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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 Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Risk Factors influencing Post-Partum Depression Severity in Iraqi Women
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Background: Post-partum depression (PPD) is a form of postnatal depression that affects mothers. Clinical manifestations usually appear within six months after delivery. Risk factors that influence the severity of post-partum depression are not fully known in the Iraqi population.
Objectives: We aim to evaluate the risk factors and identify potential predictors that may influence the symptom levels (severity) of post-partum depression among Iraqi women from Baghdad.
Subjects and Methods: The current study is cross-sectional, and we used the Edinburgh Postnatal Depression Scale (EPDS) and a cut-off value of 13 to differentiate patients into two those with lower symptom levels (LSL) and higher symptom levels (HSL). We also explored p

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Publication Date
Sun Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Possible Cardio-Protective Effects of Ethanolic Artichoke Extract against 5- Fluorouracil Induced Cardiac Toxicity in Rats
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Cardiac toxicity can occur during the therapy with several cytotoxic drugs, including 5- Fluorouracil (5- FU). It is an antimetabolite that acts during the S phase of the cell cycle and is activated by thymidine phosphorylase into fluorodeoxyuridylate (5 fluoro 2'deoxyuridine 5'monophosphate, 5-FdUMP) that inhibits thymidylate synthase, thus preventing DNA synthesis that leads to imbalanced cell growth and ultimately cell death. It is still a widely used anticancer drug, since 1957. The present study aimed to evaluate the possible cardio-protective effects of ethanolic artichoke extract (Cynara scolymus L.) against 5-fluorouracil (5-FU) induced cardio-toxicity in rats by evaluating serum levels of Alanine aminotransferase, aspartate amin

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Publication Date
Sat Sep 21 2019
Journal Name
Journal Of The College Of Education For Women
Reading Readiness Skills in Preschool Children
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This research aims to identify the following :

  • The reading willingness skill to kindergarten children.
  • There is no statistical significance difference between average scores of reading willingness skill of the sample individuals as a whole, and the hypothetical average of the scale.
  • The difference in reading willingness skill to kindergarten children according to gender variable (male & female).
  • There is no statistical significance difference between average scores of reading willingness skill for kindergarten children according to gender variable (male & female).

   To achieve the research goals, the researc

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Publication Date
Sat Jun 30 2007
Journal Name
Al-kindy College Medical Journal
Parental Perception of Fever in Children
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Back ground : Fever is a common medical problem in
children. parents have been shown unrealistic fears of
harmful effects of fever in their children. Resulting in
inappropriate management of fever in their children.
Objective: the objective of this study was to survey
parents about their knowledge andattitude concerning fever
in their children.
Methods : The study involved random selection of
parents who brought their febrile children to emergency
department or out-patient clinics of five teaching and non
teaching hospitals in Baghdad from first of October to end
of December 2002.
Parents of 400 febrile children were interviewed using a
standard questionnaire to obtain sociodemographic
informatio

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Musical Intelligence in kindergarten children
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The childhood of the important stages in which the adopted child's personality, mental and physical, motor and configure , as well as gain experience , it is the basis on which the future life of the child , studies have unanimously competent in the fields of childhood verily the first five years of a child of the most important stages of life and the most fertile life . Because the stage Childhood its an active role as the foundation upon which to build human personality , it was necessary to create all leads to raise the level of intelligence of children , because intelligence is the first element in the organization of thinking makes the child able to do the activities characterized by mental qualities .
Indicated most of the scien

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Publication Date
Sun Jun 03 2007
Journal Name
Al-kindy College Medical Journal
Parental perception of fever in children
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Back ground : Fever is a common medical problem in children. parents have been shown unrealistic fears of harmful effects of fever in their children. Resulting in inappropriate management of fever in their children. Objective: the objective of this study was to survey parents about their knowledge andattitude concerning fever in their children. Methods : The study involved random selection of parents who brought their febrile children to emergency department or out-patient clinics of five teaching and non teaching hospitals in Baghdad from first of October to end of December 2002. Parents of 400 febrile children were interviewed using a standard questionnaire to obtain sociodemographic information and current knowledge of fever. Results: Ap

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Nursing Educational Program on Recovery Following CABG Surgery: Intervention Study
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This intervention study is composed on 55 patients at Saddam Center for Cardiac Surgery (Aben-Albetar) throughout the period from 1st of July 1997 to 15th of January 1999. The study aimed to evaluate the effectiveness of constructed nursing education program on reduction of complications and improving recovery among patients with Coronary Artery Bypass Graft (CABG) surgery through the application of repeated measures. The sample is divided into 27 patients who received the nursing educational program (study group) and 28 patients who continued to receive regular care (controls). Based on previous research meth

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Publication Date
Thu Aug 31 2023
Journal Name
Oncology And Radiotherapy
The role of breath holding technique on minimizing cardiac dose in left breast cancer irradiation in the adjuvant setting
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Publication Date
Tue Aug 16 2022
Journal Name
World Journal Of Biology Pharmacy& Health Science
Long-term results of balloon pulmonary valvuloplasty in pediatric age group in surgical specialty teaching hospital/cardiac center/Hawler
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Congenital valvular pulmonary stenosis accounts for 5-10% of all congenital heart disease. Balloon pulmonary valvuloplasty is a safe and effective method in reduction of moderate to severe valvular pulmonary stenosis. This retrospective study done in Hawler surgical specialty cardiac center on pediatric patients who had pulmonary valve stenosis (with echocardiographic peak gradient 2:50mmHg) and treated by balloon pulmonary valvuloplasty. A total of 178 cases were involved, 93(52.25%) patient was male and 85 (47.75%) patients was female. 160 patient (89.89%) were treated with single balloon method 18 patient (10.11%) were managed by double balloon method technique. Follow up period of these patients range from 1 year to 10 years (mean of 5.

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Publication Date
Mon Jul 27 2026
Journal Name
Indonesian Journal Of Clinical Pathology And Medical Laboratory
The Value of Cardiac Troponin I and Midkine in predicting coronary artery obstruction severity in Chronic Coronary Syndromes (CCS)
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High-sensitive cardiac troponin I (hs-cTnI) is a recognized marker of myocardial injury in acute coronary syndromes, but its utility in chronic coronary syndromes (CCS) remains unclear. Midkine (MK), a heparin-binding growth factor, plays a role in inflammation and vascular remodeling in atherosclerosis. This cross-sectional study aimed to evaluate the predictive value of serum hs-cTnI and MK in determining the severity of coronary artery obstruction in patients with CCS. The study included 125 subjects undergoing coronary angiography (CAG) at the Iraqi Center of Heart Disease/ Medical City/Baghdad, from March to December 2024. Subjects were classified into three groups based on CAG findings: no CAD, 1- or 2-vessel disease, and 3-ve

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