Clopidogrel is a prodrug that must be transformed into an active metabolite by hepatic cytochrome P450 (CYP) isoenzymes to prevent platelet clotting. Polymorphisms of the CYP2C19 gene can cause a reduction or complete loss of CYP2C19 enzyme activity resulting in inhibiting clopidogrel metabolism, effectiveness and increase stroke recurrence risk in ischemic stroke patients. This study aims to investigate the correlation between genetic polymorphisms in CYP2C19*2 and*3 and recurrent risk in patients with ischemic stroke taking clopidogrel 75mg in Kurdistan region –Iraq. This retrospective case-control study was carried out at Kurdistan, Erbil, Medicina medical center, and Rizgary general hospital from January 2021 to August 2021. The blood sample was taken from the participants and tested for genotyping. The collection of data was taken from patients' medical charts in the hospital and patients’ electronic medical records from the neurology clinic. Sixty patients participated, (34) were male and (26) were female, with age range (38-96) years, diagnosed from not more than two years with ischemic stroke and taking 75 mg clopidogrel maintenance dose. Genotyping analysis showed 61.7 % were homozygotes for wild allele *1, the heterozygotes divided into 26.7% (*1/*2) and 6.7 % (*1/*3) genotype, while the homozygotes for mutant alleles CYP2C19*2,*3 distributed in 3.3 %(*2/*2) and 1.7 %(*3/*3). The (*2/*3) was not detected in the study population. A significant relation was found between risk of stroke recurrence with carrying the variant allele CYP2C19 *2, reduced CYP2C19 enzyme metabolic activity, and ACEIs/ARBs usage (P = 0.024, P = 0.039, P=0.24 respectively). On the other hand, there was no significant relationship between the risk of stroke recurrence and carrying the variant allele CYP2C19 *3 (P = 1.000). Ischemic stroke patients treated with clopidogrel and carrying a CYP2C19*2 allele had a higher risk of recurrent stroke as it is associated with reduced the metabolic activity of CYP2C19 enzyme leading to reduction of clopidogrel effect.
Background: Pregnancy is considered a major risk factor for development and progression of periodontal disease. There are hormonal changes in both estrogen and progesterone hormones in addition to bacterial effect and poor oral hygiene that will enhance development of periodontal disease in pregnant women. Materials and methods: Seventy subjects were enrolled in the study, the subjects with an age range (20-35) years old without any history of systemic disease. The subjects were divided into 20 non-pregnant women they represent the control group (G I), 30 pregnant women with gingivitis (GII) and 20 pregnant women with periodontitis (GIII).All periodontal parameters (plaque index, gingival index, bleeding on probing, probing pocket depth an
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The research aims to verify the dimensions of tax justice that exist in Iraq, and to determine their impact on tax compliance. Through a revised model of tax justice based on the literature of tax justice according to the classification of the studies of (Saad, 2009), (Wenzel, 2002), by using a questionnaire as an experimental measurement tool designed to be in line with perceptions of tax justice in Iraq. To define the dimensions of tax justice (the independent variable) with eight dimensions (Distributive justice, Exchange justice, Vertical justice, Horizontal justice, Retributive justice,
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The research aims at achieving a set of objectives, which is to study a vital variable in the organizations which is the talent management and its impact on encouraging and empowering employees to take part in making appropriate decisions with their heads in the Iraqi Cement State Company. The problem of this research is in finding solutions to the weaknesses that face the managers in attracting talented employees and keep them in the company, and this leads to a weak capacity of the company on authorizing talented employees and giving them the needed confidence to participate in decision making process. The research sample was included (45) managers in the researched company. Th
... Show MoreAim: The purpose of this study was to analyze the patterns of facial fractures in children and to compare them between preschool- and school-aged children. Materials and methods: This retrospective observational study included 57 children with facial fractures. The variables analyzed were the age of the patients—divided into a preschool-aged group (0–5 years) and a school-aged group (6–12 years)—gender, cause of trauma, the facial bones involved, the pattern of fracture, the modality of treatment used, the time between injury and treatment, and the postoperative complications. Results: The incidence of facial fractures in children ≤12 years was 30.2%. The patients consisted of 40 (70.2%) males and 17 (29.8%) females, and most pati
... Show MoreImage compression is an important tool to reduce the bandwidth and storage
requirements of practical image systems. To reduce the increasing demand of storage
space and transmission time compression techniques are the need of the day. Discrete
time wavelet transforms based image codec using Set Partitioning In Hierarchical
Trees (SPIHT) is implemented in this paper. Mean Square Error (MSE), Peak Signal
to Noise Ratio (PSNR) and Maximum Difference (MD) are used to measure the
picture quality of reconstructed image. MSE and PSNR are the most common picture
quality measures. Different kinds of test images are assessed in this work with
different compression ratios. The results show the high efficiency of SPIHT algori
We presented here a 25years old lady with a multiple hatdtid cysts in lung and liver and spleen in large number in each organ. Which regarded inoperable and difficult to treared.We use medical treatment with antihelimenthes drugs in new regime and follow-up over 1year clinically, laboratory investigations, U/s and CT.scan. There was good disappearance of liver and spleen cysts with very good response in lungs.
The ethyl acetate synthesis via heterogeneous reactive distillation is studied experimentally using ethanol and acetic acid. Three types of cation exchanging resins were used as catalysts: Zerolit 225, Zerolit 226 and Ambylite 400. Experiments were carried out in two units of the same dimensions. Each unit consisted of three sections: rectifying, reactive and stripping sections of heights (60+25+20) cm respectively and 2.5cm column diameter. The first unit (column-A-) was a fractionation type and the second unit (column-B-) was packed column. The packing type was hollow glass cylinders with 10 mm height, and 4, 5 mm inner and outer diameter respectively.
The experiment
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