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 objective of this paper is to study the stability of SIS epidemic model involving treatment. Two types of such eco-epidemiological models are introduced and analyzed. Boundedness of the system is established. The local and global dynamical behaviors are performed. The conditions of persistence of the models are derived.
The aim of this work is to study the factors that affect the welding joint of dissimilar metals. Austenitic stainless steel-type AISI (316L) with a thickness of (2mm) was welded to carbon steel (1mm) using an MIG spot welding. The filler metal is a welding wire of the type E80S-G (according to AWS) is used with (1.2mm) diameter and CO2 is used as shielding gas with flow rate (7L/min) for all times was used in this work.
The results indicate that the increase of the welding current tends to increase the size of spot weld, and also increases the sheer force. Whereas the sheer force increased inversely with the time of welding. Furthermore, the results indicate that i
... Show MoreThe dried fruit peel of pomegranate in Punicaceae family was fractionated chromatographically on Sephadex-LH-20 column .Gallic acid (trihydroxybenzoic acid) and its related galloyl esters such as gallotannin(i.e. β-penta-O-galloyl–D-glucose) were obtained homogenously. Different concentrations of gallic acid and gallotannin were used to determine their inhibitory effect on human serum cholinesterase. The enzyme activity was measured according to the method reported by the WHO .The inhibitory effect of these compounds on the activity of human serum cholinesterase have been studied in vitro .The inhibitory effect was remarkably clear with increasing concentration of gallic acid .Whereas galloyl ester showed n
... Show MoreThis book presents the problem of tooth decay due to bacteria Streptococcus mutans one of methods of treatment using 3 extracts of S. persica (miswak) (aqueous, acetone and methanol) and prove its effectiveness and its impact on the gtf (B, C, and D) genes that code the glucosyltransferase (Gtf) enzymes that cause decay membrane compared to the usual means used for the prevention of tooth decay
The interests toward developing accurate automatic face emotion recognition methodologies are growing vastly, and it is still one of an ever growing research field in the region of computer vision, artificial intelligent and automation. However, there is a challenge to build an automated system which equals human ability to recognize facial emotion because of the lack of an effective facial feature descriptor and the difficulty of choosing proper classification method. In this paper, a geometric based feature vector has been proposed. For the classification purpose, three different types of classification methods are tested: statistical, artificial neural network (NN) and Support Vector Machine (SVM). A modified K-Means clustering algorithm
... Show Morethe behavior of the first-order black and gray solitons propagtedin optical fiber in the presence of frequency chirp is studied analytically and numerically results show that phase profile of black solitons changes abruptly