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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
Wed Dec 30 2015
Journal Name
Al-kindy College Medical Journal
Results and predictive factors for single level L4-5, and L5-S1 disc herniation surgery
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Background: The disc prolapse is a common condition especially in young adults. Different levels are affected in the lumber region; the L4/L5 disc is more susceptible to longitudinal load and is the most common site of lumbar disc prolapse. The L5/S1 disc is protected from torsion load by strong ilio-lumbar ligaments but it is more susceptible to axial compressive forces. Many factors affect the result and outcome of surgery in these levels.Objective: The aim of this study is to correlate operative data, short-term results, complications, and prognostic factors (age, gender, mobility, hospital stay, and level of pain) for one-level lumber discectomybetween different levels (L4–L5 vs. L5–S1).Methods In this prospective study, 32 patie

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Publication Date
Mon Jul 07 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Factors associated with facial swelling severity following impacted lower third molar surgery: A prospective study
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Background: The ultimate purpose of this prospective study is to estimate and measure swelling associated with surgical extrac¬tion of impacted mandibular third molars in different four post-operative times and to identify the risk factors associated with determination of their risk degree. Material and Methods: In this prospective cohort study 159 consecutive cases in which removal of impacted lower third molars in 107outpatients were evaluated. Five groups of variables have been studied which are regarded as a potential factor for swelling after mandibular third removal which will enable the surgeon to predict and counsel high risk patients in order to offer a preventive strategy. Results: Facial measurements were carried out on 1st, 2

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Publication Date
Sat Jan 01 2022
Journal Name
Craniomaxillofacial Research &amp; Innovation
Partial Bone Necrosis Following Sagittal Split Ramus Osteotomy: Report of a Complicated Orthognathic Jaw Surgery
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Study Design

Case Report.

Objective

To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result.

Method

A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal spli

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Effects of Sleeve Gastrectomy as a Bariatric Surgery on Weight of Dietary Induced Obese Rats.
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Background: Obesity is becoming the healthcare epidemic world wide.Obesity is associated with reduced life expectancy, increased morbidity and mortality, and greater healthcare costs.Bariatric surgery is the only effective treatment for morbid obesity and is gaining increasing popularity. There has been a steady rise in the numbers and types of bariatric operations done worldwide in recent years butnon of prove to be ideal .Animal studies and use of animal models are significant element in the evolution of medical knowledge and the use of animals as a model for bariatric surgery is of importance to study the mechanisms of these operationsa and also help to develop new technique in management of obesity.Objectives:Study of effects of slee

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Nurses knowledge toward prevention of Complications related Valvular Replacement Surgery at Surgical Department in AL-Nasiriyah Heart Center
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Objectives: The study aims to assess  the nurses knowledge toward prevention of complications related to valvular  replacement surgery and to find out the relationship between nurses knowledge and their demographic and occupational characteristic's Which as (Age, gender, level of education ,years of experience in Surgical Department , and training sessions)

 

Methodology: A descriptive design  (a cross-sectional study ) was carried out from December 2017 to May 2018 in order to assess nurses' knowledge of preventing complications Valvular Replacement Surgery at Surgical Department in  Nasiriyah Heart Center on a purposive (non-probability) sample

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Publication Date
Wed Jun 01 2022
Journal Name
World Neurosurgery
Letter to the Editor “Challenges of Meeting Cerebrovascular Surgery Demands in Low-and Middle-Income Countries: An Experience from Iraq”
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Publication Date
Sat Sep 30 2023
Journal Name
Rawal Medical Journal
Effect of Six-Minute Walk Test on Health-related Quality of Life in Patients Undergone Coronary Artery Bypass Graft Surgery
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Objective: To assess the effect of six-minute walk test on health-related quality of life in patients undergone coronary artery bypass graft surgery at Iraqi center for heart diseases. Material: This descriptive study was conducted from 8th August, 2022 to 10th January, 2023. A non-probability purposive sample of 50 patients undergoing coronary artery bypass graft surgery at Iraqi center for heart diseases was included in the study. A questionnaire composed of three parts; sociodemographic and clinical data, six-minute walk test (6MWT) and health-related quality of life (HRQoL) were used. SPSS version 26 was utilized to analyze data. Results: Patient’s performance showed highly significant statistical differences at p<0.05 betw

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Publication Date
Tue Oct 04 2022
Journal Name
International Journal Of Dentistry
Comparison between Rolled and Nonrolled U-Shaped Flap in the Second Stage of Dental Implant Surgery: A Randomized Clinical Trial
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Background. The presence of black triangles around the dental implant-supported prosthesis and the failure to construct adequate papillae around them bothers dental implantologists. Peri-implant surgical soft tissue management will improve esthetics, function, and implant survival. Aim. To compare the effects of rolled and nonrolled U-shaped flaps combined with a temporary crown in enhancing the soft tissue around dental implants. Materials and Methods. Forty patients were included in this study; all patients were operated on by the same maxillofacial surgeon at Al-Iraq specialized dental clinics from January 2019 to January 2020. Patients were divided randomly into two groups: group A: at the second stage of implant surgery, a U-sh

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Craniofacial Surgery
Evaluation of the Trephine Method in Harvesting Bone Graft From the Anterior Iliac Crest for Oral and Maxillofacial Reconstructive Surgery
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Publication Date
Thu Sep 09 2021
Journal Name
International Journal Of Research In Pharmaceutical Sciences
Seroprevalence of celiac disease among children in Baghdad, Iraq
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