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: Pyogenic discitis most frequently occurs
after home delivery, hemorridectomy, and dilatation and
curettage. Discitis is generally due to blood borne bacterial
invasion of the disc from adjacent end-plate via
communicating vessels. Infective discitis remains an
uncommon, but potentially serious cause for back pain.
Delayed diagnosis can occur and a high index of suspicion
may occur.
Methods: The study included 30 patients suffering from
localized low back pain with limitation of movement.
Diagnosis was made by history, physical examination and
investigation mainly E.S.R and MRI.
Results: 50.3% of patient with discitis had a history of
vaginal delivery, 15% had a history of hemorridectomy
Channel estimation and synchronization are considered the most challenging issues in Orthogonal Frequency Division Multiplexing (OFDM) system. OFDM is highly affected by synchronization errors that cause reduction in subcarriers orthogonality, leading to significant performance degradation. The synchronization errors cause two issues: Symbol Time Offset (STO), which produces inter symbol interference (ISI) and Carrier Frequency Offset (CFO), which results in inter carrier interference (ICI). The aim of the research is to simulate Comb type pilot based channel estimation for OFDM system showing the effect of pilot numbers on the channel estimation performance and propose a modified estimation method for STO with less numb
... Show MoreThe theory of probabilistic programming may be conceived in several different ways. As a method of programming it analyses the implications of probabilistic variations in the parameter space of linear or nonlinear programming model. The generating mechanism of such probabilistic variations in the economic models may be due to incomplete information about changes in demand, production and technology, specification errors about the econometric relations presumed for different economic agents, uncertainty of various sorts and the consequences of imperfect aggregation or disaggregating of economic variables. In this Research we discuss the probabilistic programming problem when the coefficient bi is random variable
... Show MoreIn this paper, mesoscale modeling is performed to simulate and understand fracture behavior of two concrete composites: cement and asphalt concrete using disk-shaped compact tension (DCT) tests. Mesoscale models are used as alternative to macroscale models to obtain better realistic behavior of composite and heterogeneous materials such as cement and asphalt concrete. In mesoscale models, aggregate and matrix are represented as distinct materials and each material has its characteristic properties. Disk-shaped compact tension test is used to obtain tensile strength and fracture energy of materials. This test can be used as a better alternative to other tests such as three points bending tests because it is more convenient for both field and
... Show MoreBackground: Potentially malignant oral disorders (PMODs) are common precursors of oral squamous cell carcinoma (OSCC). Neoangiogenesis and signalling are important intermediate biomarkers that may govern the progression of dysplastic mucosa into carcinoma. Aims: Evaluate the importance of CD34 and Wnt3 expression in PMODs and OSCCs in relation to their clinicopathological parameters. Settings and Design: Prospective cross-sectional study. Materials and Methods: Immunohistochemical staining for CD34 and Wnt3 was performed for 41 samples. These included 27 PMODs, six OSCCs and eight normal gingival and alveolar mucosa. Analysis of variance (ANOVA) and post-hoc tests were applied. P<0.05 was considered statistically significant. Results: CD34
... Show MoreSelexipag is an orally selective long-acting prostacyclin receptor agonist, which indicated for the treatment of pulmonary arterial hypertension. It is practically insoluble in water ( class II, according to BCS). This work aims to prepare and optimized Selexipag nanosuspensions to achieve an enhancement in the in vitro dissolution rate. The solvent antisolvent precipitation method was used for the production of nanosuspension, and the effect of formulation parameters (stabilizer type, drug: stabilizer ratio, and use of co-stabilizer) and process parameter (stirring speed) on the particle size and polydispersity index were studied. SLPNS prepared with Soluplus® as amain stabilizer (F15) showed the smallest particle size 47nm wi
... Show MoreThis paper investigates the collocational use of irreversible food binomials in the lexicons of English (UK) and Arabic (Iraq), their word-order motivations, cultural background, and how they compare. Data consisted in sixteen pairs in English, versus fifteen in Arabic. Data analysis has shown their word order is largely motivated by logical sequencing of precedence; the semantically bigger or better item comes first and the phonologically longer word goes last. These apply in a cline of decreasing functionality: logical form first, semantic importance second, phonological form last. In competition, the member higher in this cline wins first membership. While the entries in each list clearly reflect culturally preferred food meals in the UK
... Show MoreThe childhood of the most important stages throughout the human and which have been more vulnerable to various factors surrounding it and with the scientific and cognitive development in all fields surfaced many psychological phenomena that play a large role in influencing children and their behavior trends is the susceptibility of the lure of psychological phenomena which plays a major role in the social attitudes of individuals it may not be predictable so that individuals vary in between them in terms of vulnerability Balasthoa You do this only _bl that the same individual at different influenced Balasthoa different depending on the positions and this was research to achieve its objectives and that are known:
_ alasthoa The childre