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: HLA-B27 can effect clinical presentation and course of ankylosing spondylitis. Different detection techniques of HLA-B27 are available with variable sensitivities and specificities. OBJECTIVE: To compare serologic and molecular diagnostic techniques of detecting HLA-B27 status and to correlate it with some clinical variables among ankylosing spondylitis patients. PATIENTS AND METHODS: A cross-sectional study was conducted on 83 Iraqi patients with ankylosing spondylitis. Clinical and laboratory evaluations were reported. HLA-B27 status was determined in all patients by real-time PCR using HLA-B27 RealFast™ kit; ELISA method was used as well to detect soluble serum HLA-B27 antigens using Human Leukocyte Antigen® kit. RESULTS:
... Show MoreHashimoto Thyroiditis (HT) is the most common autoimmune thyroid disease and the commonest cause ofhypothyroidism. C-reactive protein (CRP) is synthesized in hepatocyte in response to autoimmune disorders;strongly induced by IL-6. This study aimed to estimate serum IL-6 and CRP levels in autoimmune and non-autoimmune hypothyroidism. The present study included 60 Iraqi female hypothyroid patients divided to 30autoimmune and 30 non-autoimmune, with age ranged between 24-50 years and 30 healthy controls withage ranged between 27-52 years. Serum samples were collected from study groups. The levels of thyroidhormones (TSH, T4 and T3) were determined by using automated Chemiluminescence Immunoassay (CLIA)analysis system. Detection the levels of t
... Show MoreHepatitis B and Hepatitis C viruses are the major health problem in the worldwide. In the Middle East, the prevalence of HBV in general population with the chronic infectionsis 2-5%,whereas the prevalence of HCV is about 1% in Arabian Gulf countries. World Health Organization (WHO) revealed that the risks of HBV and HCV transmissionas well as human immunodeficiency virus (HIV) through the transfusion of contaminated blood and blood products is high, because of the fragility of health services in these countries. Several viral diseases are transportby different modes like bloodtransfusion, sexual contact, and unsafe injections. The mostcommon blood-transmitted viruses are hepatitis B virus(HBV), hepatitis C virus (HCV) and humanimmunodeficie
... Show MoreAbstract Objective: The underlying molecular basis of ischemic heart diseases (IHDs) has not yet been studied among Iraqi people. This study determined the frequency and types of some cardiovascular genetic risk factors among Iraqi patients with IHDs. Methods: This is a cross-sectional study recruiting 56 patients with acute IHD during a 2-month period excluding patients >50 years and patients with documented hyperlipidemia. Their ages ranged between 18 and 50 years; males were 54 and females were only 2. Peripheral blood samples were aspirated from all patients for troponin I and DNA testing. Molecular analysis to detect 12 common cardiovascular genetic risk factors using CVD StripAssay® (ViennaLab Diagnostics GmbH, Austria) was performed
... Show MoreBackground : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a d
... Show MoreCeliac disease (CD) is an immune-mediated disorder caused by gluten in genetically susceptible individuals characterized by chronic inflammation that essentially affects the small intestine. Objective: this study was designed to measure the potential role of some serological biomarkers including vitamin B12 and homocysteine (HCY) in the progression of CD as well as their relations to global DNA methylation (5mC). Materials and methods. Forty CD patients were enrolled in the study with an average age of (36.60 ± 2.03) years (range between 15 and 60). The diagnosis of the disease was confirmed by serological examinations and intestinal endoscopy in Gastroenterology and Liver Teaching Hospital in the Medical City Hospital in Baghdad
... Show MoreThe aim of this research is to find out the influence of Daniel's model on the skills of the twenty-first century among the students of the scientific-fifth grade at the secondary and preparatory government morning schools for the academic year 2022- 2023. Two groups were chosen out of five groups for the fifth-scientific grade, one of which represents the experimental group that is taught by the Daniel model, and the other is the control group that is taught in the traditional method. The equivalence of the two research groups was verified with a set of variables. As for the research tool, a scale was developed by the researchers for the skills of the twenty-first century, in which they adopted the framework of the Partnership Organizat
... Show MoreLecture method is still need to a part of PBL in order to explain the difficult and abstract concepts in all fields of physics particularly thermodynamics. Introducing and promoting PBL in the lecture method is wise step for innovation in teaching and learning. The objective of this study is to compare the effects of using three methods: problem-based learning (PBL), PBL with lecture method, and conventional teaching on undergraduate physics students’ understanding of thermodynamics. The actual sample size comprises of 122 students, who were selected randomly from the Physics Department, College of Education in Iraq in the academic year 2011-2012. In this study, the pre- and post-test were done and the instruments were administered to the
... Show MoreThe scarcity of irrigation water requires procedures of specific. One of these procedures is the implementation of the rationing system (a period of the irrigation followed by a period of the dry). This system can have an impact on the properties of irrigation channels. Therefore, the study of rationing system for irrigation channels is important in both water resources and civil engineering, especially if they are constructed with gypseous soil. In order to assess the rationing system on gypseous canals stabilized with a specific ratio of cement, practical experiments were conducted to detect the effect of wetting and drying cycles on the physical and hydraulic behavior of this soil and calculation of some properties of soil such a
... Show MoreThis research was based on two pillars. The first is a comparison between of research done and the result of a particular variable of research indebendently in the united state, and second, knowledge and determine the effect of managers practices on the contributions of personnel. The manager and staff are considered to be the most important elements in the organization and all of them have a duty towards the others which governed by the relationship rules of procedure of the ministry researched, on the one hand and the interests of the organization and hence employees , whether executives or employees within management formations that the availability of an acceptable level of good pract
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