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% (
Alterations of trace element concentrations adversely affect biological processes and could promote carcinogenesis. Trace element deficiency or excess is implicated in the development or progression of some cancers like colorectal cancer. The aim of the present study was to compare the serum copper (Cu) and zinc (Zn) concentrations in patients with colorectal cancer from Iraqi male patient with those of healthy subjects. During the period of March 2015 until august 2015, a total of 25 patients with metastatic colon cancer and 20 healthy volunteers were enrolled from the Al-Kadhimia Teaching Hospital after the diagnosis using a histopathological examination for the malignant tumor; their age was between (38-60) years. Higher levels o
... Show MoreHigh temperature superconductor with nominal composition Bi1.6Pb0.4Sr1.8Ba0.2Ca2 Cu3O10+? was prepared by solid state reaction method. Two sets of samples have been prepared .The first one was quenched in air; the second set was quenched in liquid nitrogen. X-ray diffraction analyses showed an orthorhombic structure with two phases, high –Tc phase (2223) and low-Tc phase (2212) in addition to that impure phase was found. It has been observed that quenched in air samples display a sharp superconducting transition and a higher-Tc phase than that of the quenched in liquid nitrogen samples.
Pharmaceutical care is a patient-centered, outcomes oriented practice that requires the pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. In addition, the presence of clinical pharmacists has led to a higher quality of patient education and provision of complete detailed information for patients. In developed countries Pharm D has become the professional degree for practice of Pharmacy. The graduates will be enrolled in a pharmacy residency program; admission to the residency programs is available to Pharm D graduates of an accredit
... Show MoreMany problems are facing the installation of piles group in laboratory testing and the errors in results of load and settlement are measured experimentally may be happened due to select inadequate method of installation of piles group. There are three main methods of installation in-flight, pre-jacking and hammering methods. In order to find the correction factor between these methods the laboratory model tests were conducted on small-scale models. The parameters studied were the methods of installation (in-flight, pre-jacking and hammering method), the number of piles and in sandy soil in loose state. The results of experimental work show that the increase in the number of piles value led to increase in load carrying ca
... Show MoreInnovative laboratory research and fluid breakthroughs have improved carbonate matrix stimulation technology in the recent decade. Since oil and gas wells are stimulated often to increase output and maximum recovery, this has resulted in matrix acidizing is a less costly alternative to hydraulic fracturing; therefore, it is widely employed because of its low cost and the fact that it may restore damaged wells to their previous productivity and give extra production capacity. Limestone acidizing in the Mishrif reservoir has never been investigated; hence research revealed fresh insights into this process. Many reports have stated that the Ahdeb oil field's Mishrif reservoir has been unable to be stimulated due to high injection pressures, wh
... Show MoreRoald Dhal's is a prominent British short story writer who presented a fictional world full of contradictions and ironies. It is also full of double meanings where things are not what they appear to be and where meaninglessness is a prominent component. Dahl's world is also colored with blackness and grotesqueness; full of comedy that makes you shiver instead of laugh and characters who invite a sneak peek into a different side, a dark side of human nature. Dahl's themes are various and gripping but usually revolve around the triangle that frames his fiction: violence, humour, and absurdity. What seems to be a prominent and recurrent theme that intersects with every element in this triangle is revenge. In one story after another Dahl pre
... Show MoreDeep submicron technologies continue to develop according to Moore’s law allowing hundreds of processing elements and memory modules to be integrated on a single chip forming multi/many-processor systems-on-chip (MPSoCs). Network on chip (NoC) arose as an interconnection for this large number of processing modules. However, the aggressive scaling of transistors makes NoC more vulnerable to both permanent and transient faults. Permanent faults persistently affect the circuit functionality from the time of their occurrence. The router represents the heart of the NoC. Thus, this research focuses on tolerating permanent faults in the router’s input buffer component, particularly the virtual channel state fields. These fields track packets f
... Show MoreIn this paper we report the use of supersonic jet laser induced fluorescence (LIF) spectroscopy to facilitate the study of the spectra of some organometallic sandwich compounds particularly the metallocenes. The charge-transfer processes within these compounds, especially ligand to metal charge transfer within decamethylrhenocene ( - C5 Me5)2 Re were of particular interest. The spectrum shows a high degree of structures, indicating that there are several levels populated and these molecules are able to undergo many possible transitions