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 survival analysis is one of the modern methods of analysis that is based on the fact that the dependent variable represents time until the event concerned in the study. There are many survival models that deal with the impact of explanatory factors on the likelihood of survival, including the models proposed by the world, David Cox, one of the most important and common models of survival, where it consists of two functions, one of which is a parametric function that does not depend on the survival time and the other a nonparametric function that depends on times of survival, which the Cox model is defined as a semi parametric model, The set of parametric models that depend on the time-to-event distribution parameters such as
... Show MoreBackground: One of the more significant hormonal systems, the renin-angiotensin-aldosterone system, controls the kidney function, adrenal gland through its effect on the balance of sodium and potassium, blood pressure, fluid volume, and also manages the functions of cardiovascular. Objective: To clarify the interrelationship between renal dysfunction and renin-angiotensin-aldosterone system. Patients and Methods: One hundred samples were collected from December 1, 2022, to February 18, 2023, from Al Shams Medical Laboratories (56 male, and 44) female, age range (of 45-60 years), all of them were volunteers suffering from chronic renal failure in the third stage the average glomerular filtration rate was 35. 70 ± 0.37 12
... Show MoreObjectives: The aim of this study was to assess the possible the association between +3061 (G>A, rs1143676) missense mutation in exon 24 of the integrin α-4 subunit (ITGA-4) gene and the response to natalizumab in a sample of Iraqi multiple sclerosis patients. Methods: A sample of 59 patients with multiple sclerosis (16 males and 43 females; mean age of 32 years; age range of 15 to 52 years) receiving natalizumab for at least 12 consecutive months were involved in the study between March and August/ 2022. The sample was categorized into two groups according to their response to natalizumab treatment (responders and non-responders). Polymerase chain reaction and Sanger’s sequencing for the extracted deoxyribonucleic acid was pe
... Show MoreKnowledge represents the foundation stone for the work of all organizations, are working who leads the thinking of individuals is the ability that leads to behavior based on rationality, it is the work that creates value to the organization and thus gain access to performance winning where that knowledge is a new type of capital based on the thought and experience and is the so-called intellectual capital, which is renewable and is constantly evolving. The study sought to explain the role of the climax knowledge in achieving the highest levels of performance Organizational and then access to the performance winning in educational organizations the study sample, was found to be a co
... Show MoreThe study aimed to determine the impact of energy for the north and south magnetic poles on the the growth of bacteria isolated from cases of tooth decay, 68 swabs were collected from surfaces of faulty tooth, the detected of Staphylococcus aureus
... Show MoreFibroepithelioma of Pinkus (FEP) is a slowly growing, low-grade malignant tumor with very low metastatic potential that is considered a distinct variant of basal cell carcinoma (BCC). It usually manifests as sessile or polypoidal lesions on the trunk of middle-aged patients. However, it may present in younger age groups, even in children. In this case, we present a rare case of FEP atypically presenting as a scaly plaque on the lower back for several years in an elderly female who was eventually diagnosed by excisional biopsy and histopathology.
The Strategy of employees' empowerment, organizational performance and total quality management represent three informative which were and still the hub of many studies and researches including the current study. The higher education is considered one of the most important services sectors and the main development as well as the civil progress in the society. It is the main source that provides the organizations with the human resources having scientific or practical professions. So Higher Education has been chosen especially Baghdad University as a sample of the study. The study problem is concentrated to find answers of the following questions: What the level of the powers mandate in the organization concerning the
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