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Personalised Warfarin Dosing in Children Post-cardiac Surgery
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Abstract<p>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% (<italic>p</italic> = 0.84) and mean %TTR was 85.47% versus 80.2% (<italic>p</italic> = 0.09), respectively. The results suggest model-based dosing can improve anticoagulation control, particularly when initiating and stabilising warfarin dosing. Larger studies are needed to confirm these findings.</p>
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Publication Date
Tue Mar 07 2017
Journal Name
Journal Of Pharmacy And Pharmacology
Personalised dosing of medicines for children
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Abstract<sec><title>Objectives

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.

Key findings

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

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Practices regarding Patients Discharge Planning post Cardiac Surgery at Cardiac Centers in Baghdad city
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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

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Functional Performance For Patients Post Heart's Valves Replacement at Cardiac Surgery Centers in Baghdad City
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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

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Publication Date
Sun Jul 30 2023
Journal Name
Pakistan Heart Journal
Evaluation of nurses Practice toward Children Safety Post Cardiac Catheterization Procedure
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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Preoperative Psycho-educational Program on Stress of Cardiac Surgery Patients
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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

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Success rate of Percutaneous Coronary Intervention of Chronic Total Occlusion in Ibn Al-Baitar Hospital for cardiac surgery and Al-Nassyeria cardiac center
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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

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Cardiac Rehabilitation Instructional Program on Health-related Quality of Life for Patients Undergone Coronary Artery Bypass Graft Surgery
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Objective(s): evaluation of effectiveness of cardiac rehabilitation instructional program on health-related quality of life and to find out the relationship between health-related quality of life and patient’s socio-demographic and clinical characteristics. 

Methodology: A descriptive study design was carried out from 8th August, 2022 to 10th January, 2023.

A non-probability purposive sample of (50) patients undergone coronary artery bypass graft surgery at Iraqi center for heart diseases using pre-experimental design. The data were collected by direct interview with sample using questionnaire composed of three parts: part (1) Socio-demographic and clinical ch

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Cardiac Rehabilitation Instructional Program on Health-related Quality of Life for Patients Undergone Coronary Artery Bypass Graft Surgery
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Objective(s): evaluation of effectiveness of cardiac rehabilitation instructional program on health-related quality of life and to find out the relationship between health-related quality of life and patient’s socio-demographic and clinical characteristics.  Methodology: A descriptive study design was carried out from 8th August, 2022 to 10th January, 2023. A non-probability purposive sample of (50) patients undergone coronary artery bypass graft surgery at Iraqi center for heart diseases using pre-experimental design. The data were collected by direct interview with sample using questionnaire composed of three parts: part (1) Socio-demographic and clinical characteristics which included 11 items. Part (2) Knowledge r

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Publication Date
Tue Dec 01 2020
Journal Name
Al-khwarizmi Engineering Journal
Studying the Radial and Tangential Velocity Components of the Epithelization Healing Post Photorefractive Keratectomy Surgery of the Human Eye
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Photorefractive keratectomy (PRK) is the refractive technique that began with a physical scraping of the epithelial layer of cornea subsequent by laser treatment. Post this procedure to about 48 hours the removed epithelial layer regenerated to protect the eye again. The regeneration process (called re-epithelization) started from the limbus of the cornea toward the central part of it. The re-epithelization mechanism consists of a change in cell density (mitosis) and cell concentration (migration) with a velocity in two directions: radial and tangential. In the present study, an estimation for both radial (responsible for the overlapped layers toward the outward direction of the cornea) and tangential comp

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents
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Abstract

urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed

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