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.
Background: Inhalation therapy has been employed as the mainstay of the treatment in chronic respiratory diseases such as asthma, Patients who taking asthma medication may be at risk of many health problems including oral health .The purpose of this study was to assess the local effect of ICS on oral tissue by measuring Candida albicans count colonies in saliva among12 years old asthmatic children who were collected from AL- Zahra Center Advisory for Allergy and Asthma, and compares them with non asthmatic children of the same age and gender. Material and Methods: The total sample involved sixty children of 12 years old, thirty asthmatic children who received medium dose of ICS/day (200-400 microgram/day) for 2 years and 30 non-asthmatic ch
... Show MoreThe research aims to know the impact of science, technology, engineering, and mathematics education on both creative thinking and mathematical achievement. To achieve it, the two researchers followed the quasi-experimental approach with an experimental design for two groups, one experimental and the other a control. The research sample consisted of (32) female students from the fourth scientific grade in Al-Intisar Preparatory School for Girls/ AlRasafa, First Directorate. The sample was chosen intentionally and was divided into two groups: a control group studying by the traditional method, their number (16), and an experimental group that applied the STEM approach, their number also (16). There was parity between the two research groups i
... Show MoreThe optimum design is characterized by structural concrete components that can sustain loads well beyond the yielding stage. This is often accomplished by a fulfilled ductility index, which is greatly influenced by the arrangement of the shear reinforcement. The current study investigates the impact of the shear reinforcement arrangement on the structural response of the deep beams using a variety of parameters, including the type of shear reinforcement, the number of lacing bars, and the lacing arrangement pattern. It was found that lacing reinforcement, as opposed to vertical stirrups, enhanced the overall structural response of deep beams, as evidenced by test results showing increases in ultimate loads, yielding, and cracking of
... Show MoreDynamic Thermal Management (DTM) emerged as a solution to address the reliability challenges with thermal hotspots and unbalanced temperatures. DTM efficiency is highly affected by the accuracy of the temperature information presented to the DTM manager. This work aims to investigate the effect of inaccuracy caused by the deep sub-micron (DSM) noise during the transmission of temperature information to the manager on DTM efficiency. A simulation framework has been developed and results show up to 38% DTM performance degradation and 18% unattended cycles in emergency temperature under DSM noise. The finding highlights the importance of further research in providing reliable on-chip data transmission in DTM application.
The optimum design is characterized by structural concrete components that can sustain loads well beyond the yielding stage. This is often accomplished by a fulfilled ductility index, which is greatly influenced by the arrangement of the shear reinforcement. The current study investigates the impact of the shear reinforcement arrangement on the structural response of the deep beams using a variety of parameters, including the type of shear reinforcement, the number of lacing bars, and the lacing arrangement pattern. It was found that lacing reinforcement, as opposed to vertical stirrups, enhanced the overall structural response of deep beams, as evidenced by test results showing increases in ultimate loads, yielding, and cracking of
... Show MoreObjective(s): To assess the adequacy of mediation program on medical attendants practice toward care of kids with diabetic's ketoacidosis. Methodology: A quasi-experimental design that applied at teaching hospitals for pediatric in AL Ramadi city to establish the Effectiveness of Intervention Program on Nurses` Practices about Care of Children with Diabetic Ketoacidosis from 3th of March 2022 till 20 of March 2023. Non-probability (purposive) sample of (50), likewise was alienated into the study (experimental) group. The study group included (50) nurses non-randomly selected from AL-Ramadi Teaching Hospital.
A preliminary study has conducted in AL-Ramadi Teaching Hospital The whole number of nurse
... Show MoreThis paper examines the decolonizing methods used by Leslie Marmon Silko in her novel Ceremony (1977) to heal the indigenous people from the patriarchal traditions of the white hegemony. This study aims to emphasize the vulnerable responses of the Pueblo people to the memories of the clan and to highlight Silko’s methods to sustain the history and lifestyle of the indigenous people. Therefore, Silko’s novel can be situated historically and culturally within memory-studies. To analyze the contrasting behaviors of characters, this paper projects the relationship between the collective patriarchal doctrines and that of the individual within the framework of memory studies. Theories of Jan and Aleida Assmann are used here to explore the
... Show MoreType 2 daibetes mellitus (T2DM) is a global concern boosted by both population growth and ageing, the majority of affected people are aged between (40- 59 year). The objective of this research was to estimate the impact of age and gender on glycaemic control parameters: Fasting blood glucose (FBC), glycated hemoglobin (HbA1C), insulin, insulin resistance (IR) and insulin sensitivity (IS), renal function parameters: urea, creatinine and oxidative stress parameters: total antioxidant capacity (TAC) and reactive oxygen species (ROS). Eighty-one random samples of T2DM patients (35 men and 46 women) were included in this study, their average age was 52.75±9.63 year. Current study found that FBG, HbA1C and IR were highly significant (P<0.01) inc
... Show MoreThe current research deals with spatial relations as a tool to link urban landmarks in a homogeneous composition with monumental sculptures, by identifying these landmarks and the extent of their impact on them, which constitutes an urgent need to evaluate the appropriate place and its effects on them, so that this analytical study is a critical approach adopted in artistic studies of monumental models in Arabcapitals .The current research came in four chapters, the first chapter of which dealt with the research problem, its importance and the need for it, then its objectives that were determined in revealing the spatial relations and their impact on
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