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.
Leishmania is the causative agent of leishmaniasis, a widely distributed disease. Amastigote forms of Leishmania are intracellular and reside within the macrophage of the vertebrate host. Previous studies showed that certain Leishmania species may scavenge host factors for survival, specially sphingolipids, the key element of the eukaryotic membranes. In this study we have investigated the survival of new world L. mexicana amastigotes in murine macrophage cell-line in the presence and absence of foetal bovine serum (FBS). Results showed that there was no significance in the infectivity of amastigotes and also the number of parasite per cell; such findings suggest that L. mexicana amastigotes have its own pathway of sphingolipid intake and c
... Show MoreBack ground: primary nocturnal enuresis (PNE) is a socially distressing condition that can be troubling for children & their families. It affects 15-26% of five years olds. Several approaches are used to treat PNE including behavioral modification, alarms & drug therapy. Aim of the study: to determine the efficacy and safety of nasal desmopressin treatment in children with PNEPatients : fifty-four children with primary nocturnal enuresis with a mean age of ( 8.2) years ( range 6-15), underwent a 2 week observation period followed by entrance into a randomized controlled study, comparing desmopressin & placebo, lasting 4 weeks. The efficacy of the drug was measured in reduction of the number of wet nights per week. The enureti
... Show MoreBackground: Dental implant is one of the most important options for teeth replacement. In two stage implant surgery, a few options could be used for uncovering implants, scalpel and laser are both considered as effective methods for this purpose. The Aim of the study: To compare soft tissue laser and scalpel for exposing implant in 2nd stage surgery in terms of the need for anesthesia, duration of procedure and pain level assessment at day 1 and day 7 post operatively using visual analogue scale . Materials and methods: Ten patients who received bilateral implants participated after healing period completed, gingival depth over each implant was recorded and then implant(s) were exposed by either scalpel or laser with determination for th
... Show MoreThis research aims to evaluate the teaching methods used by intermediate Arabic language teachers. To achieve the goal, the researcher followed the descriptive-analytical approach. The research sample was limited to Arabic language teachers at intermediate school for the academic year (2017-2018) the researcher chose a random sample included (155) teachers which form a (40%) Of the original community at Baghdad/ Rusafa1th. The researcher has developed standards of teaching methods which are (7) standards with (39) paragraphs included three alternatives. The results showed the need to pay attention to the use of various modern teaching methods. Moreover, the researcher suggested making an evaluation of the teaching methods used by Arabic
... Show MoreBackground: Acute appendicitis is the most common abdominal surgical emergency. The diagnosis of this condition is still essentially clinical and there is difficulty in the clinical diagnosis, especially among elderly, children and patients with a typical presentation, so early and accurate diagnosis of acute appendicitis is important to avoid its complications.Objectives: To evaluate the degree of accuracy of Alvarado scoring system in the diagnosis of acute appendicitis.Method: Two hundred patients were admitted to the Alkindy Teaching Hospital from January 2011 to april 2014- presented with symptoms and signs suggestive of acute appendicitis. After examination and investigations all patients were given a score according to Alvarado sc
... Show MoreABSTRACT: BACKGROUND: Infantile haemangioma one of the most common tumour of new borns , a safe and effective treatment options are under ongoing research . OBJECTIVE: The authors show the effectiveness and safety of low dose propranolol as a method for infantile haemangioma treatment . METHOD: In this study twenty- four patients with infantile haemangioma in different anatomical locations were treated with oral propranolol and the result were assessed in a retrospective analysis of the results patients were kept on 0.25 mg/kg/day for one month , then on 0.5mg/kg/day in 2 divided doses for another one month , in the third month the dose will be increased to 1 mg/kg/day in 2 divided doses , then the propranolol were given in a maintenance do
... Show MoreThis paper presents the results of experimental investigation carried out on concrete model piles to study the behaviour of defective piles. This was achieved by employing non-destructive tests using ultrasonic waves. It was found that the reduction in pile stiffness factor is found to be about (26%) when the defect ratio increased from (5%) to (15%). The modulus of elasticity reduction factor as well as the dynamic modulus of elasticity reduction factor increase with the defect ratio
A composite section is made up of a concrete slab attached to a steel beam by means of shear connectors. Under positive and negative bending moment, part of the slab will act as a flange of the beam, resisting the longitudinal compression or tension force. When the spacing between girders becomes large, it is evident that the simple beam theory does not strictly apply because the longitudinal stress in the flange will vary with distance from the girder web, the flange being more highly stressed over the web than in the extremities. This phenomenon is termed "shear lag". In this paper, a nonlinear three-dimensional finite element analysis is employed to evaluate and determine the actual effective slab width of the composite steel-concrete
... Show MoreThe study of the dynamic behavior of packed distillation column was studied by frequency response analysis using Matlab program. A packed distillation column (80 mm diameter) (2000 mm height) filled with glass packing (Raschig Rings 10mm), packing height (1500 mm) has been modified for separation of methanol-water mixture (60 vol%). The column dynamic behavior was studied experimentally under different step changes in, feed rate (±30%), reflux rate (±22%), and reboiler heat duty (±150%), the top and bottom concentration of methanol were measured. A frequency response analysis for the above step response was carried out using Bode diagram, the log modulus and the phase angle were used to analyze the process model. A Matlab progra
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