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.
Nathaniel Hawthorne (1804-1864) has been widely known for his special interest in the female characters. In many of his novels, he narrates the conditions, values, and the institutions that surround and control the life of women, leading them to be victims. In “Rappaccini’s Daughter” (1844), the heroine, Beatrice is created to be victimized by her loved ones (her father and lover). This paper focuses on the term “victim,” it shows its aspects through the development of Beatrice’s character. The paper also studies a female character in the male-dominated society, to show the cruelty done to her, and how she is considered to be a second rate person, who is unable to live normally, or at least to save herself from dea
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Experimental investigation of the influence of inserting the metal foam to the solar chimney to induce natural ventilation are described and analyzed in this work. To carry out the experimental test, two identical solar chimneys (without insertion of metal foam and with insertion of metal foam) are designed and placed facing south with dimensions of length× width× air gap (2 m× 1 m× 0.2 m). Four incline angles are tested (20o,30o,45o,60o) for each chimney in Baghdad climate condition (33.3o latitude, 44.4o longitude) on October, November, December 2018. The solar chimney performance is investigated by experimentally recording absorber pl
... Show MoreBackground: This study aimed to evaluate the effect addition of polyester fibers on the some mechanical properties of heat cured acrylic resin (implant strength, flexural strength and hardness) Materials and methods: Ninety specimens were used in the study. Thirty specimens were used for impact strength measurements (80mm X 10mm X 4mm) length, width and thickness respectively. The specimens divided into three test groups (n=10), first group formed from heat cure acrylic resin without fiber reinforcement. Second group was formed from heat cure acrylic resin was reinforced with 2 mm length polyester fiber and third group was formed from heat cure acrylic resin reinforced with 4mm length polyester fiber, impact strength measured by impact test
... Show MoreBackground: Polymethyl methacrylate (PMMA) is the most commonly used material in denture fabrication. The material is far from ideal in fulfilling the mechanical requirement. The purpose of this study was to evaluate the effect of addition of 3% wt of treated (silanized) Titanium oxide Nano filler on some physical and mechanical properties of heat cured acrylic denture base material. Materials and methods: 100 specimens were constructed, 50 specimens were prepared from heat cure PMMA without additives (control) and 50 specimens were prepared from heat cure PMMA with the addition of TiO2 Nano fillers. Each group was divided into 5 sub groups according to the test performed which was mixed by probe ultra-sonication machine. Results: A highly
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The most famous thing a person does is talk. He loves and hates, and continues with it confirming relationships, and with it, too, comes out of disbelief into faith. Marry a word and separate with a word. He reaches the top of the heavens with a kind word, with which he will gain the pleasure of God, and the Lord of a word that the servant speaks to which God writes with our pleasure or throws him on his face in the fire. Emotions are inflamed, the United Nations is intensified with a word, and relations between states and war continue with a word.
What comes out of a person’s mouth is a translator that expresses the repository of his conscience and reveals the place of his bed, for it is evidence of
... Show MoreThe research aims to identify the theoretical foundations for measuring and analyzing quality costs and continuous improvement, as well as measuring and analyzing quality costs for the Directorate of Electricity Supply / Middle Euphrates and continuous improvement of the distribution of electrical energy,The problem was represented by the high costs of failure and waste in electrical energy result to the excesses on the network and the missing (lost) energy,Thus, measuring and analyzing quality costs for the distribution of electrical energy and identifying continuous improvement leads to a reduction in missing and an increase in sales, as the research reached many conclusions, the most important of which is the high percentage o
... Show MoreBreast cancer has got much attention in the recent years as it is a one of the complex diseases that can threaten people lives. It can be determined from the levels of secreted proteins in the blood. In this project, we developed a method of finding a threshold to classify the probability of being affected by it in a population based on the levels of the related proteins in relatively small case-control samples. We applied our method to simulated and real data. The results showed that the method we used was accurate in estimating the probability of being diseased in both simulation and real data. Moreover, we were able to calculate the sensitivity and specificity under the null hypothesis of our research question of being diseased o
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