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.
For the design of a deep foundation, piles are presumed to transfer the axial and lateral loads into the ground. However, the effects of the combined loads are generally ignored in engineering practice since there are uncertainties to the precise definition of soil–pile interactions. Hence, for technical discussions of the soil–pile interactions due to dynamic loads, a three-dimensional finite element model was developed to evaluate the soil pile performance based on the 1 g shaking table test. The static loads consisted of 50% of the allowable vertical pile capacity and 50% of the allowable lateral pile capacity. The dynamic loads were taken from the recorded data of the Kobe e
The present study aimed to investigate the anatomy, histology, and immunohistochemistry of parathyroid gland in two Iraqi mammals (Weasel, Herpestes javanicus and Long-ear hedgehog, Hemiechinus auritus) as a comparative study. A total of (20) animal for each species were used in the present study. Animals collected were immediately anesthesia and dissected to get the parathyroid gland. Methods of Humason and Bancroft and Stevens were employed for histological techniques. Different stains were used (Hematoxylin- Eosin stain-(H & E), Periodic Acid Schiff stain-(PAS), Azan stain, and Methyl Blue stain-(MB)) for staining the histological sections. Anti-calcitonin, code140778 marker used for immune-histochemical study. Results of the present stu
... Show MoreMany reports confirm ulcers as an adverse effect of drugs such as nicorandil and aspirin. The exact responsible mechanisms of ulceration have until now not proved. Mucosal ulcers associated with the onset of ulcer are manifested by an increase in proinflammatory cytokine, excessive prostaglandin, and up-regulation of Endothilin-1 level, which directly impacts the release of leptin. These, released locally within mucosal tissues, have played a role in controlling the extent of local inflammatory responses and processes of mucosal repair.
This study was designed to find out the correlation of plasma leptin and prostaglandin levels as a possible mechanism of oral ulcer formation as an adverse effect of nicorandil. The effect of nicorandi
The paper studies the description of the colloquial and popular vocabulary used by wholesales tradesmen in Varonech before the Bolshevik Revolution . The vocabulary were used in the personal letters written by the poet and sent to famous poets and critics like Belenisky, kryvesky and Malsheve. And some were sent to his father and his sister. Not only did these letter bear the personal taste, but they represented a literary product reflecting on the poet's impressions, views, ambitions, and opinion in arts, poetry, prose, and theatre. The researcher used about thirty instances of various levels of grammar, style and phonology, all representing colloquial vocabulary used commonly at the time of Alexi 
... Show MoreThe insurance is considered as one of the sectors that is impact is vital to the national economy and development programs, Insurance companies as financial institutions have an effect an aspects of social, economic as well as the participation of enterprises in compensation for the risk potential losses and individuals, Insurance sector provides insurance service insurance which should be characterized by quality and satisfy needs and desires of the customer , so the raise insurance awareness in the community its members and institutions will help in maintaining the movement of production and service delivery standards, quality sought by the insured to obtain, as well as the development of promotional programs, and use
... Show MoreA total of 48 experiments were conducted to investigate the impact of slit weir dimensions and locations on the maximum scour depth and scour area created upstream. The slit weir model was a 110 mm slit opening, and it was installed at the end of the working section in a laboratory flume. The flume was 10.0 m long, 30 cm wide, 30 cm deep, and almost middle. It includes a 2 m working section with a mobile bed with 110 mm in thickness. In the mobile bed, two types of nonuniform sand (with a geometric standard deviation of 1.58 and 1.6) were tested separately. The weir dimensions and location were changed with flow rates. Then dimensions of the slit weir were changed from 60 x 110 mm to 60 x 70 mm (width x height), while th
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