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% (
The art has been turned its subject in the post modern thinking . this turning is aresult to the turning in the role of the art it self. Across its history the art was basing its subject on a universal unite it the phenomenenon which is the most elevated . that the artist try to activate the role of the subject as a axial which compose the plastic art them. Because of the history of art full with subjects which consider in alarg part of it, have relation ship with elite and aesthetics , and from the begening of renaissance the central activity of the art was based on opoint which has concentrated reaction or it going in away belong to the state in that time.so renaissance was in relegous axial and romantisim on a dream axial, classisisim
... Show MoreLinked to the post-modern historical transformations sociological which raided the developed Western societies since the middle of last century, which consisted mainly in the emergence of what he called Alsosiologion (consumer society a) and (Affluent Society), as it appeared the new social lifestyle is not only characterized by the provision of the accumulation of capital and sparingly in spending, but rather a kind of extravagance and encourage consumption, prompting some to say that consumption is a community postmodern engine, and other labels for this period of economic backgrounds, such as the new capitalism and the system of the new capitalist Alseperntiqi technical and labels purist such as industrial post-society emerged, some a
... Show MoreBackground: Restoration of root canal treated teeth with a permanent restoration affect in the success of endodontically treated teeth. This in vitro study was performed to evaluate and compare the fracture strength of endodontically treated teeth restored by using custom made zirconium posts and cores, prefabricated carbon fiber, glass fiber and zirconium ceramic posts. Materials and method: Forty intact human mandibular second premolars were collected for this study and were divided into five groups. Each group contains 8 specimens: Group1: Teeth restored with Carbon Fiber Posts; Group2: Teeth restored with Glass Fiber Posts; Group3: Teeth restored with Zirconium Ceramic prefabricated Posts; Group4: Teeth restored with Zirconium Posts
... Show MoreSeptember 11th attacks held the biggest tragedy in American history. It was a day of grief, and it proved that America was not immune to attacks and threat. Afterwards life has changed not only for the American Muslims but also American Christians and Jews and to people from other religions. The cruelty of that day has left its shed particularly on the Muslims’ life in America who in reality had nothing to do with the attacks. Arab American Muslim writer Laila Halaby’s novel, Once in a Promised Land, intensely displays the problems that Arab Muslims went through after September 11th attacks. This paper discusses this issue through analysing Halaby’s novel, where she deals with the issues such as discrimination, stereotype, and prejudi
... Show MoreObjective: To determine the effectiveness of hypothermia on renal functions for patients undergoing
coronary artery bypass graft CABG surgery.
Methodology: A purposive (non-probability) sample of (50) patients undergoing Isolated coronary artery
bypass graft surgery consecutively admitted to the surgical ward, and they were followed up in the
intraoperative, Intensive Care Unit (ICU) and in the postoperative (surgical ward). Post-operative renal function
test (glumeruler filteration rate (GFR) by using the Crockroft-Gault formula and serum creatinine level) was
determined first week post operative and post operative renal function was classified on the base of peak of
the serum creatinine level and decline of glomeru
This study was designed to evaluate the effect of anesthesia on thyroid hormones (T3, T4, rT3), thyrotropin(TSH), and cortisol levels in patients undergoing major urological surgery. The study included fifty patients scheduled for elective major urological surgery where 70% of the patients underwent general anesthesia, while30% underwent regional anesthesia. All patients were in stable control general conditions. The study showed that the thyroid hormones, thyrotropin and cortisol levels were affected with general anesthesia more than regional. The levels of these hormones responded to anesthetics and surgical stresses. This response was thought to be mainly mediated by afferent neurogenic impulses from the area of injury. Therefore, ab
... Show MoreBackground: Consanguineous marriage is a relationship between biologically related individuals. Genetic factors have a role in gene environment interactions that takes the center stage. The evidence of oral disease (gingivitis and periodontitis) may depend on genetic syndromes, inherited diseases, familial studies etc. The present study aims at assessing dental plaque and gingival health condition in children of inbreeding parents compared with children of outbreeding parents among primary schools in Al-Qasem city/ Babylon governorate in Iraq. Materials and methods: this comparative study included three hundred ninety eight (398) students, 6-12 years old, from 4 primary schools; 199 children had their parents of inbreeding marriage with
... Show MoreAbstract:
Objective: The study’s aim to evaluate the effectiveness of instructional program about healthy lifestyle on patients’ attitudes after undergoing percutaneous coronary intervention.
Methodology: Quasi-experimental design/ has been utilized for the current study starting from December 2018 to March 2020 to achieve the objectives of the study. Non-probability (purposive) sample of 60 patients was divided into intervention and control groups. Data were analyzed by the application of descriptive and inferential statistical methods.
Results: findings reported that before intervention both study and control groups demonstrated low total mean of score relat
... Show MoreObjective: The incidence of infectious diseases among hospitalized children remains high. This study describes the environmental health indicator diseases and differences between gender and age of the affected children. Patients & Methods: A review of hospitalization and death causes among children admitted to the Child Teaching Hospital for Pediatrics in Baghdad, Iraq was performed. Medical records of children admitted throughout three years period were collected for demographics data and statistical analysis using Chi-square test. Results: A total of 4,272 admissions and 309 deaths were recorded. Infectious diseases remain the primary cause of hospitalization among children and frequently lead to death; which recorded (56%) followed by ac
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