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: Candida albicans is a prevalent commensal that can cause severe health problems in humans. One such condition that frequently returns after treatment is oral candidiasis. Aim: the goal of this research is to evaluate the efficiency of 940 nm as a fungicidal on the growth of Candida albicans in vitro. Material and Methods: In vitro samples (fungal swabs) were taken from the oral cavity of 75 patients suffering from oral thrush. Following the process of isolating and identifying Albicans. The samples are divided into four groups:(Group 1): Suspension of C. albicans was put in a solution of saline as a control group. (Group 2): Suspension of C. albicans that had been treated with nystatin. (Group 3): Suspension of C. albica
... Show MoreFlexible pavements are subjected to three main distress types: fatigue crack, thermal crack, and permanent deformation. Under severe climate conditions, thermal cracking particularly contributes largely to a considerable scale of premature deterioration of pavement infrastructure worldwide. This challenge is especially relevant for Europe, as weather conditions vary significantly throughout the year. Hydrated lime (HL) has been recognized as an effective additive to improve the mechanical properties of asphalt concrete for pavement applications. Previous research has found that a replacement of conventional limestone dust filler using hydrated lime at 2.5% of the total weight of aggregates generated an optimum improvement in the mec
... Show MoreBackground: The repair of bone defects remains a major clinical orthopaedic challenge. Bone is a highly vascularised tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. Angiogenesis thus plays a pivotal role in skeletal development and bone fracture repair. The role of angiogenic and osteogenic factors in the adaptive response and interaction of osteoblasts and endothelial cells during the multi step process of bone development and repair will be highlighted in this study. This study aimed to identify the role of local exogenous vascular endothelial growth factor in bone healing and to analyze the expression of VEGF by immunohistochemistry in created bone defect af
... Show MoreInvestments in shares represent an essential component of companies’ assets and a source of profit making resources. These investments are linked to the areas of trading and speculation, which is reflected on their market value, which makes accounting for and evaluating these investments require their own accounting standards, and thus several international standards were issued regarding this as well as a statement of their impact on growth Sustainable, as the research problem is to show the impact of measuring investments in shares according to international accounting and financial reporting standards on the sustainable growth of economic units, the research sample and its reflection on audit procedures. In accordance with i
... Show MoreThe dislocation and gifts at special is the aspect of social life they reflect us how rich and influential class of society, a special category of the ruling category of the caliph and his family and his ministers and his generals and senior statesmen, a powerful and wealth and power and study here dealing with the effect the media for the distribution of dislocations and gifts to the special category both internally and for employers the state and its men or externally represented foreign relations with princes in the state and the regions and include the definition of the concepts above with surrounding contents and events distributed as the some of which were distributed in certain occasions fixed times while others did not have a spe
... Show MoreThis study is designed to detect the level of cytokine IFN-γ concentration, and some antioxidants, including super oxide dismutase (SOD) and Vitamin C, and to estimate the level of sex hormones (FSH and LH), and to determine auto-antibodies (antiphospholipid antibodies (APA) IgG\IgM, and anticardiolipin antibodies (ACA) IgG\IgM) and to estimate the blood parameters in 51 miscarriage women infected with T.gondii distributed depending on the type of antibodies. Additionally, 39 volunteers non-infected with T.gondii included (19 miscarriage women, 10 pregnant women and 10 non-pregnant women). ELISA and spectrophotometer method were used in this study. The results of IFN-γ showed a significant increase)p<0.05) in the l
... Show MoreBackground: Salivary immunoglobulin IgA plays an essential role in the immune response against dental caries. This studywas conducted to compare the salivary IgA levels and flow rate of stimulated saliva in caries active and caries free children. Materials and methods: The present study included sixty healthy children age 7-10 yearswho were divided into two groups. They were caries free and caries active children (30 children in each group). Assessment and recording of caries – experience were through the application of Decayed, Missing and Filled Tooth Index (DMFT) and (dmft) index, for permanent and deciduous teeth respectively. After dental examination, stimulated saliva samples were collected from the subjects and performed und
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