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% (
esearch Summary
Holidays and occasions in Islamic societies have a legal character and origin. Some of them are proven by the words and actions of the legislator, and some are within the scope of custom that is regulated by the honorable Sharia, and others are approved by scholars and people because of their connection, piety and charity. It has a kind of good.
One of the purposes of the noble Sharia is to glorify the honorable times associated with the blessed events, so that lessons and lessons may be recalled in them, and to activate the legitimate gifts in those events that develop in the individual, the family and the community the meanings of goodness and honor and all that is good and good. Accord
... Show MoreBackground: Fractures of the humeral shaft accounting for approximately 3% of all fractures. There is a wide array of good options for their treatment and controversy over the best methods. Although good techniques of osteosynthesis are available, the aim of this article is toemphasize on the benefit and good outcome of conservative treatment for properly selected cases to decrease the cost and avoid the complications of surgery. Method : During the period from February 2011 to June 2012 fifty-five fractures of humeral shaft were treated at orthopedicdepartment in the ALKindyteaching hospital. 22 fractures considered suitable for the study. The patients treatedconservatively by using the‘U’ shaped coaptation slab. Then we shift to POP c
... Show MoreNew developments imposed different patterns of interactions between major international powers and Iran during 2018, ranging to varying degrees between cooperation and tension, the most important of which is the new measures taken by the United States to withdraw from the nuclear agreement and impose new US sanctions on Iran, which in turn insisted on not responding to pressure to which they are exposed to make changes in their policies and to negotiate again about the main contentious files, especially the nuclear program and ballistic missiles, and the roles they play for crisis countries, especially supporting some armed organizations in Syria, Lebanon, Iraq and Yemen. These differences have put the international forces before difficult
... Show MoreCreep testing is an important part of the characterization of composite materials. It is crucial to determine long-term deflection levels and time-to-failure for these advanced materials. The work is carried out to investigate creep behavior on isotropic composite columns. Isotropy property was obtained by making a new type of composite made from a paste of particles of carbon fibers mixed with epoxy resin and E-glass particles mixed with epoxy resin. This type of manufacturing process can be called the compression mold composite or the squeeze mold composite. Experimental work was carried out with changing the fiber concentration (30, 40 and 50% mass fraction), cross section shape, and type of composite. The creep results showed that th
... Show More57 isolates of Mycobacterium tuberculosis and Mycobacterium bovis were identified; they were isolated from different clinical sources which included sputum, bronchial wash, abscess, pleural fluid, gastric fluid, eye fluid, and CSF, also urine and ear swab. This investigation was carried out on 198 patient attended National Reference Laboratory for T.B during September 2009. Also the study declared that the ratio of separation of this bacterium from male was (67.6%) and it’s higher than the ratio of separation this bacterium from females which was (32.3%). The susceptibility of Mycobacterium tuberculosis to melatonin was evaluated. Many concentrati
... Show MoreOne of the troublesome duties in chemical industrial units is determining the instantaneous drop size distribution, which is created between two immiscible liquids within such units. In this work a complete system for measuring instantaneous droplet size is constructed. It consists of laser detection system (1mW He-Ne laser), drop generation system (turbine mixer unit), and microphotography system. Two immiscible liquids, water and kerosene were mixed together with different low volume fractions (0.0025, 0.02) of kerosene (as a dispersed phase) in water (as a continuous phase). The experiments were carried out at different rotational speed (1180- 2090 r.p.m) of the turbine mixer. The Sauter mean diameter of the drops was determined by la
... Show MoreAcquisition provisions in Islamic jurisprudence
The political parties are considered to be the basic infrastructure in the political process for their great role in achieving the political movement in the country and to work on implementing the goals and interests of its voters in the event of their coming to power. If the parties that totalitarianism led to monopoly and monopolization, We can not talk in these countries about the liberal concept of the party and can not talk about the existence of a law or laws and regulations governing and regulate the work of parties. But on the other hand, which is represented by the liberal state, we find a lot of talk and practice about the form and nature of the legitimate law in regulating the formation of parties and their work in a manner th
... Show MoreThe importance of Public Relations activity has increased during the last half of the last century as a specialized and modern administrative function in most institutions. It has, moreover, become an integral part of activities of those institutions of various types, due to its pivotal role in building its reputation and drawing a good mental image among its audiences, as well as its influential and basic role in maintaining communication and the communication between its members at its various levels and their job tasks to ensure the greatest amount of understanding and to enhance trust between them. This is why public relations activity has become indispensable in all institutions, and without it, it is difficult to achieve any coordi
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