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 i

Rheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition,

The necessary optimality conditions with Lagrange multipliers  are studied and derived for a new class that includes the system of Caputo–Katugampola fractional derivatives to the optimal control problems with considering the end time free. The formula for the integral by parts has been proven for the left Caputo–Katugampola fractional derivative that contributes to the finding and deriving the necessary optimality conditions. Also, three special cases are obtained, including the study of the necessary optimality conditions when both the final time  and the final state  are fixed. According to convexity assumptions prove that necessary optimality conditions are sufficient optimality conditions.

This paper involved the registration of 1,936 cases of infection of the Leishmania tropica parasite observed at hospitals and health centers in Ramadi, Fallujah, Baghdadi, and Hit during 2017. The results revealed that the highest rates of infection were found in Ramadi and Fallujah. The 1-10 years age group recorded the highest rate at 35.5%. There was no significant difference (p ≥ 0.05) between the sexes. December and January saw the highest rate of infection, where the rate in rural townships was found to be 65.5%, higher than in urban regions which saw a rate of 34.4%. Facial lesions were the most prominent area of infection, recorded at a rate of 41.3%. The study also included an examination of 180 rodents (94 mice and 86 black r