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.
A modified Leslie-Gower predator-prey model with a Beddington-DeAngelis functional response is proposed and studied. The purpose is to examine the effects of fear and quadratic fixed effort harvesting on the system's dynamic behavior. The model's qualitative properties, such as local equilibria stability, permanence, and global stability, are examined. The analysis of local bifurcation has been studied. It is discovered that the system experiences a saddle-node bifurcation at the survival equilibrium point whereas a transcritical bifurcation occurs at the boundary equilibrium point. Additionally established are the prerequisites for Hopf bifurcation existence. Finally, using MATLAB, a numerical investigation is conducted to verify t
... Show MoreA field experiment was conducted at the experimental field of botanical garden, faculty of science, university of Baghdad, in order to study the effect of plant density on growth and yield of two local cultivars of sunflower (Sin Althieb and Shumose). The densities used were 4.4 and 8.8 plant/m2. The results showed difference between cultivars in their agronomic traits and their yields. There was a significant increase in plant height and leaf area index by increasing the plant density, while head diameter, number of seeds and leaf area decreased. But the most significant effect was the increasing in yield and biological yield by increasing the plant density. There was an increase by 72% and 58% in the yield and 79% an
... Show MorePemphigus vulgaris is an autoimmune disease of the skin and mucous membrane. Renal transplantation is a common procedure in
To study the frequency of skin tumors and infections in patients with pemphigus vulgaris compared with renal transplant recipients and normal controls.
One hundred kidney transplant recipients, their ages ranged from 14 to 70 (46.65 ± 4.74) years
Background: Coronary Artery Disease (CAD) is one of the largest causes of mortality worldwide. Clopidogrel, antiplatelet drug, has been widely used for management of CAD. The current study aimed to investigate the effect of clopidogrel on the oxidative stress in CAD patients. Methods: One hundred CAD patients, who were followed-up for 5 days after receiving clopidogrel, and 50 healthy volunteers were included in this study. Parameters include catalase (CAT), total antioxidant capacity (TAC), total oxidant capacity (TOC), total protein, albumin, and globulins were determined before and after treatment with clopidogrel. Results: CAT, TAC, and Tp were significantly decreased (P<0.0001) in CAD patients compared to healthy control and
... Show MoreBackground: Friedreich ataxia (FRDA) is the most common form of inherited ataxia, comprising one-half of all hereditary ataxias with a carrier rate between 1 in 60 to 1 in 90 and with a disease prevalence of 1 per 29,000. It can occur in two forms the classic form or in association with a vitamin E dependent ataxia. The precise role of Vitamin E in the nervous system is unknown; An Oxidative attack is suspected to play a role in Ataxia with Vitamin E deficiency, as well as in Friedreich ataxia. Vitamin E is the major free-radical-trapping antioxidant.
Objective: Theobjectives of the study is to asses vitamin E level in patients with Friedreichs ataxia phenotype in Iraqi patients.
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Background: lip lengthening procedure is one of the surgical options for the correction of gummy smile in patients with short upper lip. Methods: A comparative clinical study was conducted on 15 patients requiring lip lengthening procedure for the esthetic correction of excessive gingival exposure with gummy smile. Scalpel was used in seven patients and diode laser in the remaining eight patients. Under infiltration anesthesia, about one cm strip of mucosa was excised at the vestibular depth and the mucosa of the lip was sutured to the alveolar mucosa. Results: The diode laser group demonstrated less postoperative pain and swelling. Regarding postoperative ecchymosis, three patients in the scalpel group developed ecchymosis and no cases
... Show MoreBackground: Toll-like receptors (TLRs) play a significant role in the activation of adaptive immunity and may have an essential role in the development of rheumatoid arthritis (RA). Objectives: To assess the gene expression of TLR4 in individuals with RA compared to healthy individuals. Methods: From July to December 2022. A total of 100 individuals were encompassed in the study, consisting of 50 individuals diagnosed with RA, of whom 42 were females and 8 were males, with an average age of 45.22 years. Additionally, there were 50 healthy control participants, 40 of whom were females and 10 were males, with an average age of 45.64 years. To assess the TLR4 transcript levels, blood samples were collected from each participant, and RN
... Show MoreBackground: study the effect of various risk factors on reperfusion success after thrombolysis by measuring ST resolution.
Objectives: Early patency of the infarct-related artery is associated with reduced mortality. Thrombolytic therapy is frequently followed by rapid recanalization lead to reduction of infarct size, improve left ventricular function and increase survival by reopening of coronary artery . The reduction in ST-segment elevation on the standard 12 lead electrocardiogram 1-4 h after initiation of thrombolysis may be the simplest and most useful clinical tool to test the effectiveness of thrombolytic therapy.
Methods: Seventy patients with acute ST elevation myocardial infarction admitted to alkindy teaching hospital C
Type 1 diabetes (T1D) is an autoimmune disease with chronic nature resulting from a combination of both factors genetic and environmental. The genetic contributors of T1D among Iraqis are unexplored enough. The study aimed to shed a light on the contribution between genetic variation of interleukin2 (IL2) gene to T1D as a risk influencer in a sample of Iraqi patients. The association between IL2−330 polymorphism (rs2069762) was investigated in 322 Iraqis (78 T1D patients and 244 volunteers as controls). Genotyping for the haplotypes using polymerase chain reaction test – specific sequence primer (PCR-SSP) for (GG, GT, and TT) genotypes corresponding to (G and T) alleles were performed. A significant association revealed a decreased freq
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