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.
Language is an important means through which one can construct one's social world. Accordingly, the way we view ourselves and the world is basically formed by language use whereby identities, relations, and values are constructed and maintained. Most discourse analysts consider narrative not only the locus of construction and enactment of identity, but also a distinguished genre for its analysis.The present study is concerned with how identity can poetically be informed, hence exploring the way black poets use language when reflecting their identity and culture. The poem, right on: white america by the black American poetess Sonia Sanchez, is chosen to be analyzed based on Simpson's stylistic model (2004). In this model, the ana
... Show MoreThis review delves deep into the intricate relationship between urban planning and flood risk management, tracing its historical trajectory and the evolution of methodologies over time. Traditionally, urban centers prioritized defensive measures, like dikes and levees, with an emphasis on immediate solutions over long-term resilience. These practices, though effective in the short term, often overlooked broader environmental implications and the necessity for holistic planning. However, as urban areas burgeoned and climate change introduced new challenges, there has been a marked shift in approach. Modern urban planning now emphasizes integrated blue-green infrastructure, aiming to harmonize human habitation with water cycles. Resil
... Show MoreThe dyes Azo have a lengthy history and are a vital part of our daily lives. There are numerous potentials uses for these substances and their derivatives in various industries and environmental and biological research. In this study conversion of various azo compounds into other derivatives, complexes, and polymers was accomplished. This review included examining the chemistry reactions, synthesis, and applications of azo dye ligands and their complexes, mentioned spectral, analytical, thermal, and morphology methods of investigation, and confirmed by mass fragment mechanisms for some azo dyes and metal complexes. One of the aims of this review is to explain the role of these azo dye derivatives and the effect of metal complexes on leather
... Show MoreThe dangers of (Israel's) integration with Arab countries in the middle east region will threaten the Arab security structure dimension, which the latter makes the Arab regional system vulnerable for distortion due to its nominal and symbolic value which is far from the Arab self and questioning with its effectiveness in comparing with the real capabilities to Arab countries in achieving the common targets. So, how to assess the different problems that began to hit the structure of the Arab regional system? and how to pledge an allegiance after putting forward what is known as the American Deal of the Century for the administration of former US President Donald Trump for making another step toward normalization with (Israel)?. The reveal
... Show MoreThe present work deals with five species of parasitic Hymenoptera belonging to Pteromalidae, Eupelmidae and Eurytornidae which have been reared from brachid beetles. A new species, Eurytoma irakensis is described and the species, Bruchocida orientalis Crawford is recorded for the first time from Iraq.
The mediation system is based on settling the dispute amicably through the intervention of a third party by bringing views closer away from the judiciary, which is an amicable way to settle disputes, which disputants resort to voluntarily, but some Western legislation has begun to impose resorting to mediation to settle disputes compulsorily, to take advantage of its advantages, get rid of the disadvantages of resorting to the judiciary in some disputes, and relieve pressure on the courts.
The study aims to identify the colleges women in the USA where he was browsing the Internet for five universities and sixty-two women's college located these colleges in 25 states only three general and other civil 51% supported by the churches and religious associations of various began its founding in Alqrnn eighteenth and continued in the nineteenth and twentieth and to provide an opportunity for women to complete higher education, while most men's colleges opened their doors to the admission of women and turned it on coeducation