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.
Membrane distillation (MD) is a hopeful desalination technique for brine (salty) water. In this research, Direct Contact Membrane Distillation (DCMD) and Air Gap Membrane Distillation (AGMD) will be used. The sample used is from Shat Al –Arab water (TDS=2430 mg/l). A polyvinylidene fluoride (PVDF) flat sheet membrane was used as a flat sheet form with a plate and frame cell. Several parameters were studied, such as; operation time, feed temperature, permeate temperature, feed flow rate. The results showed that with time, the flux decreases because of the accumulated fouling and scaling on the membrane surface. Feed temperature and feed flow rate had a positive effect on the permeate flux, while permeate temperatu
... Show MoreIn this work, we introduce Fibonacci– Halpern iterative scheme ( FH scheme) in partial ordered Banach space (POB space) for monotone total asymptotically non-expansive mapping (, MTAN mapping) that defined on weakly compact convex subset. We also discuss the results of weak and strong convergence for this scheme.
Throughout this work, compactness condition of m-th iterate of the mapping for some natural m is necessary to ensure strong convergence, while Opial's condition has been employed to show weak convergence. Stability of FH scheme is also studied. A numerical comparison is provided by an example to show that FH scheme is faster than Mann and Halpern iterative
... Show MoreToxic substances have been released into water supplies in recent decades because of fast industrialization and population growth. Fenton electrochemical process has been addressed to treat wastewater which is very popular because of its high efficiency and straightforward design. One of the advanced oxidation processes (AOPs) is electro-Fenton (EF) process, and electrode material significantly affects its performance. Nickel foam was chosen as the source of electro-generated hydrogen peroxide (H2O2) due to its good characteristics. In the present study, the main goals were to explore the effects of operation parameters (FeSO4 concentration, current density, and electrolysis time) on the catalytic perform
... Show MoreIt is believed that Organizations around the world should be prepared for the transition to IPv6 and make sure they have the " know how" to be able to succeed in choosing the right migration to start time. This paper focuses on the transition to IPv6 mechanisms. Also, this paper proposes and tests a deployment of IPv6 prototype within the intranet of the University of Baghdad (BUniv) using virtualization software. Also, it deals with security issues, improvements and extensions of IPv6 network using firewalls, Virtual Private Network ( VPN), Access list ( ACLs). Finally, the performance of the obtainable intrusion detection model is assessed and compared with three approaches.
Heart diseases are diverse, common, and dangerous diseases that affect the heart's function. They appear as a result of genetic factors or unhealthy practices. Furthermore, they are the leading cause of mortalities in the world. Cardiovascular diseases seriously concern the health and activity of the heart by narrowing the arteries and reducing the amount of blood received by the heart, which leads to high blood pressure and high cholesterol. In addition, healthcare workers and physicians need intelligent technologies that help them analyze and predict based on patients’ data for early detection of heart diseases to find the appropriate treatment for them because these diseases appear on the patient without pain or noticeable symptoms,
... Show MoreThere are numerous bidirectional interactions between the reproductive system and the liver. Sex steroids regulate metabolic health through signaling effects in both peripheral and central metabolic tissues, including adipose tissue, liver, skeletal muscle, and brain, and have a role in the etiology of structural and functional liver diseases. Blood samples were obtained from 90 healthy women (control group) and 90 women that have hormonal changes (patients’ group). The levels of reproductive hormones (follicle stimulation hormone/FSH, luteinizing hormone/LH, estradiol/E2, progesterone/P4) were measured by using fully automated Cobas E411, whereas those of liver enzymes (alanine transaminase /ALT, aspartate aminotransferase/AST, a
... Show MoreThis study was conducted to assess the hydrocarbon degradation abilities of Sphingomonas paucimobilis, Pentoae species, Staphylococcus aureus, and Enterobacter cloacae, which isolated from diesel contaminated soil samples. Single strains and mixed bacterial consortia have been investigated their ability to degrade 1.0 % (v/v) of diesel oil in Bushnell- Haas medium as sole.carbon.and.energy.source. At temperature 30∘C, the individual.bacterial.isolates exhibited low growth and low degradation.than did the.mixed. bacterial.culture. After 28 days.of incubation the.combination.of four isolates degraded.an upper limit.of diesel 88.4%. This was. continued.by 85.1% by S. paucimobilis, 84 % by Pentoae sp., 79% by S.aureus, and
... Show MoreMeta-heuristic algorithms have been significantly applied in addressing various real-world prediction problem, including in disease prediction. Having a reliable disease prediction model benefits many parties in providing proper preparation for prevention purposes. Hence, the number of cases can be reduced. In this study, a relatively new meta-heuristic algorithm namely Barnacle Mating Optimizer (BMO) is proposed for short term dengue outbreak prediction. The BMO prediction model is realized over real dengue cases data recorded in weekly frequency from Malaysia. In addition, meteorological data sets were also been employed as input. For evaluation purposes, error analysis relative to Mean Absolute Percentage Error (MAPE), Mean Square Err
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