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.
Al-Wasiti's drawings are the first attempt to document the Arab landscape more than 778 years ago. These drawings were associated with a fine literary material, and the relationships between words and poetic sentences are matched by artistic, aesthetic and color relations in drawing, as they are all outputs of a sense that agreed in creativity and differed in the language of expression. Al-Wasiti was creative in drawing these events. Islamic painting has a goal that differs from the goals of the painting arts that preceded it or its contemporary, as it tends to “beautification” only. This is achieved by true copying from nature, just as it is achieved by drawing what is transmitted from nature, transforming and refining it. The
... Show MoreThis research aims the effects of negative media on the educational identity of community. Whereas display the concept of educational identity and its basic components, as well as the role of educational institutions for example the school and the family in form it and reinforcing this identity to individuals. The study showcasing the harmful impact of both traditional and modern media on identity and values, spotlight several examples like the promotion of consumerism and materialism through television programs. which results in the young people to adopt materialistic values like simplicity. The study concludes that media is a double-edged weapon: it can instill virtues and support education if used duly, but it can also weaken the educat
... Show MoreIn today's cities, it is easy to see large numbers of vacant lands and unused abandoned sites in downtown areas that are not only ugly but also potentially becoming fertile ground for criminal activities that endanger residents and visitors and contribute to the further degradation of neighborhoods,
can provide reuse of spaces Neglected opportunities to reshape the appearance of the city and to improve the city center for its users that the presence of many neglected sites, whether they were abandoned buildings or sites for destroyed buildings in Mosul after the war on ISIS and with large areas amid the urban fabric led to the emergence of the research problem is (lack of urban planning to reactivate abandoned sites within the ci
... Show MoreThe current research aims to test the relationship of the entrepreneurial leadership and its factors (strategic factors, communication factors, personal factors, motivational factors) in managing the organizational crisis and its stages (detection of warning signs, readiness and prevention, containment of damages, restoration of activity, learning) among a sample of companies of the Ministry Water resources (Al-Fao State Company for the implementation of irrigation projects, Al-Rafidain Company for the implementation of dams, Iraq Company for the implementation of irrigation projects), as well as standing at the level of interest of the research companies in the search variables and their factors and stages, there is no doubt tha
... Show MoreThe problem of the study is concerned with the work of The Iraqi Airways Company in political, economic, and social environment that suffers instability for many years. This has its negative outcomes regarding its decisions of providing services to its markets and customers as a result of the orientations, behavior, and marketing values the company management adopted. The aim of this study is to investigate the marketing philosophy adopted by the management and to identify the extent it suits the materialistic and the human capacities of the company and its current environmental circumstances within the marketing culture common to the thoughts and behaviors of the management and their employees. And in order to achiev
... Show MoreThere are different types of corruptions such as administrative, political, economic and financial corruption. The corruption forms also varied such as bribery, nepotism and extortion. All types and forms of corruption play significant role in the all economic variables generally and on investments in particular, and the corruption used to be an intermediate means in reducing the rate of economic growth. The corruption contributes in reducing the domestic investments via pay bribery by investors to officials’ persons for supplemental contracts and tenders which finally leads to reduction in the investment efficiency. The corruption also contributes in rise of operational costs for the investment projects. In additio
... Show MoreThe research aims to investigate the relationship and impact of e-governance as an independent variable in achieving creative performance as a dependent variable. These variables have been studied in the Directorate of Passports Affairs, and seek to come up with a set of recommendations that help in promoting e-governance in the researched organization, and the researcher adopted the descriptive-analytical approach, included The sample (122) of the total (194) individuals distributed in several administrative levels (officers, associates, and administrative staff). By adopting the questionnaire, which included (49) paragraphs as the main tool for the collection of data and information, as well as personal interviews and field obs
... Show MoreBackground: Type 2 diabetes mellitus is a condition characterized by an elevation of oxidative stress, which has been implicated in diabetic progression and its vascular complications. Aim: Assessing the impact of gliclazide modified release (MR) versus glimepiride on oxidative stress markers, glycemic indices, lipid profile, and estimated glomerular filtration rate in uncontrolled type 2 diabetic patients on metformin monotherapy. Methods: This was an observational comparative study conducted in Thi-Qar specialized diabetic, endocrine, and metabolism center. Sixty-six patients were randomized into two groups based on the addition of the sulfonylureas (SUs). Group 1 (33 patients) was on gliclazide MR, whereas Group 2 (33 patients)
... Show MoreBackground: Mouth breathing can lead to introduce cold, dry unprepared air that insults the tissue of oral cavity, nasopharynx and lung, leading in turn to pathological changes in oronasal cavity, nasopharyngeal and other respiratory tissue, mouth breathing associated with nasal obstruction may lead to many health problems, in particular oral health problems such as inflammation of gingiva, oral dryness, change in oral environment that may decrease pH, salivary flow rate and increase bacteria and dental caries.Aims of the present study were to assess the oral health condition among mouth breather associated with nasal obstruction, including dental caries, oral cleanliness and gingival health condition as well as to evaluate the changes in s
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