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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
Mon Nov 01 2021
Journal Name
Journal Of Physics: Conference Series
Light scattering detector based on light-emitting diodes-Solar cells for a flow analysis of Warfarin in pure form and pharmaceutical formulations
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Abstract<p>Continuous turbidimetric analysis (CTA) for a distinctive analytical application by employing a homemade analyser (NAG Dual & Solo 0-180°) which contained two consecutive detection zones (measuring cells 1 & 2) is described. The analyser works based on light-emitting diodes as a light source and a set of solar cells as a light detector for turbidity measurements without needing further fibres or lenses. Formation of a turbid precipitated product with yellow colour due to the reaction between the warfarin and the precipitation reagent (Potassium dichromate) is what the developed method is based on. The CTA method was applied to determine the warfarin in pure form and pharmaceu</p> ... Show More
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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of  infection  in  some situations  does not outweigh  the risks which  attend the administration of even the safest antibiotic drug. The aim of this study was to comp

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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)
Possible Cardiac Adverse Effects Induced by Therapeutic Doses of Ciprofloxacin in Juvenile Rats
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Ciprofloxacin is widely used in treating adults infected with Gram-negative bacteria. It is contraindicated in children, growing adolescents and during pregnancy due to joint toxicity. Its toxicity concerning other organs needs to be clarified. Thus, this study was designed to study the possible cardiac damage induced by two selected doses of ciprofloxacin in juvenile rats.Eighteenth healthy juvenile rats (4 weeks old and their weight 30 ± 2 gm) were utilized in this study and divided into three groups. Group-I control; group II and group III, respectively injected IP with 25 mg/kg and 50 mg/kg ciprofloxacin every 12 hours for one week. Serum enzymes activities alanine aminotransferase (ALT), aspartate aminotransferase  (AST), cr

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Publication Date
Sat Dec 31 2022
Journal Name
Al-kindy College Medical Journal
Changing the Trends in Surgery during the COVID-19 Times: An Experience from the Eastern Uttar Pradesh State, India: CHANGING TRENDS IN SURGERY DURING COVID TIMES
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Background: The COVID-19 pandemic has an immense effect not only on the social and economic lives of people but also on the surgical lives of surgeons, residents, nursing staff, and patients as well as ground level staff. Amidst this COVID pandemic, emergency surgeries were being done but at a decreased rate, whereas elective cases depended on the will of hospitals, surgeons, and patients. Study aims to promulgate a "Neo–Surgical Check Box" by amalgamating the WHO surgical checklist and the results obtained from the questionnaires.

Subjects and Methods: After receiving ethical clearance from the Institute Ethical Committee, an online questionnaire with 50 questions divided into

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Publication Date
Sat Dec 30 2023
Journal Name
Al-kindy College Medical Journal
Health System in Iraq Post 2003 War
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Background: War represents a major human crisis; it destroys communities and results in ingrained consequences for public health and well-being

Objective: We set this study to shed light on the public health status in Iraq after the successive wars, sanctions, sectarian conflicts, and terrorism, in light of certain health indicators.

Design: The primary source of data for this analysis comes from the Iraqi Ministry of Health, and The World Health Organization disease surveillance.

Results: Most of the morbidity indicators are high, even those that are relatively declining recently, are still higher than those repor

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Publication Date
Sun Oct 29 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Determination of Job Stress among Nurses in Cardiac Surgical Intensive Care Units in Baghdad City
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Objective: The study aimed to determine the sources and level of job stress experienced by nurses who were
working in intensive care units, and to find-out the relationship between work-related stress and some variables
such as age, gender, educational level, marital status, and years of experience in cardiac surgical intensive care
unit.
Metl]odo]ogy: A descriptive study was conducted on nurses working in the cardiosurgical intensive care units in
Baghdad hospitals. The study sample was selected purposively and consisted of (60) nurses who were working
in cardiosurgical intensive care units in Baghdad city (Ibm Al-Betar Hospital for Cardiac Surgery, Ibn A1-Nafis
Hospital for Cardiovascular Diseases, and the Iraqi Ce

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of 2 different techniques in second stage implant surgery
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Background: Dental implant is one of the most important options for teeth replacement. In two stage implant surgery, a few options could be used for uncovering implants, scalpel and laser are both considered as effective methods for this purpose. The Aim of the study: To compare soft tissue laser and scalpel for exposing implant in 2nd stage surgery in terms of the need for anesthesia, duration of procedure and pain level assessment at day 1 and day 7 post operatively using visual analogue scale . Materials and methods: Ten patients who received bilateral implants participated after healing period completed, gingival depth over each implant was recorded and then implant(s) were exposed by either scalpel or laser with determination for th

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Publication Date
Thu Nov 01 2012
Journal Name
Journal Of Computer Science
VOICE ACTIVATION VISUALIZATION FOR ECHOCARDIOGRAPH AND 3D ANGIOGRAPHIC IMAGES IN SURGERY
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In some cases, surgeons need to navigate through the computer system for reconfirmation patients’ details and unfortunately surgeons unable to manage both computer system and operation at the same time. In this paper we propose a solution for this problem especially designed for heart surgeon, by introducing voice activation system with 3D visualization of Angiographic images, 2D visualization of Echocardiography processed video and selected patient’s details. In this study, the processing, approximation of the 3D angiography and the visualization of the 2D echocardiography video with voice recognition control are the most challenging work. The work involve with predicting 3D coronary three from 2D angiography image and also image enhan

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Publication Date
Fri Nov 02 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of nurses practices toward patients who undergo cardiac catheterization
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Objective: To evaluate the nurse's practices and it's relationship between with thier demographic characteristic.
Methodology: A descriptive study was carried out , from January 15th 2002 to April 15th 2002 , to evaluate the
nurse’s practices toward patients who undergo cardiac catheterization . A purposive sample of ( 65 ) nurse , was
selected out of three teaching hospitals in Baghdad city . These nurses were worked at the catheterization units
and catheterization labs .A questionnaire was constructed for the purpose of the study , which comprised of three
major parts in which there were ( 45 ) items . Reliability and validity of the questionnaire were determined
through the conduct of a pilot study .
Data were c

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