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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 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
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
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
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of monetary policy in reducing inflation in Iraq through monetary sterilization mechanism. post-2003
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The main objective of the central bank is to achieve price stability and target in fractionates. Therefore, the bank sought to use modern tools and policies in order to reduce the negative effects of the accumulation of foreign reserves represented by monetary sterilization, similar to developed and developing countries alike, but with different available tools that are possible and imposed by the local financial and monetary environments, such as the window for buying and selling foreign currency, open market operations and deposit facilities. And lending existing. Because any in crease in the monetary base resulting from the accumulation of foreign reserves will affect price stability directly due to the consumer nature of the

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effects of Two Different Doses of Zinc Sulfate on Serum Troponin I 3 Enzyme Level and Cardiac Malondialdehyde Contents in Mitoxantrone-Induced Cardiotoxicity in Rats
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Abstract

   Mitoxantrone is an antitumor agent used in the treatment of breast and prostate cancer, acute leukemia, lymphoma, and also in the treatment of multiple sclerosis due to its immunosuppressive properties. The mitoxantrone's cardiotoxicity is irreversible, dose-dependent, and it may occur years after treatment. Zinc is considered as an essential mineral for cell division and the synthesis of DNA and protein; furthermore, such mineral has an important role in states of cardiovascular diseases; and may have protective effects in coronary artery disease and cardiomyopathy.

Objective: The current study is designed to investigate effects of two different doses of zinc sulfat

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Etiology of Bloody Diarrhea among Children Admitted to Maternity and Children ’ s Hospital-Erbil
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Background: Bloody diarrhea plays a major role in
morbidity and mortality especially in developing
countries, it is usually a sign of invasive enteric
infection, there is a thought that amoebic dysentery is
more common than bacillary dysentery in Iraq, and
from 1989 to 1997 amoebic dysentery increase from
20000to 550000 patients.
Objectives: This study aims to:
1. Outline the incidence of various infectious causes of
bloody diarrhea in Erbil district.
2. Assess the effect of multiple factors like age, sex,
source of water supply, etc... On the incidence of
amebic and bacillary dysentery.
3. To provide baseline data for making strategic plan to
reduce the diarrhoeal mortality and morbidity.
Met

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Educational Program on Nurses’ Knowledge About Communication Skills with Children at Welfare Children Teaching Hospital in Baghdad City
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Background: Therapeutic communication is the basis of interactive relationships among nursing team and their children: that affords opportunities to establish rapport, understand the client’s experience, formulate individualized or client interventions and optimize health care resources.

Objectives: The main aim of the study is to determine the Effectiveness of Education Program on Nurses’ Knowledge about Communication Skills with Children.

Methodology: A quasi-experimental study was conducted in Children Welfare Teaching Hospitals from 7th, October 2018 to the 20th, May 2019. The program and instruments have been constructed by the researcher for the purpose of the study. A non- prob

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Publication Date
Sun May 10 2020
Journal Name
Baghdad Science Journal
Temperature Impacts on the Cardiac Activity of the Snail Pomacea canaliculata from Shatt Al-Arab Region, Basrah, Iraq
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The effects of temperature on an exotic aquatic snail Pomacea canaliculata  (Lamarck, 1819) collected from the Shatt Al-Arab intertidal zone were investigated. A series of laboratory experiments were conducted during the summer period of 2017. Individuals of new born snails hatched in the laboratory from adult snails were collected from Shatt Al-Arab intertidal zone, and subjected to five fixed temperatures: 15, 25, 35, 40 and 45 Cº, after short term thermal acclimation. The heartbeats (HB) were counted at each temperature level. The results showed significant  direct increase of HB from 15 Cº (19.8 HB/min) up to 25 Cº (76 HB/min) (P<0.05)  as well as from 25 Cº to 35 Cº (93 HB/min). At 40 Cº the snail HB

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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Educational Program on Nurses Knowledge toward Nursing Management for Patients Undergoing Percutaneous Coronary Intervention in Cardiac Center at Al-Dewaniyah City
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Objectives: The study aims to evaluate the effectiveness of the educational program on nurses’ knowledge towards nursing management for patients undergoing percutaneous coronary intervention (PCI), as well as to find out the relationship between nurses' knowledge and some of their demographic characteristics (age, gender, level of education, and years of experience in cardiac units).

Methodology:  A Quasi-experimental as one group (pre and post test) study was conducted at the Heart Center in Al-Diwaniyah city for the period from December 7, 2019 to February 23, 2020. A sample of (40) nurses working in the heart center was chosen from different nursing addresses. The sample covered one gro

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Publication Date
Fri Dec 31 2021
Journal Name
Dental And Medical Problems
Effect of the local application of bupivacaine in early pain control following impacted mandibular third molar surgery: A randomized controlled study
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Background: Postoperative pain is one of the main complications following impacted mandibular third molar (IMTM) surgery. Objectives: The aim of this study was to assess the effect of the local application of bupivacaine on reducing early postoperative pain following IMTM surgery. Material and methods: A prospective, single-blinded, randomized controlled study was conducted on 40 patients who had undergone the surgical removal of an IMTM under local anesthesia. In the study group (n = 20), absorbable gelatin sponge (AGS) soaked in 3 mL of 0.5% plain bupivacaine hydrochloride was locally applied in the post-extraction socket. In the control group (n = 20), AGS soaked in 3 mL of normal saline was used. Pain intensity was assessed using a pa

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