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 study aimed to know the effect of the use alcoholic ethanol extraction of Boswellia Carterii In prolonging the period of preservation cooled ground meat in 4C for 6 days, it has been mixing ground meat with 150,300,450 mg/ml of alcoholic extract Consecutive, Where (0 was the control sample), All samples were stored separately for 0 , 3 , 6 days in Refrigerator temperature 4 C, Conducted by some microbial tests, Results have shown that mixing the ground meat with Boswellia Carterii extraction Led to prolong the storage of meat for 6 days at 4 C .and the Best result came when adding alcoholic ethanol extract of Boswellia Carterii by 450mg/ml Which Equal 0.9 g ,that reducing microbial load more higher than 150&300 mg/ml. All of thes
... Show MoreThe transition structure is considered as the most important hydraulic structure controlling the w/s transtion, morever it decrease the scouring of outlet structure.
seven experiment samples for transition structure was used in this research at different angles ( 10° - 90° ).
It was shown that froud number has a clear effect on the depth of the scouring, morever the high discharge rates cause an increase of the ratio between the length of the scour and its depth.
In order to select the best flaring angle it was shown that the angle of 40° has the most discharge rate, least structure length and least angle scour depth, with the firmly of t
... Show MoreThe settlement rate and pore water pressure dissipation rate are mainly controlled by the permeability of soil. Both laboratory and field tests show that the permeability is varied during the loading and consolidation process. It is known that consolidation process is accompanied by decrease in void ratio which leads to decrease in the coefficient of permeability. The importance of the decrease of the coefficient of permeability on the time rate of settlement and pore water pressure needs to be investigated.
This paper takes into account the change in coefficient of permeability during consolidation and studies its effect on consolidation characteristics of a clay layer. The finite element method is used in the analysis and the packag
One of the most popular and legally recognized behavioral biometrics is the individual's signature, which is used for verification and identification in many different industries, including business, law, and finance. The purpose of the signature verification method is to distinguish genuine from forged signatures, a task complicated by cultural and personal variances. Analysis, comparison, and evaluation of handwriting features are performed in forensic handwriting analysis to establish whether or not the writing was produced by a known writer. In contrast to other languages, Arabic makes use of diacritics, ligatures, and overlaps that are unique to it. Due to the absence of dynamic information in the writing of Arabic signatures,
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This paper presents an intelligent model reference adaptive control (MRAC) utilizing a self-recurrent wavelet neural network (SRWNN) to control nonlinear systems. The proposed SRWNN is an improved version of a previously reported wavelet neural network (WNN). In particular, this improvement was achieved by adopting two modifications to the original WNN structure. These modifications include, firstly, the utilization of a specific initialization phase to improve the convergence to the optimal weight values, and secondly, the inclusion of self-feedback weights to the wavelons of the wavelet layer. Furthermore, an on-line training procedure was proposed to enhance the control per
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