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 aim of the research is to determine the impact of the Iraqi public budget on IPSASs by conducting the questionnaire; the research was based on the hypothesis that "there is an impact of the adoption of the International Accounting Standards in the general budget of Iraq”. The research concluded that the government accounting system closely interferes with the general budget at all stages. The shifting towards the accrual basis is the first element of the reform package towards reaching the reform of the state budget. Without reforming government accounting, it is almost impossible to develop the budget. IPSASs are a recognized reference to the assessment and development of governmen
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Money matters exert a considerable influence on man’s life-style, social
rank and his relationship with other people. This paper aims at exploring the impact
of money matters on the characters’ inner feelings, social status, and personal
relationships in Muriel Spark’s modern novel The Ballad Of Peckham Rye. This
paper aspires to show that Spark’s subtle portrayal of characters reveals the
dominance of money matters over human and social relationships.
Muriel Spark ( 1918-2006) is a modern Scottish novelist whose wit and
detached sense of humour has brought her prolific body of both popular and critical
acclaim. Spark is interested not in building suspense but in exploring the moral
significance of the
Tumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept.
Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patient
... Show More Despite the availability of information technology banking features and benefits of the banking sector, they involve many risks and challenges and put in the face of the administrative authorities and regulatory institutions in the banking system, organizational matters and control sensitive and bear direct responsibility for conducting independent assessments of their regulatory and information and determine the degree of its durability and its ability to confront problems imposed by the technical challenges and technological .
And the success of the administrative authorities and regulatory institutions in achieving its objectives in the management of risks and threats oversight resulting from the act
Iraq has seen many changes at the social, economic and political levels. This led to cause many shifts in the structure of its society and imposed great challenges reflected in the behavior and awareness of that society in general and youth in particular.
Those changes made the Iraqi society undergoing the transformation of value and culture aspects formed a political awareness that caused cultural and political diversity within the family and society. A greater openness to the outside world caused by the communication revolution, as the world has witnessed during the past two decades, has helped in making that change. Iraq had its share of media and political openness, which were included after the US occupation in 2003. As a re
... Show MoreBackground: The pandemic crisis prompted the world to adopt unexpected approaches to continue life as normally as possible. The education sector, including professors, students, and the overall teaching system, has been particularly affected. Objective: This study seeks to evaluate the benefits, challenges, and strategies related to COVID-19 from the perspectives of college students, particularly those in higher education in Iraq. Method: The online survey questionnaire was distributed via Google Forms and specifically aimed at undergraduate dental students. Results: A total of 348 students participated in the survey. There was a significant correlation (P > 0.01) between student satisfaction with hybrid learning and their experi
... Show MoreThis research is aiming to analyze the impacts of the current budget in Iraq by using the Government Finance Statistics Manual (GFSM) , the research is based on hypothesis: (There is an impact on the using of the Government Finance Statistics Manual (GFSM) In public budget in Iraq) .This hypothesis was demonstrated by using the questionnaire, a number of conclusions were reached, the most important being the lack of terminology adopted in the government accounting system and the Iraqi financial and accounting manual as a result of their adoption of the monetary basis for the lack of accounting terminology that meets t
... Show MoreThere are Islamic sources and books that deal with the different doctrinal and differential framework of the Islamic religion with a monistic approach, describing them with embarrassing jurisprudential titles such as: excommunication and expiation, and epithets that carry the characteristics of hatred and rejection, in addition to removing them from the sect and religion, and the reason for that is that the doctrine (A) or (b) considers itself the doctrine that represents only the Islamic religion, and other doctrines are misguided and disbelieving. the reasons behind this - besides the attempt to establish doctrinal and fiqih rooting in claiming truth and escaping from within the foundational differential doctrinal system – is the pol
... Show MoreRecently, environmental noise has arisen from various sources, such as those from exhaust mufflers of combustion engines found in cars, trucks, or power generators, which produce significant noise during their operation. Controlling the radiated noise from these mufflers is a major factor in improving acoustic comfort and minimizing the impact on the surrounding communities. Numerous research has been presented for this reason by modification of the internal structure of the exhaust muffler. The main objective of this work is to reduce the noise level emitted from exhaust mufflers. This can be achieved by adjusting structure parameters to attenuate the surrounding environment's radiated noise. Analysis of pressure-wave propagation h
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