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% (
For the time being, the cold-formed sections are widely used due to their simple manufacturing and construction processes. To be feasible, the strength of cold-formed columns should be determined based on their post-buckling behavior. Post-buckling relations are cumbersome and need design aids similar to those of American Iron and Steel Institute (AISI) to be applicable. These design aids have been developed to sections and materials other than those available in the local market. Therefore, this paper tries to develop a general finite element model to simulate the postbuckling behavior of cold-formed steel columns. Shell element has been used to discretize the web, flanges, and lips of the column. A linear bucking analy
... Show Morehe paper presents the results of exposure of normal concrete to high temperatures (400 and 700°C). In addition to the exposure of steel reinforcement bar Ø 12 mm, where two types of steel reinforcement burning situations were performed. Directly exposed to high temperatures (400 and 700°C) and others were covered by concrete layer (15 mm). From the experimental results of fire exposure for 1 hour of 400 and 700°C and gradually cooled, it was found that the residual average percentage of compressive strength of concrete was 85.3 and 41.4%, while the residual average percentage of modulus of elasticity of concrete was 75 and 48%, respectively. The residual average percentage of yielding tensile stress (Ø 12 mm) after burning and cooling
... 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 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 MoreThis 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 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
Background: The normal decline in systolic blood pressure during recovery phase of treadmill exercise dose not occur in most patients with coronary artery disease, in others recovery values systolic blood pressure may even exceed the peak exercise value. Objectives: Treadmill exercise test parameters indicating the presence and extent of coronary artery disease have traditionally included such as exercise duration, blood pressure and ST-segment response to exercise. The three –minute systolic blood pressure ratio is another important indicator of presence and significance of coronary artery disease is useful and obtainable measure that can be applied in all patients who are undergoing stress testing for evaluation of suspected is
... Show MoreBackground: Osteoporosis is a skeletal defect manifested by a reduction of bone strength as a result of reduced bone mass to the extent that there is a higher risk of fracture even on minor trauma. Hysterectomy in a premenopausal woman is a well known cause of ovarian failure resulting in an increased risk of osteoporosis.
Objective : To clarify bisphosphonate's preventive effect on osteopenia and osteoporosis in premenopausal women after hysterectomy.
Type of the study: Cross –sectional study.
Method: 84 premenopausal females post hysterectomy aged between 40 – 50 years, were enrolled in this randomized controlled double blinded trail a
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