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.
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
The research aims to study the reliability of government institutions, including the audit directors, which are one of the most important oversight formations in the Ministry of Construction, Housing and Public Municipalities, on which the responsibility for comprehensive auditing of all the Ministry's (municipalities) formations falls on the Managing the Audit Program according to the specification (ISO 19011: 2018) to improve the audit performance which requires compliance with the application of the audit management system in accordance with the standard Specification (ISO 19011: 2018), depending on the methodology of the case study, and using of checklists, which were chosen ac
... Show More“Child of today is a man of the future" this slogan is one of the most popular logos of international organizations and institutions that dealing with human beings needs in general and children needs in particular, whether these needs are educational, health, social, or economic. Children require special care and extra legal protection, since the child-raising is not the Child’s own issue, but it's the issue of the society in which he/she would integrate.
As the education and language skillsacquisition primarily associated with hearing, because human being receives most of the skills and knowledge through the hearing; that imitate sounds and learn how to speak isacquired only by hearing, so therefore the hearing - impairedchi
... Show MoreThe research aims to demonstrate the impact of tax techniques on the quality of services provided to income taxpayers by studying the correlational and influencing relationships between the exploited variable (tax techniques) and the dependent variable (the quality of services provided to income taxpayers), and in line with the research objectives, the main hypothesis of the research was formulated (there is a relationship Significance between tax techniques and the quality of services provided to income taxpayers) a number of sub-hypotheses emerged from this hypothesis that were stated in the research methodology, and a number of conclusions were reached, the most important of which were (through the use of the correlation coeff
... Show MoreThe research aims to achieve a set of objectives, the most important of which is to educate the management of companies operating in the private sector about the advantages and risks of using creative accounting practices, as on the one hand they serve the interests of the company and improve its image, and on the other hand it exposes it to the risks of non-compliance with tax laws and legislation or the risks of default and bankruptcy as a result of exploiting gaps and flexibility in the application Accounting standards, and in line with the objectives and through the research problem that was formulated in the form of a question (Are their creative accounting practices that are reflected in the honesty and fairness of financia
... Show MoreIn Iraq, government contributions to the public companies have become a very important aspect which contributes to the survival and sustainability of these institutions as it consider one of the main sources of funding, if not it consider the basis of funding.
According to the vital roles assigned to these institutions to follow up, which usually include important activities in the national economy, the research focused on studying the field reality of the method used in evaluating the stock of total production and purchases of goods for the purpose of selling the strategic commodities of the General Company for Grain Trade. As a result, the aim of this study came to came to highlight&n
... Show MoreBackground:The technology of nanoparticles has been expanded to many aspects of modern life. Titanium dioxide nanoparticles were of many nanomaterials utilized in biomedical applications. The interactions between nanoparticles and proteins are believed to be the base for the biological effect of the nanoparticles. The oxidation reaction of many substances is catalyzed by oxidizing enzymes called peroxidases. The activity of salivary peroxidase is elevated with periodontal diseases. the aim ofthis study is to examine the action of titanium dioxide nanoparticles on salivary peroxidase activity.Material and method75 participants were enrolled in this study—Periodontitis group with 44 participants and the non-periodontitis group with 31 pa
... Show MoreThe subject of Iranian no clear program and the Russian Attitude from it, regard as an important matter in international relations, really it was remarkable and distinctive position towards.
The development of Iranian no clear program in this study we treated Three sides.
The firs the collapse of USSR and its effect of Iran while the second aspect concentrate on the nature of Iranian- Russia Relation, the Third side research the Russia A attitude from
Iranian nuclear program, briefly this attitude is represented by positive, supporting and predication but in the sometime focused on Russian interests in the region of Middle East.
Background: Chronic hepatitis B virus (HBV) infection is a common health problem that has a worldwide distribution. Apart from the direct effect of the virus on the liver, there are many extrahepatic manifestations among which the probable effect on bone turnover associated with low bone mineral density (BMD). Objectives: This study aimed to determine the association between treated and untreated chronic HBV infection with BMD. Methods: This is a cross-sectional study which included a total of 48 patients with chronic HBV (28 patients treated with tenofovir-disoproxil-fumarate [TDF] antiviral drug and 20 patients have not yet started treatment). Other age- and sex-matched 30 apparently healthy individuals were recruited to represent the hea
... Show MoreThis review paper examines the crucial impact of YouTube on learning English as a Foreign Language. Recently, learners’ interaction and development of their skills have been improved due to the integration of digital platforms into language education. YouTube is regarded as one of the most prevalent platforms due to its accessibility, multimodal content, and capacity to simulate real-life communication. This study tackles thirty selected research articles from various cultural and institutional backgrounds to identify the pedagogical benefits and challenges associated with using YouTube in teaching English. Conventional methods of teaching English as a foreign language encounter difficulties in improving students’ engagement and
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