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% (
Melatonin, a hormone synthesized mainly by the pineal gland, has been found in extra-pineal organs as well. It’s known as an organizer of circadian rhythms and more recently as an anti-oxidant. In addition to its role in maintaining immunity, pathophysiology of cardiovascular and neurological diseases, and as an anti-cancer agent, evidence has demonstrated that melatonin exerts a positive impact on male and female fertility primarily through oxygen scavenging effects. In In Vitro Fertilization (IVF) programs, supplementation of melatonin may be associated with better outcomes in terms of sperm quality, oocyte quality, embryo quality and pregnancy rates. This review summarizes various actions of melatonin on the body focusing on male an
... Show MoreThe aesthetic expression and its orders are important for steel structures forming. Steel structures are a compilation of structural elements, where its shapes have standard dimensions and pre-fabricated. As the steel construction systems not only aim to achieve the functional requirements for users, but must also have the symbolic aesthetics which provides visually and cognitive expression for viewers. In this sense the research interested in expressional aesthetics in these systems and highlights the importance of attention as structural items. Therefore the visual items which related with steel structures contain some of the most powerful forms of modern architecture, steel structures with a glass cladding, agility an
... Show MoreIn this paper, some basic notions and facts in the b-modular space similar to those in the modular spaces as a type of generalization are given. For example, concepts of convergence, best approximate, uniformly convexity etc. And then, two results about relation between semi compactness and approximation are proved which are used to prove a theorem on the existence of best approximation for a semi-compact subset of b-modular space.
The principle in the language is that each word has one meaning. This is because the purpose of language development is for understanding, understanding, and communication between people. The language is sounds with which each people expresses their Arabic language did not stop at this point, but rather needed another next stage or to convey additional features or characteristics that would qualify it. To be the language of the Qur’an and revelation, and capable of carrying this heavy burden.
This is a research in which I studied the opinions of Arab scholars, in their studies
For (what) and (whatever) the two conditionals and their indication of time, and its name
B (time in (what) and (whatever) the two conditions), and I mentioned their opinions in it
This issue was discussed and discussed, and in this study it relied on the sources of the Arabic language.
Especially the books of grammar, interpretation, and the opinions of the scholars of the principles of jurisprudence are mentioned,
I also mentioned the opinion of the scholars of jurisprudence, and how they likened (whatever) to (everything).
In its indication of repetition, and as long as it indicates repetition, it indicates
time Because repetitio
Background: Respiratory distress is one of the
commonest disorders within the firs 48 - 72 hours of live
and any sign of postnatal respiratory distress is an
indication for roentgenogram of the chest.
Objectives: Is to show the range of chest radiographic
findings in full term newborn babies suffering from
respiratory distress, at or soon after birth.
Method: This is a prospective study that was conducted
in the special care baby units in Baghdad teaching
hospital and Children welfare teaching hospital during
2002. Anteroposterior chest radiograph in supine
position of (129) full term newborn babies, presented
with a chief complaint of respiratory distress were
examined.
Results: The commonest ca
It is the dynamic tension between the relatively fixed built environment and the constantly changing in social life that determines the nature of urban spaces belonging to different historical periods, and considered as a tool for diagnosing transformations in urban spaces, that’s why, the characteristics of urban space became unclear between positive spaces and negative spaces, so emerged the need to study contemporary urban space belonging to the current period of time and show the most important transformations that have occurred in contemporary urban space to reach urban spaces that meet the current life requirements. Therefore, the research dealt with a study of the characteristics of contemporary urban space and the most pr
... Show MoreThe art of pantomime mime is one of the arts that has taken a wide space in theater performances, and because it is one of the spectacle shows that relies on an acting performance that is unique from the traditional acting performance, because of the peculiarity of pantomime art in that it is a silent performance that assumes the clarity of meaning, and for the purpose of clarifying the actor’s work in such kind of performances, the art of pantomime must be We have to know the skills that the actor can possess in order to produce a silent show that has the elements of a successful presentation, so there was a need to study the skills of the actor in this type of acting performance. The researchers divided this study into an introd
... Show Moreالنظام السياسي في كوريا الشمالة
This study focuses on the relative frequency of Streptococcus pneumoniae in children with culture-proven bacterial meningitis. The epidemiology has been investigated with clinical and laboratory findings in The Central Public Health Laboratory, Iraq from April to September, 2010. From (138) samples , (55) cases (39.85 %) were diagnosed by physician as bacterial meningitis, (23) cases (16.66 %) as viral menginitis , (18) cases (13.04 %) as different medical cases (e.g febrile convulsion , meningoencephalitis , epilepsy …etc) and (42) cases (30.43 %) as unidentified medical cases. For bacterial meningitis S.pneumoniae was isolated from (10) cases (18.18 %) only. The median age for bacterial meningitis was (130.75) month and the predomina
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