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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
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
Minimal sternotomy surgery in comparison to standard sternotomy in the coronary bypass Surgery
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Background Median sternotomy is the gold standard incision for most cardiac operations. However, with the advent of minimal invasive surgery, a new approach emerged in cardiac surgery named mini-sternotomy and has been successfully used to perform a variety of operations.

 The aim of this paper is to present our experience of using mini-sternotomy to harvest the left internal mammary artery (LIMA) for off-pump revascularization of the left anterior descending artery (LAD)

 Methodology Over a 2-year period (October 2012-October 2014), 100 patients underwent coronary artery bypass grafting (CABG) via conventional median sternotomy (CMS) (n=80) and mini-sternotomy (MS) (n=20). The

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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
The Commonest Negative Behavioral Manifestations among Kindergarten Children in the Post-Terrorist Phase: شيماء حارث محمد , امل داود سليم
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Behavioral and emotional disorders represent one of the commonest problems facing children in particular and disturbing their parents and educators in general. This is because Iraqi people have long been living in difficult conditions and faced various terrorists’ operations, such as killing, destruction, robbery, and looting. Such operations are said to be one of the reasons that leads to the development of such disorders, and may negatively affect the psyche of the child and be reflected on his behavior as represented by playing with the IPad for hours, and suffering from nightmares. Accordingly, the current research aims to examine specifically the commonest negative behavioral disorders among kindergarten children during the post-t

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Publication Date
Sun Jan 01 2023
Journal Name
Cerebral Ventricles
Third Ventricle: Surgery
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Publication Date
Wed Jan 03 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Assessment of Adherence and Self-Efficacy in a Sample of Iraqi Patients Receiving Warfarin or Direct Oral Anticoagulants
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Background: While warfarin and direct oral anticoagulants (DOACs) are used to manage thromboembolic events, they possess several features that impact adherence. Objective: To assess medication adherence and self-efficacy in patients receiving warfarin or DOAC treatment. Methods: A cross-sectional study was performed at Ibn Al-Bitar Hospital in Baghdad from December 2022 to May 2023 on patients receiving either warfarin or DOACs. The Arabic version of the Adherence to Refills and Medications Scale (ARMS) questionnaire and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C) questionnaire were used to assess adherence and self-efficacy. Results: 181 patients were enrolled in the study, of whom 56.9% received warfarin an

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Harmonic Knife New Haemostatic Procedure In Thyroid Surgery
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Background: Thyroid operation needs very meticulous haemostasis to have minimal morbidity and mortality.

Objectives: Assessment of harmonic knife in open thyroid surgery as anew haemostatic procedure .

Type of the study: Cross-sectional study.

Methods: This study had been conducted at Alkindy teaching hospital in Baghdad city from the 1st of May 2013 to the 1st of January 2017  on 229  goiterous patients who needs thyroidectomy(36 males,193 females),divided in 2 groups according to the haemostatic procedure used during their operations, Group A (15 males,85females)using the usual conventional surgery(

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Publication Date
Tue Dec 20 2022
Journal Name
2022 International Conference On Computer And Applications (icca)
IoT E-health System for Cardiac Telemonitoring
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Publication Date
Sat Jun 30 2007
Journal Name
Al-kindy College Medical Journal
Pyogenic Discitis in Female after Delivery and Pelvic Surgery
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Background: Pyogenic discitis most frequently occurs
after home delivery, hemorridectomy, and dilatation and
curettage. Discitis is generally due to blood borne bacterial
invasion of the disc from adjacent end-plate via
communicating vessels. Infective discitis remains an
uncommon, but potentially serious cause for back pain.
Delayed diagnosis can occur and a high index of suspicion
may occur.
Methods: The study included 30 patients suffering from
localized low back pain with limitation of movement.
Diagnosis was made by history, physical examination and
investigation mainly E.S.R and MRI.
Results: 50.3% of patient with discitis had a history of
vaginal delivery, 15% had a history of hemorridectomy

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Engineering
Upgrading of Alum Preparation and Dosing Unit for Sharq Dijla Water Treatment Plant by Using Programmable Logic Controller System
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One of the important units in Sharq Dijla Water Treatment Plant (WTP) first and second extensions are the alum solution preparation and dosing unit. The existing operation of this unit accomplished manually starting from unloading the powder alum in the preparation basin and ending by controlling the alum dosage addition through the dosing pumps to the flash mix chambers. Because of the modern trend of monitoring and control the automatic operation of WTPs due to the great benefits that could be gain from optimum equipment operation, reducing the operating costs and human errors. This study deals with how to transform the conventional operation to an automatic monitoring and controlling system depending on a Programmable

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Acquired Error in using Antibiotic for Surgery Patients in Iraqi Hospitals
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The use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 fro

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Acquired Error in using Antibiotic for Surgery Patients in Iraqi Hospitals
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The use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 from Al-

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