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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 Jun 30 2014
Journal Name
Al-kindy College Medical Journal
The Efficacy of fractional CO2 laser in management of surgical wound scars
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Background: Atrophic postoperative and traumatic scarring are common cosmetic problems for patients. Combining CO2 laser ablation with a fractional photothermolysis system in a treatment known as ablative fractional resurfacing fulfilling the new demands for a lesser risk of side effects and minimal or no downtime.Objective: To assess the safety and efficacy of ablation fractional CO2 laser treatments for surgical scarring .methods: Twenty one patient ( 14 women, and 7 men ) with various skin types , I to IV , aged 3 to 48 years , presents with 24 scars between June and December 2012 , four patients excluded from study because they are not continued in follow up , the remaining 17 patient completed all 3 treatments & 6 months follow

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia
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Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intrav

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Employing semantic coding to build meaning in action films: ابراهيم خلف جاسم
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Action films employ many artistic and literary elements that contribute greatly to building the general meaning of the film and push the wheel of the film forward. The element of mystery and suspense is used as two basic elements in action films. The cinematic language in action films depends on global coding, which is not models as it might be. It is based on logic, rather as units that aspire to morphology and not their homogeneity as the physical sense, but as the logical harmony of interpretive authority and enlightenment and in action films as a field of communication and a field in its origin in which the signifier contrasts with the perceptions of the meaning and in it takes a certain number of units preventing each other and thro

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Publication Date
Fri Jan 01 2021
Journal Name
Bulgarian Journal Of Veterinary Medicine
First isolation and molecular phylogenetic analysis of Coxiella burnetii in lactating cows
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Q fever is an infectious disease of animals and humans, caused by globally distributed C. burnetii. In Iraq, there are no previous studies associated with the detection of the organism in cattle. An overall of 130 lactating cows were submitted to direct collection of milk samples. Initially, the samples of milk were tested using the molecular polymerase chain reaction (PCR) assay targeting three genes (16S rRNA, IS1111a transposase, and htpB). However, positive results (18.46%; 24/130) were detected only with the 16s rRNA gene. Concerning risk factors, the highest prevalence of C. burnetii was showed in the district of Badra (42.86%), whereas the lowest - in Al-Numaniyah and Al-Suwaira districts (P=0.025). There was no significant v

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Experience of Disabled Female Students at Academic Study in Saudi Universities
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The current study aims to examine the experience of female students with disabilities who studying in university in kingdom of Saudi Arabia. To this end, the researcher used semi-structured interview as an instrument to collect the study data which regards as one of the descriptive approach tools. The sample comprised (12) disabled-female students from multidiscipline within both college of arts and college of education. To analyze the collected data, the author utilized a thematic analysis method following six steps as stated by (Braun and Clark, 2006). The findings revealed that disabled students have a high self-confidence which push them forward to take part in activities that hold on campus. Besides, significant variation were shown

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Publication Date
Fri Sep 23 2016
Journal Name
Spie Proceedings
Quantifying charge trapping and molecular doping in organic p-i-n diodes
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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
An Application of Non-additive Measures and Corresponding Integrals in Tourism Management
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Non-additive measures and corresponding integrals originally have been introduced by Choquet in 1953 (1) and independently defined by Sugeno in 1974 (2) in order to extend the classical measure by replacing the additivity property to non-additive property. An important feature of non –additive measures and fuzzy integrals is that they can represent the importance of individual information sources and interactions among them. There are many applications of non-additive measures and fuzzy integrals such as image processing, multi-criteria decision making, information fusion, classification, and pattern recognition. This paper presents a mathematical model for discussing an application of non-additive measures and corresp

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Publication Date
Tue Sep 01 2015
Journal Name
Journal Of Biomechanics
In vitro wear testing of a contemporary design of reverse shoulder prosthesis
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Reverse shoulder arthroplasty is an increasingly common surgical intervention. However there are concerns and known limitations in relation to such joint replacement, while novel designs of reverse shoulder prostheses continue to appear on the market. Many claim to offer improvements over older designs but such assertions are difficult to validate when there is no consensus as to how such implants should be tested in vitro or even if such testing is necessary. In order to permit appropriate in vitro testing of reverse shoulder prostheses a unique, multi-station test rig was designed which was capable of applying motion in three axes to test prostheses. The shoulder simulator can apply up to 110° of motion in the flexion–extension and abd

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Federal and problematic relationship between the center and the region in Iraq
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The US invasion of Iraq in 2003 unleashed the repressed national aspirations of the Kurdish people. After the colonial powers, especially Britain, failed to establish a homeland of scattered Kurds in Iraq, Turkey, Syria and Iran, Iraq's Kurds managed to establish a semi-independent state in the north of the country Which lasted decades against the central authority in Baghdad in protest against what they call the forced integration of Kurds in the Iraqi state, and to obtain more rights and privileges as partners in this country. The federal region in the Kurdistan region of Iraq has become a reality, and it is eager not to strengthen its authority in return for the authority of the central government, but to annex other areas inhabited b

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Publication Date
Fri Jul 01 2011
Journal Name
Journal Of Craniofacial Surgery
Management of Retained Foreign Bodies in Missile Injuries of the Maxillofacial Region
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This study evaluates 22 patients with retained foreign bodies in the maxillofacial region that were all caused by penetrating missile injuries. Surgical intervention for the retrieval of the foreign bodies was carried out in 20 patients through the existing wounds and through separate incisions; all patients were followed up for a minimum of 2 months during which all the complications were registered and managed. Preoperative imaging is a prerequisite for the accurate localization of the foreign body and the subsequent successful removal of it. All patients developed complications that were categorized in this study into those that result from the injury itself and those that occur because of the retrieval procedure, the latter category bei

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