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% (
This research aims to introduce the general tax on sales in gordan and the most important concepts related to this type of taxes and identify the most on characteristics and stand on its role in supplying the general budget of the necessary fundig to cover the over head of the state and the factorsinfluencing it and whether such a tax has been able to chieve the desired goals.including in contribute to an important and growing role in puplic revenues or not to be able to achieve these goals through the use of descriptive and analytical technique based on the data and information relevant.wasreached some conclusion and recommendations was most important is that the general sales tax comes in
... Show MoreThe provision of electric power is necessary for the advancement of the country's economy. It is the main engine of the economy and its various activities. It is an indicator of social welfare and it is considered as the basic pillars for achieving sustainable development (economic, social, environmental and institutional) by raising the levels of performance and meeting local needs. The problem of research was the absence of a program to audit the performance of the electricity sector contributes to ensure the application of sustainable development. The research was based on the hypothesis that the preparation of a proposed program to audit the performance of the electricity sector contributes to the achievement of The researchers sough
... Show MoreThis research –paper tack les some of matters relating to marriageability of the young man who has not attained discretion. the aim of this study is to highlight the religious precepts concerned. the religious missive to this effect reads; ''all praise be to Allah ,lord of the world ;I witness that there is no god but Allah, the sole and only, to him all creation is attributed. He taught man with pen, and all that he does not know, so exalted is he, and I witness that Mohammed is his servant and messenger, the master of all messengers and the seal of all prophets who was entrusted with a message of march to all mankind. May the blessings of Allah be to him, his household and companions. Until the day of Judgement. "this missive i
... Show MoreThe main objectives of present study are to evaluate the trace elements pollution in the sediment of the Tigris River and drainage canals in Wasit Governorate, Iraq. Assessment of trace elements pollutants were conducted for 18 sediment samples collected in March 2017. Trace elements were analyzed in sediment Tigris River samples in Wasit Governorate. This metal pollution was evaluated using geo-accumulation (I-geo) index, Contamination Factor (CF) and Pollution Load Index (PLI). According to these statistical indices, the sediments collected from Tigris River in the study area are highly polluted with Titanium (71.9 ppm), Nickel (226.6 ppm) Chromium (425.2 ppm), Cadmium (2ppm) and Molybdenum (15.8 ppm) while the sediments&nb
... Show MoreInfertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, infertility affects approximately 15% of all couples trying to conceive. Male infertility is responsible for about 50% of the infertility cases. Chromosomal abnormalities and Y-chromosome microdeletions are the most common genetic causes of male infertility. Klinefelter syndrome (KS) is the most prevalent factor of the chromosomal abnormality in the infertile male. Azoospermia Factor (AZF) microdeletions located on the Y chromosome are one of the recurrent genetic cause of male infertility. This study aims to investigate the prevalence of chromosomal anoma
... Show MoreThis research aims to focus on the reality of the imbalance of the balance of trade structure in order to improve it and determine the size of the imbalance as a result of dependence on one commodity, namely crude oil in the structure of exports versus the diversity of the structure of imports of various goods and goods.
In order to achieve that goal, a deductive approach was adopted, which included a shift from general theory data to special applications.
We have reached through the research to a number of conclusions, most notably the effectiveness of public spending in correcting the imbalance of the balance of trade structure during the study pe
... Show MoreThe dividends is one of difficult and important decisions taken by the administration in the economic units, because this decision has a direct impact on the investor and economic unit, so the main objective of any investor is achieve earnings, as well as information borne by dividends about the earnings quality of the economic unit and the level and efficiency of management to achieving earnings.
The research aims at explaining the effect of the dividends policy on the earnings quality in the companies listed in the Iraq Stock Exchange. The Miller model was used to measu
... Show MoreBackground: Acute appendicitis is regarded as one of the most common inflammation that needs surgical intervention. Different scoring systems have been used for diagnosing of acute appendicitis. ALVARADO score is one of the most widely used score in diagnosing of acute appendicitis, but the accuracy of the latter is insufficiently low in Middle-East patients. Thus a new scoring system called RIPASA score has been designed for diagnosing of acute appendicitis in those patients. The aim of this study is to use RIPASA score and compare its result with ALVARADO score in diagnosing of acute appendicitis.
Subjects and Methods: The study includes 200 patients with symptoms and signs of
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