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: The use of electronic apex locators for working length determination eliminates many of the problems associated with the radiographic measurements (interference of anatomical structures, errors in projection such as elongation or shortening, and lack of three-dimensional representation). Its most important advantage over radiography is that it measures the length of the root canal to the apical constriction, not to the radiographic apex. The aim of this study was to assess the accuracy of a new fifth generation apex locator (Joypex 5) in recording the apical constriction and comparing it with a third generation apex locator (Root ZX) in vitro. Materials and method: Twenty four single-rooted sound human premolars, extracted for t
... Show MoreBackground: Different diagnostic definition and criteria have been recommended by different expert groups for the diagnosis of metabolic syndrome, however, it’s prevalence in the same population could differ depending on the definition used yielding different results. In Iraq, there is a lack of research comparing these different diagnostic definitions. Objective: To find out the most suitable metabolic syndrome definition to be used for Iraqi people. Methods: 320 participants were recruited for this study, 53.4% men and 46.6% women, aged between 25-85 years, visiting Baghdad Teaching Hospital, the prevalence of metabolic syndrome according to different definitions were compared and the agreement was assessed by the Kappa st
... Show MoreMobile Wireless sensor networks have acquired a great interest recently due to their capability to provide good solutions and low-priced in multiple fields. Internet of Things (IoT) connects different technologies such as sensing, communication, networking, and cloud computing. It can be used in monitoring, health care and smart cities. The most suitable infrastructure for IoT application is wireless sensor networks. One of the main defiance of WSNs is the power limitation of the sensor node. Clustering model is an actual way to eliminate the inspired power during the transmission of the sensed data to a central point called a Base Station (BS). In this paper, efficient clustering protocols are offered to prolong network lifetime. A kern
... Show MoreOBJECTIVE: Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections, and even tumor conditions. In this study, we assess the functional outcome of this modality in different spinal conditions. PATIENTS AND METHODS: Thirty-six cases operated from October 2010 to December 2017. Twelve patients had spinal type A3 fractures, 11 cases with spinal tuberculosis (TB), and 13 cases with spinal tumors. They were followed clinically for a mean period of 2.4 years. RESULTS: All the cases were approached anteriorly. Seven cases had a post-operative infection. No neurological worsening reported. We had dramatic neurologic
... Show MoreThis study aimed to reveal the stage for teachers of basic training needs from the perspective of workers in Mafraq Governorate, through a survey of a sample of counselors look at the Ajloun area schools reached (58) counselors.
To achieve the objective of the study was constructed questionnaire where they are finalized (18) items distributed on two dimensions (professional needs, performance requirements) and after confirmation of the validity and reliability have been applied to the sample where the results showed that training needs were high, both on a professional or per formative level .
The results also showed no statistically significant differences in the areas of tool due to gender, educational qualification. The study co
Background: The desire for an attractive appearing fixed orthodontic appliance fueled the use of ceramic brackets and clear accessories. Elastics are one of the most versatile materials available to orthodontists so studying their effect on the esthetic appearance is important. This an in vivo study, conducted to evaluate the effect of exposing stretched clear elastomeric ligatures to the oral environment from four different companies (OrthoTechnology, Morelli, Ortho Organizer, and Ormco). Materials and Methods: A total of 240 elastomeric modules were examined, 60 modules from each brand. Each of the 60 patients enrolled in the study, received 4 elastomeric modules on the 4 lower incisors, one from each brand. The specimens were placed on t
... Show MoreAlthough the events of September 2001 marked the United States' employment of solid forces in its direct comprehensive strategy to counter terrorist organizations and any other challenges to US national security, the United States did not lose sight of the importance of the cultural variable. The cultural variable is the United States' most important instrument of soft power in ensuring its dominance of the international system and promoting its global project. France viewed US soft power as a threat to its own civilizational pattern. Therefore, France considers culture to be an inherent component of its national personality and a cornerstone of its international standing as a major force. Additionally, the US-French political and economic
... Show MoreThe Purpose of this research is analysis and discussion " The Effect of Insurace Company Capital Adequacy in it’s Profitafility: An Empirical Study compared the two insurance (national, Iraqi), for a period of one year (2005) and the year (2014), as it is framed theoretical side for two topics head adequacy money the insurance company, and the profitability of the insurance company, and I've been using the research methodology and analytical, in the analysis and measurement of the capital of the insurance company adequacy, and profitability of the company, as the capital adequacy ratio was measured by dividing the total capital available on the total capital rate risk, after measured and appreciated in two insurance research, while I u
... Show MoreBackground: Intense pulsed light (IPL) devices produce polychromatic incoherent high-intensity pulsed light with a specified wavelength spectrum, fluence, and pulse duration through the use of flashlamps and bandpass filters. Similar to lasers, IPL devices operate on the selective photothermolysis principle, with melanin acting as the chromophore. Despite this similarity, they are constructed differently and produce different amounts of light Aim of the study: To investigate the efficacy of IPL home-use device in hair reduction technique for women with unwanted facial hair. Subjects and methods: The study was conducted in Baghdad on forty-five female subjects with Fitzpatrick skin phototype (II to IV) and black, brown hair in a period of ei
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