. 4 m tall lengthening square RC column with a cross- section of 0.4 m × 0.4 m was used as a test specimen. The RC column was reinforced by 4Ø28 mm longitudinal bars bonded by steel tie bars of Ø10 mm spaced at 400 mm. The firing temperature was increased to 60