Warfarin dosing is challenging due to a multitude of factors affecting its pharmacokinetics (PK) and pharmacodynamics (PD). A novel personalised dosing algorithm predicated on a warfarin PK/PD model and incorporating CYP2C9 and VKORC1 genotype information has been developed for children. The present prospective, observational study aimed to compare the model with conventional weight-based dosing. The study involved two groups of children post-cardiac surgery: Group 1 were warfarin naïve, in whom loading and maintenance doses were estimated using the model over a 6-month duration and compared to historical case-matched controls. Group 2 were already established on maintenance therapy and randomised into a crossover study comparing the model with conventional maintenance dosing, over a 12-month period. Five patients enrolled in Group 1. Compared to the control group, the median time to achieve the first therapeutic INR was longer (5 vs. 2 days), to stable anticoagulation was shorter (29.0 vs. 96.5 days), to over-anticoagulation was longer (15.0 vs. 4.0 days). In addition, median percentage of INRs within the target range (%ITR) and percentage of time in therapeutic range (%TTR) was higher; 70% versus 47.4% and 83.4% versus 62.3%, respectively. Group 2 included 26 patients. No significant differences in INR control were found between model and conventional dosing phases; mean %ITR was 68.82% versus 67.9% (
Doses for most drugs are determined from population-level information, resulting in a standard ?one-size-fits-all’ dose range for all individuals. This review explores how doses can be personalised through the use of the individuals’ pharmacokinetic (PK)-pharmacodynamic (PD) profile, its particular application in children, and therapy areas where such approaches have made inroads.
The Bayesian forecasting approach, based on population PK/PD models that account for variability in exposure and response, is a potent method for personalising drug therapy. Its potential utility is eve
Objective (s): to assess nurses' practices regarding discharge planning post-cardiac surgery and to find out the relationship between nurse practices and demographic characteristic (age, gander, level of education, years of experiences, and years of experiences in surgical ward).
Methodology: A descriptive study was carried out at cardiac centers and hospitals in Baghdad (Ibn Al- Bitar specialized center for cardiac surgery; Iraqi center for heart disease and Ibn al Nafees hospital). For the period of 6th February 2017 up to 1st of June 2018. A non-probability (purposive) sample of (58) nurses (male & female) who were working in surgical wards. The data was collected, by using of a questionnaire, which consists of two parts, part
Abstract
Objectives: The study is carried out to assess functional performance for heart's valve replacement patients and find out relationship with sociodemographic data and clinical data
Methodology: Descriptive design is carried out at cardiac surgery centers in Baghdad ; Ibn -Al Betar Specialized for cardiac surgery center and Al-Iraqi center for cardiac disease. its initiation from December28the 2013 to September 1st 2014,A non- probability (purposive) sample of 50 adults patients are attended cardiac surgery centers at Baghdad city and who have heart valves replacement. The data collection through development of questionnaire which is composed from three parts(socio demographic data, clinical information, functional performa
Background: Dobutamine stress echocardiography (DSE) is a well established non invasive test for the diagnosis and risk stratification of patients with coronary artery disease. Aim of the study was to conduct a pilot study in order to establish the basis for the future routine practice of DSE in our center (Ibn Al- Bitar Hospital for Cardiac Surgery).
Patients and Methods: Fifty consecutive patients who were referred from the outpatient of our center, from August 2007 to July 2008, were included. The age range was 39 – 70 years with an average of 57.18 years. Fifty-eight percent were males. Patients were enrolled in the study in accordance with the American Heart Association/ American College of Cardiol
Objective: The study aimed to determine the effectiveness of preoperative psycho - education al
program on cardiac surgery patients information and their level of stress. And find out the differences
in the Psycho educational
program with regard to patients demographic characteristics such as age and gender.
Methodology Aquazi-experimental study was carried out to determine the effectiveness of
preoperative education program on stress for cardiac surgery patients in Baghdad city from the 28th of
March, 2010 , to 19th of September ,2011.
The preoperative psycho - educational program, as well as the questionnaire was constructed as a tool of
data collection for the purpose of the study. Purposive (non probability) s
Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI
J. Fac. Med. Baghdad 2023. Vol 65, No. 4
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Background: previously type 1 diabetes mellitus (T1DM) was listed among the causes of severing growth retardation. Iraq was exposed to wars and conflicts that affect health services which in turn affect the glycemic state of diabetic patients.
Objective: To report on the growth of diabetic children in post-conflict Iraq.
Methods: A total of 100 children with T1DM were included in the study. They were attending the consultancy clinic in Children Welfare Teaching Hospital for the period from 1st of Feb to 30th of May 2017. Weight and height were measured. The growth indices at diagnosis were taken from a case file.
Results: A total of 100 children with T1DM included in this study. Their age was 9.3 ± 3.2 years with a male to fema
Background: Regional anesthesia is a common procedure in an adult patient undergoing ophthalmic surgery, but it cannot be done alone in the pediatric age group. General anesthesia is accompanied by complications intra- and post-operatively.
Objectives: to determine whether or not using regional anesthesia in combination with general anesthesia in pediatric eye procedures improves patient outcomes.
Methods: Forty children, with an age range of 6 - 12 years were included in the study that was conducted at Ghazi Al-Hariri Hospital / Department of Ophthalmology and Ibn Al-Haytham (Ophthalmology Hospital), both teaching hospitals, from December 2018 to October 2019. These childr
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