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 galvanic corrosion of the (Cu - Fe), (Cu - Zn) and (Fe - Zn) couples have been investigated in 3.5% NaCl solution, 40ºC, different velocities (Re = 5000, 10000 and 15000) and different area ratio’s of cathode to anode (AR= 0.5,1 and 2), by using commercial metal pipe (cylindrical tube).The Zero Resistance Ammeter has been used to measure the galvanic current (Ig) and galvanic potential (Eg) with time. The galvanic current density increases with increasing velocity (Re) and the area ratio (AR). The galvanic potential (Eg) is shifted to less negative with increasing velocity (Re) and the area ratio (AR). A statistical relations for the galvanic current density and galvanic potential as a function of (Re). and the area ratio had been
... Show MoreIn this work, nanostructure zinc sulfide (ZnS) thin films at temperature of substrate 450 oC and thickness (120) nm have been produced by chemical spray pyrolysis method. The X-Ray Diffraction (XRD) measurements of the film showed that they have a polycrystalline structure and possessed a hexagonal phase with strong crystalline orientation of (103). The grain size was measured using scanning electron microscope (SEM) which was approximately equal to 80 nm. The linear optical measurements showed that ZnS nanostructure has direct energy gap. Nonlinear optical properties experiments were performed using Q-switched 532 nm Nd:YAG laser Z-scan system. The nonlinear refractive index (n2) and nonlinear absorption coefficient (β) estimated for Z
... Show MoreMoisture damage is described as a reduction in stiffness and strength durability in asphalt mixtures due to moisture. This study investigated the influence of adding nano silica (NS) to the Asphalt on the moisture susceptibility of hot-mix-asphalt (HMA) mixtures under different aging conditions. NS was mixed with asphalt binder at concentrations of 2%, 4%, and 6% by weight of the binder. To detect the microstructure changes of modified Asphalt and estimate the dispersion of NS within the Asphalt, the field emission scanning electron microscope (FE-SEM) was used. To examine the performance of Asphalt mixed with NS at different aging stages (short-term and long-term aging), asphalt mixture tests such as Marshall stability,
... Show MoreAn efficient networks’ energy consumption and Quality of Services (QoS) are considered the most important issues, to evaluate the route quality of the designed routing protocol in Wireless Sensor Networks (WSNs). This study is presented an evaluation performance technique to evaluate two routing protocols: Secure for Mobile Sink Node location using Dynamic Routing Protocol (SMSNDRP) and routing protocol that used K-means algorithm to form Data Gathered Path (KM-DGP), on small and large network with Group of Mobile Sinks (GMSs). The propose technique is based on QoS and sensor nodes’ energy consumption parameters to assess route quality and networks’ energy usage. The evaluation technique is conducted on two routing protocols i
... Show MoreBackground: Color stability of glass ionomers (GIs) could be affected by many factors such as pH and consumption of liquid medications like antibiotics. Most common antibiotics used during childhood are amoxicillin suspension (AM.S) and azithromycin suspension (AZ.S) which have acidic and basic pH respectively. Aim: to evaluate and compare the effect of AM.S and AZ.S on color stability of nano resin-modified GI. Methods: Thirty disc of nano resin-modified glass ionomer (2mm height x 4mm diameter) were divided into three groups (n=10 for each) and independently exposed to AM.S, AZ.S, and artificial saliva (A.S.). Color stability was evaluated in triplicate by VITA Easyshade® before and after three immersion protocols, repeated over
... Show MoreThe importance of the present work falls on the pitting corrosion behavior investigation of 304 SS and 316 SS alloys in 3.5 wt% of aqueous solution bearing with chloride and bromide anion at different solutions temperature range starting from (20-50)oC due to the pitting corrosion tremendous effect on the economic, safety and materials loss due to leakage. The impact of solution temperatures on the pitting corrosion resistance at 3.5wt% (NaCl and NaBr) solutions for the 304 SS and 316 SS has been investigated utilizing the cyclic polarization techniques at the potential range -400 to1000 mV vs. SCE at 40 mV/sec scan rate followed by the surface characterization employing Scanning Electron&nbs
... Show MoreMefenamic acid (MA) is one of the non-steroidal anti-inflammatory drugs, it is widely used probably due to having both anti-inflammatory and analgesic activity, the main side effects of mefenamic acid include gastrointestinal tract (GIT) disturbance mainly diarrhea, peptic ulceration, and gastric bleeding. The analgesic effects of NSAIDs are probably linked to COX-2 inhibition, while COX-1 inhibition is the major cause of this classic adverse effects. Introduction of thiazolidinone may lead to the increase in the bulkiness leads to the preferential inhibition of COX-2 rather than COX-1 enzyme. The study aimed to synthesize derivatives of mefenamic acid with more potency and to decrease the drug's potential side effects, new series of 4-t
... Show MoreHelicobacter pylori (H. Pylori) is one of the most common infectious human pathogens. H. pylori could induce inflammation, that causes illnesses and disorders of upper gastrointestinal which including peptic ulcer diseases, dyspepsia, gastroesophageal reflux disease and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. It is important to use a better tolerated and greatly effective eradication regimen. In this study, 75 newly diagnosed adult patients with H. pylori infection were included and completed the study, they were allocated into three groups with three different treatment regimens for H. pylori eradications; Group A (25 patients) received oral standard clarithromycin-based tr
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