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.
The present study aims to give some details about the normal anatomical and histological structure of the liver, pancreas and gall bladder in Cyprinus carpio Linnaeus, 1758 and Mesopotamichthys sharpeyi (Günther, 1874). Anatomical results revealed that the liver of C. carpio is a reddish-brown in color, located in the anterior part of abdominal cavity and dispersed between most of the intestines, which is divided into two lobes; while in M. sharpeyi the liver is light brown in color located in the anterior part of abdominal cavity and extends to the end of the intestinal tract with two lobs. The gallbladder situated in the right side of the liver in both species. Histological results in both species showed that the liver consists
... Show MoreThere is a global shortage of health care providers needed to address all levels of primary and specialty care. The recent COVID-19 pandemic also highlights the importance and added value of health professionals with specialty training in infectious diseases. In the United States, advanced practice providers (APPs) are being engaged to meet the expanding demand for generalist and specialist patient care. The history and development of advanced practice registered nurses (APRNs) and physician assistants (PAs), are discussed as collaborative healthcare providers to promote better understanding of the ways they can be incorporated into a healthcare system. An example of how APPs are utilized to provide both inpatient and outpatient
... Show MoreIn this study, dead and live anaerobic biomass was used in biosorption of Pb(II), Cr(III) and Cd(II) ions from a synthetic wastewater. The biosorption was investigated by batch adsorption experiments. It was found that, the biosorption capacities were significantly affected by biosorbent dosage. The process follows Langmuir isotherm (regression coefficient 0.995, 0.99 and 0.987 for Pb(II), Cr(III) and Cd(II) ions, respectively, onto dead anaerobic biomass) model with uniform distribution over the biomass surface. The experimental uptake capacity was 51.56, 29.2 and 28 mg/g for Pb(II), Cr(III) and Cd(II), respectively, onto dead anaerobic biomass, compared with 35, 13.6 and 11.8 mg/g for Pb(II), Cr(III) and Cd(II), respectively, onto live
... Show MoreIn the present work effect of recycled heating and cooling on the values of concrete compressive strength due to high temperature of 4000C was studied.
The tests show that the percent of reduction in compressive strength of the samples which exposed to a temperature of 4000C for one cycle was 32.5%, while the reduction was 52.7% for the samples which were exposed to recycled heating and cooling of ten times .
Moreover a study of the effect of specimen sizes on the percentages of compressive strength reduction due to high temperature
... Show MoreThis study aims at detecting the differences in genotyping of coding region fusA gene in clinical isolates of Acinetobacter baumannii from Baghdad, Iraq. Collected two hundred clinical samples (50 samples from urine, 50 samples from wound, 50 samples from sputum and 50 samples from otitis infections). Laboratory diagnosis for bacterial isolates carried out by some biochemical tests and confirmed by using VITEK- 2 compact system. The results appeared that twenty isolates of Acinetobacter baumannii in all these samples. Genotyping study was performed of coding region fusA gene of the extracted genome of all bacterial isolates and used specific primers in achieved amplification process of this target gene. DNA sequencing of this gene and alig
... Show MoreThe present study discusses the significant role of the historical memory in all the Spanish society aspects of life. When a novelist takes the role and puts on the mask of one of the novel’s protagonists or hidden characters, his memory of the events becomes the keywords of accessing the close-knit fabric of society and sheds lights on deteriorating social conceptions in a backwards social reality that rejects all new progressive ideas and modernity. Through concentrating on the society flawing aspects and employing everything of his stored memory, the author uses sarcasm to criticize and change such old deteriorating reality conceptions.
&nbs
... Show MoreThis paper compare the accurecy of HF propagation prediction programs for HF circuits links between Iraq and different points world wide during August 2018 when solar cycle 24 (start 2009 end 2020) is at minimun activity and also find out the best communication mode used. The prediction programs like Voice of America Coverage Analysis Program (VOACAP) and ITU Recommendation RS 533 (REC533 ) had been used to generat HF circuit link parameters like Maximum Usable Frequency ( MUF) and Frequency of Transsmision (FOT) .Depending on the predicted parameters (data) , real radio contacts had been done using a radio transceiver from Icom model IC 7100 with 100W RF
... Show MoreLand Use / Land Cover (LULC) classification is considered one of the basic tasks that decision makers and map makers rely on to evaluate the infrastructure, using different types of satellite data, despite the large spectral difference or overlap in the spectra in the same land cover in addition to the problem of aberration and the degree of inclination of the images that may be negatively affect rating performance. The main objective of this study is to develop a working method for classifying the land cover using high-resolution satellite images using object based method. Maximum likelihood pixel based supervised as well as object approaches were examined on QuickBird satellite image in Karbala, Iraq. This study illustrated that
... Show More