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 general assumption of linear variation of earth pressures with depth on retaining structures is still controversial; investigations are yet required to determine those distributions of the passive earth pressure (PEP) accurately and deduce the corresponding centroid location. In particular, for rigid retaining walls, the calculation of PEP is strongly dependent on the type of wall movement. This paper presents a numerical analysis for studying the influence of wall movement on the PEP distribution on a rigid retaining wall and the passive earth thrust location. The numerical predictions are remarkably similar to existing experimental works as recorded on scaled test models and ful
Over the course of six decades, Iraq exposed to many events that have affected the Iraqi people from the social, physical and mental aspects. In this study, two groups of people (2369), from Iraq (G1) and the Michigan, United States (U.S) of America (G2) selected to compare the prevalence rate and effects of trauma factors such as mental illness (anxiety, depression and PTS), somatic diseases (heart disease, hypertension, and diabetes), substances abuse (illicit drugs, alcohol and tobacco), and chemicals pollution), and self-rated health among the two groups. The study results reveals a significant different between the two groups in the all indicators for trauma. The study conclude that Iraqi in U.S. (G2) suffer from factors completely dif
... Show MoreABSTRACT Background: Viral hepatitis places a heavy burden on the health care. Large number of patient with bleeding disorders has chronic hepatitis C infection, while few are chronic carriers of hepatitis B virus. Aims of study: evaluate the prevalence of HBV, HCV infection among patient with Von Willebrand disease and to find factors that associated with the chance of getting the infection.
The Impact of Intellectual trends on the nature of the Economic Structure of Iraq
This research means a study (the impact of the Arab-Islamic environment on contemporary painting, the artist Abd al-Rahman al-Suleiman as a model). The research falls into two axes: the first: the theoretical axis, and the second: the applied axis. The first axis dealt with an introduction that contained: (the research problem, its importance, its goal, its limits, and the definition of terms). This research aims to uncover (the impact of the Arab-Islamic environment on contemporary painting, and the artist Suleiman was a model). And the research limits spatially: Saudi Arabia, and temporally: 2010-2014. This theme included two topics: The first: the characteristics of the Saudi environment and its impact on art. The second: the s
... Show MoreThe current research aims to identify the level of impact of strategic improvisation as an independent variable on organizational health. The dependent variable in the Department of Health of Dhi Qar to reach appropriate mechanisms in order to reach appropriate mechanisms and recommendations proposed to contribute to the achievement of organizational health in the Department of Health of Dhi Qar (the research department) and based on the importance of the subject of research in government institutions and the important and service role of the Department of Health of Dhi Qar in the Iraqi society. The descriptive analytical approach was adopted in the completion of the research based on the opinions of the leaders in the surveyed depa
... Show MoreKurdistan power system is expanded along years ago. The electrical power is transmitted through long transmission lines. The main problem of transmission lines is active and reactive power losses. It is important to solve this issue, unless, the most of electrical energy will lost over transmission system. In this study, High Voltage Direct Current links/bipolar connection were connected in a power system to reduce the power losses. The 132kV, 50 Hz, 36 buses Kurdistan power system is used as a study case. The load flow analysis was implemented by using ETAP.16 program in which Newton-Raphson method for three cases. The results show that the losses are reduced after inserted HVDC links.