Bleeding disorders in pediatrics is an important issue and can be lifethreatening if not diagnosed and treated appropriately. We aimed to evaluate Iraqi pediatric practice (as an example of resource-limited settings) about the use of Recombinant Activated Factor VII (RFVIIa) in bleeding disorders, with emphasis on its effectiveness and safety, in comparison with adjuvant therapy. Budget restrictions may affect the availability of even lifesaving drugs such as (RFVIIa). Therefore, we tried to investigate the local experience of pediatric bleeding, with the evaluation of the potential ability of adjuvant therapy of blood products and vitamin K to substitute RFVIIa in case of non-availability. During a complete one year‘s period, 35 patients were recruited prospectively and divided into two categories; study group (on RFVIIa, with or without adjuvant therapy) and control group (only on adjuvant therapy of blood products, and vitamin K), involving 19, and 16 patients, respectively. The mortality rate in the study group was signiϐicantly less than the control group; (36.84%) versus (56.25%). Larger drops in prothrombin time (PT) (42%), and partial thromboplastin time (PTT) (47%), with less multi-organ dysfunction (29%) were noticed with the use of RFVIIa. Septicemia-associated disseminated intravascular coagulation was the most frequent indication of both groups; (31.58%) versus (37.50%), with a signiϐicant positive outcome in the study group. Total serum bilirubin levels were found to be lower in all neonates with jaundice within the study group. One patient had venous thrombosis following the RFVIIa administration. In conclusion, RFVIIa has the potential to stop pediatric bleeding episodes signiϐicantly better than adjuvant therapy alone, with signiϐicantly less mortality. Safety was ensured in all survived cases except one who had thromboembolism. Neonatal jaundice was improved by the use of RFVIIa.
Abstract:
The current research aims to demonstrate the relationship of correlation and influence between the independent variable strategic control through its dimensions represented by (organizational structure, human resources management, commitment to specialization, defining powers and responsibilities, values and integrity) and the dependent variable the performance of the insurance company, and the degree of arrangement of these dimensions according to their importance, as well as Detection of significant differences in the sample's response to the questionnaire paragraphs in the researched company, and the research problem
... Show MoreBackground: Neural tube defects (NTDs) are said to be inherited in a multifactorial fashion, i.e. genetic-environmental interaction. Maternal nutritional deficiencies had long been reported to cause NTDs, especially folate deficiency during early pregnancy. More attention had been paid to the exact mechanism by which this deficiency state causes these defects in the developing embryo. The most significant of all researches was that connecting reduced folate and increased homocysteine level in maternal serum on one hand and the risk of developing a NTD baby on the other hand. Objectives : to determine the significance of homocysteine level in Iraqi mothers who gave birth to babies with NTDs as compared to normal controls. Patients, Materials
... Show MoreThe health care industry is witnessing an increasing trend in the use of generic medicines because of their presumed low cost compared with innovator medicines. The aim of this study was to determine and compare the performance of the copy drug Osveral®and its innovator drug deferasirox (Exjade®).
A prospective observational study including 223 patients receiving the branded medicine Exjade®and 101 patients receiving the copy Osveral®was carried out. Data were assessed for a 1-year period and included clinical symptoms, serum ferrit
Objectives Acid sphingomyelinase deficiency (ASMD) is an inherited autosomal recessive disease caused by pathogenic variants in the sphingomyelin phosphodiesterase-1 (SMPD1) gene, which encodes acid sphingomyelinase (ASM). ASMD has 3 broad phenotypes (type A, type A/B, and type B) characterized by the age of onset, symptomatology, and the rapidity of disease progression. The diagnosis of ASMD can be delayed or missed because of the wide spectrum of severity and its variable manifestations. Analysis of genotype-phenotype correlations can help to determine ASMD disease type and inform management. Here, we describe the clinical presentation of 47 patients with ASMD referred to a single center in Iraq since 2007, whose diagnosis was confirmed b
... Show MoreUniversity campuses in Iraq are substantial energy consumers, with consumption increasing significantly during periods of high temperatures, underscoring the necessity to enhance their energy performance. Energy simulation tools offer valuable insights into evaluating and improving the energy efficiency of buildings. This study focuses on simulating passive architectural design for three selected buildings at Al-Khwarizmi College of Engineering (AKCOE) to examine the effectiveness of their cooling systems. DesignBuilder software was employed, and climatic data for a year in Baghdad was collected to assess the influence of passive architectural strategies on the thermal performance of the targeted buildings. The simulations revealed that the
... Show MoreBackground: Inflammatory bowel disease (IBD) is a collection of chronic, recurrent inflammatory illnesses of the gastrointestinal system, including Crohn's disease (CD). Infliximab is one of the biological medications used to treat CD. Therapeutic drug monitoring has evolved as a treatment in IBD, aiming to optimize benefit while meeting more demanding, objective end criteria. Objective: To determine the achievement of target trough level (TL), develop anti-drug antibodies (ADAs) to infliximab, assess response to therapy, and study TL relations with different variables. Methods: The present study was cross-sectional and conducted from May 2022 to November 2022. It included 40 CD patients allotted into 2 groups: group 1 patients ach
... Show MoreThe organizational integration forms a necessity according to McKinsey model, especially for service organizations. In the context of various service sector developments, importance adoption of compact mechanisms by these organizations to upgrade their services has increased and senior management must be more aware of environmental, competitive and developmental requirements. It gets more important when it shows in an organization seeking at excellence of making services within its policies and strategies. Subject organizational integration dimensions (strategy, structure, systems, style, staff, shared values, and skills) are effective components in directing behaviors of employees and organization. This motivated both researcher
... Show MoreVarious visual media are becoming an increasingly important and active instrument of communication. This fact has led some political parties and leading personalities in Iraq to make use of them as an accepted forum for the discussion of public affairs usually in a manner that conforms to their declared policy. They have to draw as much popular support as they could for the causes which they fight for. As a result, a state of great confusion has been created from the contradictory statements made by the contending parties and gave left grave consequences on all types of the audience receiving them. The problem of the study can be summarized in one major question: What is the opinions of the audience as regards the statements made by the
... Show MoreTwo groups of chronic hepatitis B and C virus patients were divided into Pre-treated patients (25 CHB patients with positive HBs Ag for more than 6 months and 40 CHC patients), and post-treated patients [12 CHB patients (4, 6, and 2 were treated with lamivudine, IFN-? and combination of LMV + IFN-? respectively), and 27 patients for CHC (3, 13 and 11 patients were treated with Ribavirin, IFN-? and combination therapy (RBV+ IFN-?) respectively].These patients were followed up for 6 months. By using ELISA technique, levels of IL-6, IL-10, IFN-? and TNF-? were measured in vivo and in vitro (supernatant of PBMCs stimulated with PHA) and compared with healthy control. The mean level of IL-6, IL-10 and TNF-? in CHB patients showed significant dif
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