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.
Previous reports demonstrated the effectiveness of silibinin hemisuccinate as a potential intraocular pressure-lowering agent. The exact mechanism by which silibinin exerted this effect has not yet been documented, but might suggested to interfere with aqueous humor formation. The present study was designed to evaluate the comparative efficacy of silibinin as IOP lowering agent to that of betaxolol in normotensive rabbits, and the interaction of silibinin with betaxolol as a way for investigating the possible mechanism of action of silibinin in this respect. The effects of instillation of 0.75% silibinin solution and 0.5% betaxolol eye drops in the eyes of normotensive rabbits were evaluated using indentation tonometry. The results showe
... Show MoreBackground: Post-partum depression (PPD) is a form of postnatal depression that affects mothers. Clinical manifestations usually appear within six months after delivery. Risk factors that influence the severity of post-partum depression are not fully known in the Iraqi population.
Objectives: We aim to evaluate the risk factors and identify potential predictors that may influence the symptom levels (severity) of post-partum depression among Iraqi women from Baghdad.
Subjects and Methods: The current study is cross-sectional, and we used the Edinburgh Postnatal Depression Scale (EPDS) and a cut-off value of 13 to differentiate patients into two those with lower symptom levels (LSL) and higher symptom levels (HSL). We also explored p
In the light of the globalization Which surrounds the business environment and whose impact has been reflected on industrial economic units the whole world has become a single market that affects its variables on all units and is affected by the economic contribution of each economic unit as much as its share. The problem of this research is that the use of Pareto analysis enables industrial economic units to diagnose the risks surrounding them , so the main objective of the research was to classify risks into both internal and external types and identify any risks that require more attention.
The research was based on the hypothesis that Pareto analysis used, risks can be identified and addressed before they occur.
... Show MoreObjective: Pregnancy-induced hypertension (PIH) is a major pregnancy complication that leads to maternal mortality. Here, we have scrutinized the correlation between serum levels of hydrogen peroxide (H2O2) and superoxide dismutase (SOD) in PIH.Methods: Serum samples were collected from 80 Iraqi women (40 women with PIH as patients group, 20 normotensive pregnant women as a positive control, and 20 normotensive non-pregnant women as a negative control) all groups were diagnosed clinically.Results: Serum of H2O2 and SOD levels was measured for all studied groups. Results showed that there were no significant variances in age and gestational age distribution between all studied groups. Furthermore, result showed that the serum level o
... Show MoreTwo-dimensional unsteady mixed convection in a porous cavity with heated bottom wall is numerically studied in the present paper. The forced flow conditions are imposed by providing a hydrostatic pressure head at the inlet port that is located at the bottom of one of the vertical side walls and an open vent at the top of the other vertical side wall. The Darcy model is adopted to model the fluid flow in the porous medium and the combination effects of hydrostatic pressure head and the heat flux quantity parameters are carefully investigated. These governing parameters are varied over wide ranges and their effect on the heat transfer characteristics is studied in detail. It is found that the time required to reach a desired temperature at th
... Show MoreAbstract
This study aimed to identify the business risks using the approach of the client strategy analysis in order to improve the efficiency and effectiveness of the audit process. A study of business risks and their impact on the efficiency and effectiveness of the audit process has been performed to establish a cognitive framework of the main objective of this study, in which the descriptive analytical method has been adopted. A survey questionnaire has been developed and distributed to the targeted group of audit firms which have profession license from the Auditors Association in the Gaza Strip (63 offices). A hundred questionnaires have been distributed to the study sample of which, a total of 84 where answered and
... Show MoreObjectives: Dickkopf-1 (DKK-1) is WNT/b-catenin pathway antagonist which plays a detrimental role in the development of diabetic retinopathy (DR). This research aimed to assess serum DKK-1 levels in diabetic patients who have and have not developed DR and, compare them with the control subjects finding out whether we can use it as an indicator for DR early diagnosis and to find out which one of the widely used two groups of antidiabetic treatments had the greater effect on this biomarker and hence on the progression of DR. Methods: The study participants were divided into two subgroups: First, 70 patients (36 male, 34 female) with type 2 diabetes mellitus, among them 35 patients diagnosed with DR and 35 with no evidence of DR, and s
... Show MoreIn this paper, the bowtie method was utilized by a multidisciplinary team in the Federal Board of Supreme Audit (FBSA)for the purpose of managing corruption risks threatening the Iraqi construction sector. Corruption in Iraq is a widespread phenomenon that threatens to degrade society and halt the wheel of economic development, so it must be reduced through appropriate strategies. A total of eleven corruption risks have been identified by the involved parties in corruption and were analyzed by using probability and impact matrix and their priority has been ranked. Bowtie analysis was conducted on four factors with high score risk in causing corruption in the planning stage. The number and effectiveness of the existing proactive meas
... Show MoreThrough an experimental program of eighteen specimens presented in this paper, the bond strength between reinforcing bar and rubberized concrete was produced by adding waste tire rubber instead of natural aggregate. The fine and coarse aggregate was replaced in 0%, 25%, and 50% with the small pieces of a waste tire. Natural aggregate replacement ratio, rebar size, embedded rebar length, the rebar yield stress of rebar, cover, and concrete compressive strength were studied in this investigation. Ultimate bond stress, bond stress-slip response, and failure modes were presented. The experimental results reported that a reduction of 19% in bond strength was noticed in 50% replaced rubberized concrete compared with convention
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