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: Bilastine is a non-sedating, second-generation antihistamine used to treat urticaria and allergic conjunctivitis. Objective: to formulate and test bilastine as a mucoadhesive ophthalmic in situ gel in order to extend its presence at site for longer time and help treat conjunctivitis and allergic rhinitis. Methods: We prepared formulations using different concentrations of poloxamers (Poloxamer 407 (P407) and Poloxamer 188 (P188)) in combination with hydroxypropyl methyl cellulose (HPMC). The prepared formulas were evaluated for their physicochemical properties, sol-gel transition temperature, viscosity, mucoadhesive strength, drug release, and kinetic modeling. Results: The prepared in situ gels were clear and transparen
... Show MoreRepresents the narrative and drama important sources in the serial drama television structure, and the advent of modern narrative techniques within the dramatic structure of the series of television directorial and processors that hired them, form a quantum leap in the level of the emergence of distinct forms of dramatic rely on narrative techniques according to the harmonic fabric is in control of making the form of art. dramatic and running events, but in order to discharge the need to adhere to the basics of drama and adapted within the mediator television capabilities, and narrative to make forms of television series to Atantzm in drift fixed because of the nature of governing structure formalism, this does not mean the existence of
... Show MoreAfrican countries are among the countries in the world that suffer from the phenomenon of child recruitment in wars and conflicts. There are many reasons behind it, including the nature of the human formation of children, the societal violence to which they are exposed, lack of access to education, economic hardships, as well as the role of African wars and conflicts and other reasons that compelled children to join armed groups and participate in military operations. The recruitment of children is divided into two types, compulsory and voluntary, and this leads to many humanitarian and security repercussions that are not limited to a specific period of time but extend to subsequent generations, and due to its seriousness, t
... Show MoreA sense of job security for divorced female teachers is one of the basic and very important requirements for enjoying the mental health that a person needs in order to be positive, balanced and productive. job security is one of the important things that workers must feel not only to ensure interaction and harmony between them and officials, but to ensure their satisfaction and increasing their motivation towards work, as job security is one of the most important indicators of job satisfaction and optimism in life, and it leads to the experience of psychological reassurance, which affects the building of individuals' personalities, the development of their intellectual competence and the identification of their psychological characteristic
... Show MoreIn recent years, there is more interest in water sources availability, including groundwater due to an increase in demand for water because of the increasing population in the world, and the water recedes due to climate change also. Therefore, the study of groundwater has required more attention. The aim of the present study is to establish a MODFLOW model in the groundwater modeling system software to simulate the movement of groundwater in the Turssaq alluvial fan which is located in the Qazaniyah city, east of Diyala Governorate. The solid model was used to define the aquifer in the study area. Using the GIS software, mapping and preparing the data needed to create a conceptual model were carried out. The data of the
... Show MoreBladder cancer (BC) is the predominant malignant neoplasm in the urinary system and ranks as the tenth most prevalent malignant tumor worldwide. Compared with females, males displayed a four-fold more common incidence of bladder cancer. It mainly affects men. Bladder cancer is the fourth most prevalent neoplasm in males. The most important protein that makes up high density lipoprotein (HDL), ApoA-I apolipoprotein A1 is essential in regulating the right amount of cholesterol. Multiple inquiries have demonstrated that APOA1 plays a pivotal role in the progression, infiltration, and spread of tumors. Objectives. The objective of this study was to measure the level of urine to serum apolipoprotein A1 in patients suffering from bladder
... Show MoreIn this work a study was made in centrifugal fan blower to investigate the effect of impeller blade design on sound pressure level (SPL). Shroud and unshroud impeller of nine blades are used. The sound generation from flow inside the test rig at different positions was displayed by using spectral analyzer. The experiments were carried out in anechoic chamber with small holes in its walls, under ambient condition about (25-27) C ° to avoid the effect of temperature on the sound pressure level. The results showed that (SPL) decreased with the increase of distance from the source about (3-4)dB when distance varied about (0.8-1.06)m, and the (SPL) decreased with the decrease of velocity about (8-12)dB when velocity varied between (13000-260
... Show MoreStatistical learning theory serves as the foundational bedrock of Machine learning (ML), which in turn represents the backbone of artificial intelligence, ushering in innovative solutions for real-world challenges. Its origins can be linked to the point where statistics and the field of computing meet, evolving into a distinct scientific discipline. Machine learning can be distinguished by its fundamental branches, encompassing supervised learning, unsupervised learning, semi-supervised learning, and reinforcement learning. Within this tapestry, supervised learning takes center stage, divided in two fundamental forms: classification and regression. Regression is tailored for continuous outcomes, while classification specializes in c
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