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% (
Improving the quality of health services in the health sector is an important and necessary matter that must be taken care of and improved, and this study seeks to demonstrate the role of quality costs in improving the quality of health services and achieving a high level of quality to satisfy the beneficiaries and to provide health services of good quality, and the research concluded that the main point of service provision Good health is the costs of prevention and evaluation (costs of quality conformity) and attention to it, and that technical competition contributes greatly to the development of the level of quality, as well as the use of health and medical staff with competent expertise, and that the costs of internal failure and th
... Show MoreBackground : Hyperglycosylated hCG a newly discovered variant of hCG which can be used as a predictor of invasion of trophoblastic cells in patient with gestational trophoblastic disease. Objectives : To measure hyperglycosylated human chorionic gonadotrophin and to assess how far it can be used as predictor of invasion in invasive mole and choriocarcinoma. Study design control study. Setting: : Case Gynecological department in Baghdad Teaching Hospital from January 2016 to January 2017. Patient and Methods : 60 women were enrolled in this study 30 of them were with gestational trophoblastic disease (no.= 30 ) the remainder were normal pregnancy (no. =30) , hCG –H level was measured in both groups. Results : Mean serum hCG-H le
... Show MoreKE Sharquie, SA Al-Meshhadani, AA Al-Nuaimy, Saudi medical journal, 2007 - Cited by 9
Nasiriya field is located about 38 Km to the north – west of Nasiriya city. Yammama, a giant lower cretaceous reservoir in Nasiriya field which is lithologically formed from limestone. Yammama mainly was divided into three main reservoir units YA, YB1, YB2 and YB3 and it is separated by impermeable layers of variable thickness. An accurate petro physical evolution of the reservoir is of great importance perform an excellent geological model so that four petro physical properties which are shale volume, porosity, water saturation and permeability was re-evaluated. The volume of shale was calculated using the density and neutron logs (VSH-DN) rather than using gamma ray log because of presence a uranium content in the formation that make
... Show MoreIt is well known that the spread of cancer or tumor growth increases in polluted environments. In this paper, the dynamic behavior of the cancer model in the polluted environment is studied taking into consideration the delay in clearance of the environment from their contamination. The set of differential equations that simulates this epidemic model is formulated. The existence, uniqueness, and the bound of the solution are discussed. The local and global stability conditions of disease-free and endemic equilibrium points are investigated. The occurrence of the Hopf bifurcation around the endemic equilibrium point is proved. The stability and direction of the periodic dynamics are studied. Finally, the paper is ended with a numerical simul
... Show MorePauses as pragmatic markers are considered important devices that help readers to gain a better and deeper understanding of certain texts as well as speech, promoting effectively language communication. They can help both the speaker and the hearer, due to the functions they have in a text. Their occurrence in speech has a value that they make it more understandable. In this regard, the present study aims to examine the forms and functions of pauses in literary texts, more specifically, in selected extracts from two dramas, namely, Pinter's The Homecoming and Baker's Circle Mirror Transformation and to compare how the two writers use pauses in these two dramas. To do so, the sequential production approach of turn-taking by Sacks, Sc
... Show More