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% (
The Iraqi political and social arena has been characterized, subjectively and objectively, by the weakness of leadership building. This has led to a leadership crisis, which is reflected in the quality of the outcome of the process of rebuilding the state in Iraq. Thus, this building process has lacked the simplest requirements and conditions of success. It has suffered from a major and obvious failure: the situation in Iraq has raised conflict leaders, not constructive leaders, and this confirms the existence of a cultural crisis in the production of conscious, aware leadership compatible with democratic action. The weakness of leadership in Iraq is reflected in a series of ongoing crises that require radical solutions in accordance with l
... Show MoreAbstract
Objectives: To assess patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention, and to find out the relationship between patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention
Methodology: A descriptive design was carried out at Al- Nasiriyah Heart Center in Thi-Qar Governorate for the period between May 19th, 2022 to October 25th, 2022. A non-probability sampling was used among (50) patients after their Percutaneous Coronary Intervention. The study instrument that used to collect data was composed of three parts namely: sociodemographic charac
... Show MoreThe Russian foreign policy of the post-cold-war era faced dilemmas in the light of the international and regional realities of the disintegration of the Soviet Union and the formation of a new unipolar international order led by the United States of America. Thus, Russian foreign policy-making was divided over the nature of the foreign policy to be followed. The achievement of the Russian goals, especially as the objectives of Russian foreign policy have been set within the framework of trying to regain the status and leading role, as well as the establishment of some fundamental changes to be consistent with the new international situation of the post-one The Russian Federation has adopted in the sphere of its foreign policy to the vari
... Show MoreThe study started from the problems of wars and the damage that result from deterioration and destruction of infrastructure and the absence of planning and urban reconstruction. The study aims to address the condition of the bad destroyed bridges that have paralyzed traffic from the right and left sides of the city of Mosul. The study is based on the assumption that the reconstruction of bridges will improve the transportation network in the city of Mosul. The study relied on several approaches, including: the historical approach by reviewing global and local experiences and the descriptive approach to review the reality of the state of Mosul after the liberation process, through maps and the analytical approach through statistics and da
... Show MoreIschemic heart disease is a major causes of heart failure. Heart failure patients have predominantly left ventricular dysfunction (systolic or diastolic dysfunction, or both). Acute heart failure is most commonly caused by reduced myocardial contractility, and increased LV stiffness. We performed echocardiography and gated SPECT with Tc99m MIBI within 263 patients and 166 normal individuals. Left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) were measured. For all degrees of ischemia, there was a significant difference between ejection fraction values measured by SPECT and echo
Reprehensible during the period of human life ,particular in child hood and after weaning
baby,analmeating habits have acquired his remaining life time and here high Iights,the role of
the mother in the childs education,dietar habits, and health methods and what is beneficial to
his health and in sufficien quantities for the baby .brooze trails are learned by the childin the
home with animportant and significant role in the future,inacht.aaralgame course wisely,after
becoming more in dependent in its delision-making an choices beyond the control of parents.
The present study aimed to message measure the awareness of food the mother and her role in
the development of food awareness sons, and its relation ship with som
The current research aims to: 1- Identify the emotional sensitivity of children from the parents' point of view. 2- Identifying the differences in the emotional sensitivity of children from the parents ’point of view, according to the parents’ gender variable (father - mother). The basic research sample consisted of (285) male and female students from the sixth grade (primary school), chosen in a randomized stratified method from the districts (Al-Karkh and AlRasafa). While the sample of statistical analysis amounted to (200) father and (200) mothers of male and female students who were randomly selected from the sixth grade of the education directorates (Al-Karkh and Al-Rasafa). The two researchers also used a number of sta
... Show MoreBackground: Cerebral palsy is non-progressive disorder of posture or movement due to a lesion of the developing brain. It is the commonest physical disability in childhood. Objective: To study the clinical, neurological abnormalities, prevalence of convulsion (epilepsy) & to asses the value of CT scans of brain in patients with cerebral palsy.