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.
For the design of a deep foundation, piles are presumed to transfer the axial and lateral loads into the ground. However, the effects of the combined loads are generally ignored in engineering practice since there are uncertainties to the precise definition of soil–pile interactions. Hence, for technical discussions of the soil–pile interactions due to dynamic loads, a three-dimensional finite element model was developed to evaluate the soil pile performance based on the 1 g shaking table test. The static loads consisted of 50% of the allowable vertical pile capacity and 50% of the allowable lateral pile capacity. The dynamic loads were taken from the recorded data of the Kobe e
The radon gas concentration in environmental samples soil and water of selected regions in Al-Najaf governorate was measured by using alpha-emitters registrations which are emitted form radon gas in (CR-39) nuclear track detector. The first part is concerned with the determination of radon gas concentration in soil samples, results of measurements indicate that the highest average radon concentration in soil samples was found in (Al-Moalmen) region which was (100.0±7.0 Bq/m3), while the lowest average radon concentration was found in (Al-Askary) region which was (38.5±4.7 Bq/m3), with an average value of (64.23±14.9 Bq/m3) ,the results show that the radon gas concentrations in soil is below the allowed limit from (ICRP) agency which is (
... Show MoreBackground: Nasal obstruction is common in otorhinolaryngology outpatient visitors. The diagnosis of such compliant is by history, clinical examination and diagnostic procedures. Nasal endoscopy and computerized tomography scan are common diagnostic investigations. Nasal obstruction is either anterior or posterior (nasal septal deviations, hypertrophied turbinate pathological cyst, polyps, mass etc), or postnasal obstruction (hypertrophied turbinate, adenoid hypertrophy, nasopharyngeal cyst or nasopharyngeal tumors).
Aim of study: Prospective study to compare endoscopic finding and computerized tomography of nose, paranasal sinuses and postnasal space as diagnostic methods for nasal obstruction and other nose, p
... Show MoreIn latest decades, genetic methods have developed into a potent tool in a number of life-attaching applications. In research looking at demographic genetic diversity, QTL detection, marker-assisted selection, and food traceability, DNA-based technologies like PCR are being employed more and more. These approaches call for extraction procedures that provide efficient nucleic acid extraction and the elimination of PCR inhibitors. The first and most important stage in molecular biology is the extraction of DNA from cells. For a molecular scientist, the high quality and integrity of the isolated DNA as well as the extraction method's ease of use and affordability are crucial factors. The present study was designed to establish a simple, fast
... Show MoreThis study expands the state of the art in studies that assess torsional retrofit of reinforced concrete (RC) multi-cell box girders with carbon fiber reinforced polymer (CFRP) strips. The torsional behavior of non-damaged and pre-damaged RC multi-cell box girder specimens externally retrofitted by CFRP strips was investigated through a series of laboratory experiments. It was found that retrofitting the pre-damaged specimens with CFRP strips increased the ultimate torsional capacity by more than 50% as compared to the un-damaged specimens subjected to equivalent retrofitting. This indicated that the retrofit has been less effective for the girder specimen that did not develop distortion beforehand as a result of pre-loading. From
... Show MoreSteel-concrete-steel (SCS) structural element solutions are rising due to their advantages over conventional reinforced concrete in terms of cost and strength. The impact of SCS sections with various core materials on the structural performance of composites has not yet been fully explored experimentally, and in this work, both slag and polypropylene fibers were incorporated in producing eco-friendly steel-concrete-steel composite sections. This study examined the ductility, ultimate strength, failure modes, and energy absorption capacities of steel-concrete-steel filled with eco-friendly concrete, enhanced by polypropylene fiber (PPF) to understand its impact on modern structural projects. Eco-friendly concrete was produced by the partial
... Show MoreThis study has been accomplished by testing three different models to determine rocks type, pore throat radius, and flow units for Mishrif Formation in West Qurna oilfield in Southern Iraq based on Mishrif full diameter cores from 20 wells. The three models that were used in this study were Lucia rocks type classification, Winland plot was utilized to determine the pore throat radius depending on the mercury injection test (r35), and (FZI) concepts to identify flow units which enabled us to recognize the differences between Mishrif units in these three categories. The study of pore characteristics is very significant in reservoir evaluation. It controls the storage mechanism and reservoir fluid prope
In diabetes, impaired wound healing and other tissue abnormalities are considered major concerns. Many factorsaffect the time and quality of wound healing. One of the purposes of medical sciences is wound healing in a short time withreduced side effects. The herbal products are more precious in both prophylaxis as well as curative in delayed diabetic woundhealing activity when compared to synthetic drugs.A wide range of evidence has shown that capers plant possesses differentbiological effects, including antioxidant, anticancer and antibacterial effects. Phytochemical analysis shows thatC. spinosahashigh quantities of bioactive constituents, including polyphenolic compounds, which are responsible for its health-promotingeffects. The healing
... Show MoreIsolation and identification of bacterial isolates were carried out according to the morphology and biochemical characteristics on one hundred and twenty stool specimens collected from children under five years old via using biochemical tests and Api 20E compact system for further confirmation. Bacterial isolates were distributed as (34.48, 20.68, 5.17,0.86) % for Escherichia coli, Salmonella typhi ,Enterobacter aerogenos, Citrobacter freundii and Hafnia alvei respectively and 9.48 % for each Proteus mirabilis, Pseudomonas aeruginosa and Klebsiella Pneumonia. As well as, 2.58% for both Shigella sonnei and Serratia marcescens. Antibiotic susceptibility test for 116 bacterial isolates was performed towards 20 antibiotics types using disk d
... Show MoreThe reaction of L-ascorbic acid with the tirchloroacetic acid in the presence of potassium hydroxide gave new product Bis[O,O-2,3;O,O-5,6(chlorocarboxylicmethyliden)]Lascorbic acid (H2L) which was isolated and characterized by 1H,13C-NMR, elemental analysis (C,H,N), UV-Visible and Fourier Transform Infrared (FTIR). The complexes of the ligand (H2L) with metal ions, M+2= (Cu, Co, Ni, Cd and Hg) were synthesized and characterized by FTIR, UV-Visible, molar conductance, atomic absorption, magnetic susceptibility and the molar ratio. The analysis evidence showed the binding of the metal ions with (H2L) through the bicarboxylato group manner resulting in six-coordinated metal ion. The TLC for (H2L) and complexes showed one spot for each
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