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% (
Methotrxate (MTX) has become the standard of care and first-line therapy for patients who have RA and consider as a gold standard of treatment for RA. The role of MTX in the treatment of RA has now been well established. The use of MTX treatment of RA inhibits proliferation of the lymphocytes, reduces signs and symptoms this disease, reduces progression damage of the joints and improves quality of life outcome. Progranulin (PGRN) acts a role in autoimmune inflammatory, has important function in several processes including immune response. Present study has conducted to find the effect of MTX drugs as a therapeutic target for RA patients because of its ability to bind with tumor necrosis factor receptor (TNFR), with progranulin, obestatin an
... Show MoreWriting as a female playwright in theatre gives a deeper depiction of woman’s real- self. Beth Henley has succeeded in providing a new realist vision of women’s abilities to face their inevitable tragic fates and how to conquer their despair. In Crimes of the Heart, the playwright uses certain method to present the development of the heroines’ characters through blending the tragic events with a comic frame. In fact, Henley focuses on the simple humorous activities more that the importance of the tragic event to present her vision of how to survive and face the crisis of life.
Crimes of the Heart is a play that is concerned about three sisters whose lives are headed in distinctly different directions; howe
... Show MoreThis research deals with the audio part of the cinematic film, which is the sound and its elements inside the space of the cinema picture. It also deals with the psychological side of the sound and the effects made by the sound on the audience through the carefully studied use of the film maker in employing the sound and the picture. For the importance of this element, most of the directors were aware of the seriousness that sound causes to the cinematography, and consequently working as a whole such as the indications, meanings, symbols, metaphors ,transitions…etc. The research included the methodological framework which consists of the research problem, in which the researcher ma
... Show MoreThe current study included a detail morphological study of all parts of the species Ipomoea carnea Jacq. (Convolvulaceae) cultivated in different gardens, the roots, stems, leaves, flowers and fruit were studied in detail, also the pollen grains were studied and there are photographs for all the parts were putted.
Thiamethoxam is a synthetic organic insecticide belong to The most significant new class of pesticides created in the last thirty years is neonicotinoids. This study's objective was to determine the effect of thiamethoxam, lambda cyhalothrin and their combination on biochemical parameters, the levels of free radicals and enzymes activities liver of male.Forty Rats ( 150-170 g ) were used. animals Were separated into four groups, each with ten rats.The Gp1 was used as control, the Gp2 was used to study the effect of thiamethoxam for 3weeks, the Gp3 was employed to examine the impact of lambda cyhalothrin for 3 weeks and the Gp4 was used to research the impact of thiamethoxam and lambda cyhalothrin for 3 weeks. thiamethoxam and/or lambda cyha
... Show MoreBackground: Aesthetic archwires are used to overcome the aesthetic problems of stainless steel wires but the color of the coating layer can be changed with time when exposed to oral environments. The aim of this study was to evaluate the degree of color change of different aesthetic archwires from different companies under different coloring solutions. Materials and Methods: One hundred fifty samples of coated archwires from three companies (Highland, G&H and Dany) were immersed in 5 solutions (artificial saliva, turmeric, tea, coffee and Miranda) to evaluate the degree of color changes after 7, 14 and 21 days using visible spectrophotometer. Data were collected and analyzed using one way ANOVA and post hoc Tukey’s tests. Resu
... Show MoreWhen exercising their authority in the jurisprudence, judges are subject to a set of restrictions that they must adhere to, as they do not want their jurisprudence to be accepted and welcomed by law practitioners in general, and legal scholars in particular, and in contrast to it, the arrows of criticism and defamation will extend to that jurisprudence, and then they will have to reverse them . Perhaps the most important of those restrictions imposed on judges is their observance of justice between the parties to the lawsuit through their lack of bias for one of the parties at the expense of the other, in addition to their observance of public order and public morals, as well as their observance of the legal texts that they work under its u
... Show MoreIn the field of residential community planning, one of the appropriate places to study the mutual influences between man and the environment, away from the influences, concepts and mechanisms of contemporary planning theories are isolated environments in rural areas, and the marshlands in Iraq represent one of these models. These areas still retain the planning patterns of residential communities for thousands of years. This research attempts to conduct a descriptive study of traditional settlement patterns, which relied on the capabilities of the surrounding areas to provide planning and architectural solutions based on the environmental factor. Establishing such a clear framework for these impacts can help in any future interventi
... Show MoreThis paper aimed at specifying the leading obstacles which faced by Iraqi EFL secondary school teachers in teaching English language. According to studies and observations, lack of adequate materials, overcrowding classrooms, lack of infrastructures, and low job satisfaction are the main barriers to English language teaching in Iraq. Data were collected from 130 EFL teachers from Iraqi schools through a standard questionnaire. The data were analyzed using a descriptive statistic to summarize and present it in a meaningful way. The findings supported previous studies regarding the classroom overcrowding, lack of teaching aids and materials, and dilapidated facilities. Furthermore, regarding job dissatisfaction and salary, interesting and eye
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