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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
Wed Jan 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluating the Impact of Pharmacist Counselling for Asthmatic Children at Karbala Teaching Hospital for Children: An Interventional Prospective Study (Conference Paper )#
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Asthma is one of the most common chronic, non-communicable diseases affecting children worldwide. The estimated prevalence of pediatric asthma in Iraq is 15.8%. Physiologic, inflammatory and structural factors contribute to the development of asthma. Assessment and monitoring of asthma control can be done by a validated children asthma control test (CACT). Management of asthma must address three components which are an appropriate management plan, the most appropriate medication if necessary, and the use of safe and effective medication. The management plan should consider patient counseling and education about the definition of asthma, signs, and symptoms, the pathophysiology of asthma, common triggers for asthma and how can avoid them,

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Relationship between Blood Lead Levels and Hematological Parameters in Children from Al-Fallujah City in Iraq
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Environmental exposures to lead remain a serious problem in the developing and industrializing countries. Children are the highest risk aged-group for lead poisoning. This study was designed to assess lead exposure in Al-Fallujah city by analyzing blood lead levels in children and adults and to explain the relationship between blood lead levels, hematological parameters and ferritin levels in the children. The study was performed on-(90) subjects, (65children and 25 adults).Venous blood samples were taken for estimation of hematological parameters, serum ferritin levels and blood lead levels. The children group was subdivided into four groups as: group (A) (low ferritin, low Hb), group (B) (low ferritin, normal Hb), group (C) (normal fer

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Value of random urinary calcium to creatinine ratio in diagnosing hypercalciuria in children with nocturnal enuresis
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Background:Nocturnal Enuresis is a common problem affecting 20% of five years old children and up to 2% of adolescent and young adult. Although it is a self limiting benign condition, it has social and psychological impact on the child and his family. Many pathophysiological theories had been suggested, but none is confirmed. Hypercalciuria has been suggested to be associated with higher incidence of nocturnal enuresis. Objectives:The aim of our study to test the value of Ca/Cr ratio, on random urine sample, in diagnosing hypercalciuria in enuretic children. Type of study: Cross sectional study.Methods:Forty four enuretic children were enrolled in this study and forty five children without nocturnal enuresis were taken as control group.

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Publication Date
Tue Sep 08 2020
Journal Name
Al-kindy College Medical Journal
Comparison between the Use of bupivacaine 0.5%alone and bupivacaine 0.5% with nefopam 20mg in sciatic n block ( popliteal approach) and femoral n block in patients undergoing below knee surgery
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Objective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.
Methods: 100 patients with American society of anest

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Publication Date
Wed Jan 01 2020
Journal Name
Euromediterranean Biomedical Journal
ESCHERICHIA COLI O157: H7 INVESTIGATION IN CHILDREN WITH DIARRHEA: AN IRAQI CROSS-SECTIONAL STUDY
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NA Nasir, SHM Ali, HQMA AL-Ess, WA Hussein, MKW Al-Janabi, KIA Mohammed, JM Mosa, Euromediterranean Biomedical Journal, 2020

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Scopus
Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Comparative Biochemical Study of Proteins Profile in Iraqi Children and Adolescent with ?-Thalassemia
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The aim of the present research is to study different protein fractions in sera of children and adolescent with  β –thalassemia major and minor and to compare the results with that of healthy control.One hundred fifty children and adolescents were enrolled in this study,including 50 patients with β- thalassemia major , 50 patients with  β- thalassemia minor as pathological control group and another apparently 50 healthy individuals as a control group. The age of all studied  groups ranged from (4-18)years.Total protein, albumin and immunoglobulins were estimated in sera of all subjects.  A Significant  decrease  was  found  in  the  total  protein and  albumin&nb

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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Electronic Games on Children Behaviors who Attending Teaching Hospitals in Baghdad City
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Objective(s): current study aims to find the effect of electronic games on children's behavior, and find the
relationship between child demographic data and the effect of electronic games on the child's behavior.
Methodology: A descriptive-analytic study was conducted for assessing the Effect of electronic games on
children's behaviors that attending to teaching hospitals in Baghdad city during the period of (October/ 20th
/2017 to March/1st /2018). A (50) purposive (non- probabilistic) sample from: Child Protection teaching
Hospital, Child Central Hospital in AL-Iskan. The sample is selected according to the criteria: Children who
visited the consulting unit of children in the hospitals in the first visit, children in

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Publication Date
Thu Jan 01 2015
Journal Name
Iraqi Journal Of Biotechnology
Detection of E. coli and rotavirus in diarrhea among children under five years old‏
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Health Assessment and unhealthy eating habits for children nurseries in the city of Baghdad
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This study was conducted to identify the health status of children's nurseries in the city of Baghdad and to identify improper dietary habits practiced by these children have shown the results of this study that the same proportion of childhood diarrhea disease research and infections

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Publication Date
Sat Feb 01 2025
Journal Name
Saudi Medical Journal
Spectrum and classification of ATP7B variants with clinical correlation in children with Wilson disease
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