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% (
الخلاصة
یعد والت وتمن شاعرا استثنائیا سواء أكان ذلك في المكانة التي یحتلھا في الأدب الأمریكي او في نمط
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Arab heritage have teem much of the literature value, written by evacuated, who had a legacy of linguistic great scientists, but the circumstances are unknown, did not write those books or authors emerge, chose to search for a book of those compositions, he did not write to him and his book emerge, fell hands a book (Altvsh in the language) to Abu Sufyan grammar, a fourth-century scientists, as it is Abu Sufyan grammar of scientists who rolled up the time their impact, and the cryptic revelations among the stars, preferring to stand on this book and its author, a statement of the most important grammatical aspects contained therein; to notch the curtain for this world, and his book (Altvsh in strewn language and Mnzawmha and express the
... Show MoreComprehensive automobile insurance is considered as an important insurance which is managing by National Insurance Company due to the continuous accidents the company is endeavoring to this market not for trading motives only but also to increase the insurance awareness of people and insurance benefit for other insurance portfolios .On this basis the researcher had chosen her subject ( obstacles in marketing comprehensive automobile Insurance policy ) the company faces several obstacles and limitations in marketing the policies of this portfolio due to certain factors and influences beyond the mainly connected with the reduction of marketing programmes of the company . the aim of this study is to shade the light upon the internal factors
... Show MoreThis research presents a method for calculating stress ratio to predict fracture pressure gradient. It also, describes a correlation and list ideas about this correlation. Using the data collected from four wells, which are the deepest in southern Iraqi oil fields (3000 to 6000) m and belonged to four oil fields. These wells are passing through the following formations: Y, Su, G, N, Sa, Al, M, Ad, and B. A correlation method was applied to calculate fracture pressure gradient immediately in terms of both overburden and pore pressure gradient with an accurate results. Based on the results of our previous research , the data were used to calculate and plot the effective stresses. Many equations relating horizontal effective stress and vertica
... Show MoreEmergency vehicle (EV) services save lives around the world. The necessary fast response of EVs requires minimising travel time. Preempting traffic signals can enable EVs to reach the desired location quickly. Most of the current research tries to decrease EV delays but neglects the resulting negative impacts of the preemption on other vehicles in the side roads. This paper proposes a dynamic preemption algorithm to control the traffic signal by adjusting some cycles to balance between the two critical goals: minimal delay for EVs with no stop, and a small additional delay to the vehicles on the side roads. This method is applicable to preempt traffic lights for EVs through an Intelli
A critical milestone in nano-biotechnology is establishing reliable and ecological friendly methods for fabricating metal oxide NPs. Because of their great biodegradable, electrical, mechanical, and optical qualities, zirconia NPs (ZrO2NPs) attract much interest among all zirconia NPs (ZrO2NPs). Zirconium oxide (ZrO2) has piqued the interest of researchers throughout the world, particularly since the development of methods for the manufacture of nano-sized particles. An extensive study into the creation of nanoparticles utilizing various synthetic techniques and their potential uses has been stimulated by their high luminous efficiency, wide bandgap, and high exciton binding energy. Zirconium dioxide nano
... Show MoreBackground. Alopecia areata (AA) is a common form of noncicatricial hair loss of unknown cause, affecting 0.1-0.2% of the general population. Most evidence supports the hypothesis that it is disease of the hair follicle of autoimmune nature mediated by T-cells, with important cytokine role. Objective of the Study. The objective of this study is to study the association and changes in serum levels of interleukin-15 (IL-15) and tumor necrosis factor-α (TNF-α) in patients with AA in relation to the type, activity, and disease duration. Patients and Methods. Thirty-eight patients with AA and 22 individuals without the disease as controls were enrolled in this case-controlled study conducted in the Department of Dermatology in the Al-K
... Show MoreBackground: Medical-surgical nurses are responsible of providing competent care to clients with a wide-array of acute and chronic health problems. This challenging task requires arming nurses with advanced competencies of health literacy to effectively educate their clients. However, evidence about medical-surgical nurse’s health literacy-related knowledge and experience is limited. Purposes: This study aimed to determine the level of the health literacy-related knowledge and experience among medical-surgical nurses.Design: A descriptive-cross-sectional study was conducted among a total sample of 177 nurses who were practicing in medical-surgical wards in teaching hospitals in Iraq. A convenience sampling method was used to sele
... Show MoreBackground: Oocytes are susceptible to alterations in the various fatty acid contents of follicular fluid (FF), which may influence maturation and embryogenesis. Different fatty acids exert various effects on intracytoplasmic sperm injection (ICSI), which needs further studies to uncover the involved mechanisms. Objectives: To assess FF fatty acids in women undergoing ICSI and to correlate them with ICSI parameters, namely the total count of aspirated oocytes, oocyte maturation rate, fertilization rate and percentage of good-quality embryos. Methods: Fifty women undergoing ICSI were enrolled in this cross-sectional study. FF samples were collected during oocyte retrieval and were analyzed for fatty acids using gas chromatography. Fa
... Show MoreA rapid, sensitive and without extraction spectrophotometric method for determination of clonazepam (CLO) in pure and pharmaceutical dosage forms has been described. The proposed method was simply depended on charge transfer reaction between reduced CLO (n-donor) and metol (N-methyl-p-aminophenol sulfate) as a chromogenic reagent (π- acceptor). The reduced drug, with zinc and concentrated hydrochloric acid, produced a purple colored soluble charge-transfer complex with metol in the presence of sodium metaperiodate in neutral medium, which has been measured at λmax 532 nm. All the variables which affected the developed and the stability of the colored product such as concentration of reagent and oxidant, temperature and time of rea
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