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% (
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
... Show MoreBackground: Mental health of children has recently been
receiving increased attention in many parts of the world.
However, such attention has been lacking in developing
countries, particularly in the form of systematic research
Aim: The study aimed to find out the frequency of
behavior disorders in a sample of primary school children
and the different social and demographic factors that might
be related to this disorder.
Methods: The study is a cross-sectional one that included
918 primary school pupils in both urban and rural areas of
Baghdad. Rutter's questionnaire teacher's version was used
to assess the pupils, and the demographic data was obtained
by special questionnaire sent to the parents to be
Objective: 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
... Show MoreDBN Rashid, IMPAT: International Journal of Research in Humanities, Arts, and Literature, 2016 - Cited by 5
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 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
... Show MoreBackground: Myocardial infarction (MI) is distinguished by the necrosis of myocardial cells as a result of substantial and prolonged ischemia. Anxiety, problems sleeping, and feelings of depression are some of the most common psychosocial consequences of having a myocardial infarction. Aim: The purpose of this study is to evaluate the effects of post-myocardial infarction on patients' levels of anxiety, depression, and quality of sleep. Method: The collection of data from 94 individuals with MI was carried out according to a descriptive cross-sectional design. Sleep quality, depression, and anxiety were evaluated using standard questionnaires. Results: 69.1% of the participants reported having trouble getting quality sleep. The perc
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