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% (
Ischemic 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
A ventricular septal defect (VSD) is defined as a communication between the left and right ventricles or between the left ventricle and the right atrium. VSDs are amongst the most common abnormalities of the heart. They can be present in isolation or in association with other congenital cardiac abnormalities. This is study done with the aim to evaluate the types, size, associated CHD with ventricular septal defect in children and adolescent in two cardiac centers (Medical City Complex cardiac clinics, Ibn Al Nafaes teaching hospital) in Baghdad - Iraq
Childhood is characterized by ahigh privacy in the life of the child overall educational institutions in the world. Based on this specificity, modern education begins with a holistic vision of the child through all developmental aspects (moral, religious, emotional, social, linguistic, physical, health, and mental). This integration could be achieved through taking into consideration the needs and rights of children and developing curricula that consider these needs and capacities to provide opportunities for developing and supporting the developmental aspects of the child. The contemporary technological developments in the field of computer and the Internet have brought with it new forms, ideas, and problems for children in recent years
... Show MoreBackground: Pervasive Developmental Disorder (PDD) is a term refers to the overarching group of conditions to which autism spectrum disorder (ASD) belongs .
Objective: This study was designed to determine the existing behavior of children with autism in dental sitting, the behavior improvements in recall dental visits and evaluate the improvement in oral hygiene with using specific visual pedagogy chart.
Type of the study: Cross-sectional study.
Methods: Forty children of both genders, ages ranged from 4 – 6 years having primary teeth only were selected whose medical history included a diagnosis
... Show MoreThe aim of this research is to measure the logical maturity of kindergarten children. To achieve this aim, the researcher adopted the scale of Gold Schmid and Bentler (1968), which was translated to the Arabic language by Shabili (1988). The scale was administered to a sample of (100) kindergarten children were chosen randomly from a number of kindergartens in Baghdad city for the academic year (2017-2018). SPSS was used to analyze the collected data. The results revealed there is a level of logical maturity among the kindergarten children. The researcher came out with a number of recommendations and suggestions. &
... Show MoreThe deprivation Some of the children to exercise some fine motor activities a big problem , as a consequence, this problem plays of the delay in motor development during early childhood , Usually it happens to be the reasons for the lack of the right place to play , and the lack of the presence of the tools needed to play motor, or fear excessive protection by parents for their children as a result of lack of awareness of the importance of physical activity for the child to use his fingertips and fine his muscles . In addition to that small percentage of children spend most of their time in the daily activities and skills of non-motor , Such aswatching television, or play video games or they tend to play computer and mobile but they are
... Show MorePrograms directed to children through the media in general and in television in particular are among the main factors that help in forming the cultural and educational values of this important segment of society, and in light of this the study problem was identified in answering a major question: What are the cultural and educational values that Ajyal channel seeks Space planted in children through my program, Iftah Ya Simsim (in its new season) and Friends of Ajyal? , While the objectives of the study were evident in identifying the most prominent cultural and educational values that the Ajyal satellite channel worked to instill in children, and identifying the nature of the techniques used by Ajyal channel in providing the value conten
... Show MoreRenal transplantation is a principal treatment option for end-stage kidney failure. Bone loss and fracture are serious complication of kidney transplantation, associated with morbidity and mortality. The pathogenesis of post transplantation bone loss is multifactorial and complex
Chronic lymphocytic leukaemia (CLL) patients display a highly variable clinical course, with progressive acquisition of drug resistance. We sought to identify aberrant epigenetic traits that are enriched following exposure to treatment that could impact patient response to therapy.
Epigenome-wide analysis of DNA methylation was performed for 20 patients at two timepoints during treatment. The prognostic significance of differentially methylated regions (DMRs) was assessed in independent cohorts of 139 and 1