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: Coronavirus, which causes respiratory illness, has been a public health issue in recent decades. Because the clinical symptoms of infection are not always specific, it is difficult to expose all suspects to qualitative testing in order to confirm or rule out infection as a test. Methods: According to the scientific studies and investigations, seventy-three results of scientific articles and research were obtained using PubMed, Medline, Research gate and Google Scholar. The research keywords used were COVID-19, coronavirus, blood parameters, and saliva. Results: This review provides a report on the changes in the blood and saliva tests of those who are infected with the COVID-19.COVID-19 is a systemic infection that has
... Show MoreBackground: Interleukin-6 (IL-6) is a cytokine that has several functions, including stimulating growth and inhibiting cell death. It has the potential to operate as a biomarker for the accurate prediction of disease severity and activity, platelets-rich plasma was used in the treatment of oral lichen planus and can change the salivary IL-6 level.
Objectives: To study the clinical outcome of intralesional platelets-rich plasma in patients with oral lichen planus and to measure salivary IL-6 levels before and after the treatment with platelets-rich plasma were the aims of this study.
Subjects and Methods: In this clinical trial, for each patient a standardi
... Show MoreThis research dealt with the subject of negotiation skills of employees in public relations departments which is one of many skills supposed to be available to these employees. These skills combined help in the success of the job of public relations departments; and give them an important and vital role within the roles distributed in the departments of any government institution wither is governmental or non-governmental.
Negotiation is a skill that requires intelligence, tact, culture, information, intuition, and knowing to use the means of communication to access the information that is useful in reaching satisfactory results
... Show MoreThe article reflects the results of the analysis of the use of metaphors when creating the image of the main character of the story by D. Rubina "You and me under the peach clouds" - a pet, a dog named Kondraty. Through metaphorization, the image of the dog is filled by the author with purely human qualities, thus passing into the category of a full member of the family. The article is a continuation of the study of the work of D. I. Rubina.
يعد التكرار من الظواهر الاسلوبية التي اتخذت دورها في بناء النص الشعري الحديث ويقوم على جملة من الاختيارات الاسلوبية لمادة دون أخرى ولصياغة لغوية دون سواها ، مما يكشف في النهاية عن سرّ ميل هذا النص الشعري أو ذاك لهذا النمط الاسلوبي دون غيره ، وعلى الرغم من ان التكرار يعد مسألة عامة وشائعة في العمل الأدبي ، فأن الاهتمام بهذا الجانب من المنهج الاسلوبي يأتي من جهة كونه مهيمناً له ايحاءاته ودلال
... Show MoreThis research focuses on the contemporary geostrategic transformations that afflicted the countries of the Middle East, with a focus on the countries of the Arab East, after the collapse of the system of international relations, and the emergence of the unipolar system led by the United States of America. After the events of September 11 and the events that followed, especially the occupation of Iraq in 2003, the study area witnessed a group of geopolitical variables and the emergence of dangerous phenomena that threatened the state structure in the countries of the Middle East; the most notably are the phenomenon of terrorism, cross-border armed groups, sectarian polarization, the phenomenon of migration and the internal and the externa
... Show MoreTeresa Fitzpatrick presents a connection between oppressed women and the plant of Wisteria in gothic fiction in her article “Wisteria: A Female Eco-Gothic Metaphor in American Fiction Through the Ages.” The connection between women and nature is common in literature as women are usually compared to the beauty or ferocity of flowers, rivers, or natural phenomena in general. The connection extends to the architecture and sort of plants that appear in gothic literature. Gothic novels have routinely been connected to the secrets and life stories of women who cannot have the liberty to live or share them outside their homes. A fearful house with a prisoned person, ghost, or a secret is mostly normally found in gothic writing. Women have exce
... Show Morefashion designers who have benefited greatly from the mobilization of ancient aesthetic ideas in the heritage of the people and guaranteed in their productions so that there is no change In the aesthetic value created by the designers of the research in the ancient heritage to find new signs that reflect the connection of man to the present as the aesthetic value of all the man created by the designs of fabrics and fashion through the ages The problem of research was determined in the absence of a precise understanding of the nature of classical thought in fashion and the absence of a clear perception of the sustainability of this thought in contemporary fashion. He
... Show MoreIn this paper, the finite element method is used to study the dynamic behavior of the damaged rotating composite blade. Three dimensional, finite element programs were developed using a nine node laminated shell as a discretization element for the blade structure (the same element type is used for damaged and non-damaged structure). In this analysis the initial stress effect (geometric stiffness) and other rotational effects except the carioles acceleration effect are included. The investigation covers the effect speed of rotation, aspect ratio, skew angle, pre-twist angle, radius to length, layer lamination and fiber orientation of composite blade. After modeling a non-damaged rotating composite blade, the work procedure was to ap
... Show MoreIs no longer a football player looks to sport as a means of entertainment and physical development. But become see as part of The economic and is getting in return for the effort of، Through a contract with a club to organize the activity which is called a contract of professional, This contract is similar to the rest of the contracts in terms of problems and dispute that arise during the implementation or after it ends because of the nature of sports to such disputes and privacy being subject to special rules (regulations, national and international professional) required that subject to judicial bodies private mission confined settle sports disputes these entities and is affiliated unions legal committees and the court of arbitration for
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