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.
This study presents the findings of a 3D finite element modeling on the performance of a single pile under various slenderness ratios (25, 50, 75, 100). These percentages were assigned to cover the most commonly configuration used in such kind of piles. The effect of the soil condition (dry and saturated) on the pile response was also investigated. The pile was modeled as a linear elastic, the surrounded dry soil layers were simulated by adopting a modified Mohr-Coulomb model, and the saturated soil layers were simulated by the modified UBCSAND model. The soil-pile interaction was represented by interface elements with a reduction factor (R) of 0.6 in the loose sand layer and 0.7 in t
To investigate the antiplaque and antigingivitis efficacy in addition to evaluating side effects and subjects’ perceptions of three commercially available mouthwashes.
This study was a double‐blind, parallel, and short‐term trial. A total of 75 dental students with biofilm‐induced gingivitis were included in the final analysis of the current study. Clinical parameters (plaque index and bleeding on probing) and the staining effect were measured at baseline and after 7 days. In addition, a VAS‐based assessment questionnaire was completed by the participants.
Assessing performance efficiency is critical to the management need for oversight, planning, and continuous periodic evaluation of the multiple activities of Northern Cement State Company in order to determine the level of achievement of the objectives set, and to correct the deviations and delays that the evaluation shows and limitation of liability. What cannot be measured cannot be managed. The aim of this research is to highlight the impact of using BSC, financial and non-financial, to give comprehensive and clear picture of the company's performance and to measure the quality of its performance by using six-sigma and the level of deviations in achieving the planned goals. Therefore, four-key hypotheses were formulated for th
... Show MoreSince the invention of the automobile, no aspect of American life, including crime and its control, has remained untouched by this far-reaching innovation in transportation. Vehicular "hot pursuit"-when suspects in motor vehicles use excessive speed in attempting to elude the police. Unfortunately, accounts of wild chases across crowded inner city streets, through tree-lined suburban boulevards, and over remote country roads are very real and not merely fictional material created for entertaining television and motion picture audiences. The specter of "hot pursuit," complete with screaming sirens and red or blue flashing lights, has become a recurring fact of modem life.1 So, too, are the mishaps involving police vehicles or the vehicles pu
... Show MoreThe research Aim is to provide support to small enterprises by providing tools that enable measurement and test their performance and identifying weaknesses and work on them is determined by the problem of searching using traditional assessment methods for small projects with only financial performance measurement standards that do not provide a complete picture of the performance of these projects so use the balanced scorecard the four pillars (financial, customer, learning and growth, and internal processes) and identify deviations and work on them through the use of the outputs of the programme (probe), PROmoting Business Excellence-PROBE), which It is a model of performance evaluation, with which you can deve
... Show More This research aims to identify the economic design techniques and materials that can be used in the implementation of cosmetic supplements to the spaces of the dwelling. The research relied on the descriptive and analytical approach by describing and analyzing models of design techniques and materials that can be used in the production of cosmetic supplements in the interior spaces of the dwelling.
The results of the research concluded that the beautification of the spaces of the dwelling is one of the necessary and important pieces to add aesthetic touches to the internal spaces, and that the use of economic design techniques and materials contributes to the implementation of many pieces of complementary beautification of the
Abstract:
Today, the financial and banking sector is witnessing a qualitative shift thanks to financial technology services, which provide their services to many individuals and companies in quick, easy and less expensive ways compared to traditional means. Financial technology is a new form of financial science that combines financial transactions and technological skills concerned with providing financial services and improving the work environment within Banking institutions, and financial technology provides many advantages such as lower transaction costs, instant payment, and saving more time and effort in conducting banking
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