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.
In any language there is some amount of difference between written language (planned) and spoken language (spontaneous). Since planned speech could be considered a form of written language, it could be inferred that there are also differences between planned speech and spontaneous speech. Some of these differences are very clear in terms of syntax, lexis, phonology and discourse. These differences are highlighted in order to make a clear distinction between spontaneous and planned speech.
This paper is an attempt to show the differences between the two forms of a language (written & spoken English) as far as number of linguistic features are tackle
... Show MoreKnowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.
Research Hypothesis from the fact that kicks off the effect that agricultural production in Iraq plays an important role in overcoming the food problem and achieving food security, but he became far far away from the provision of sufficient quantities of food products and then securing the Iraqi consumer food basket by the challenges faced by the agricultural sector.
To prove the hypothesis research in its structure in three axes came, the first axis eating historical significance to the subject of food over time periods as well as to clarify the concept of food security, and the second axis touched on the most important challenges facing the agricultural sector in Iraq and prevent the achievement of food requirements for members of
Colorectal cancer (CRC) is the most common gastrointestinal malignancy and one of the top ten common cancers worldwide with approximately 2 million cases. There are multiple risk factors that could lead to CRC emergence; of which are genetic polymorphisms. Excision repair cross-complementing group 2 (ERCC2) gene encodes for ERCC2 enzyme which plays a crucial role in maintaining genomic integrity by removing DNA adducts. Several studies suggested that there could be a link between genetic polymorphisms of ERCC2 gene and the risk of CRC development. Hence the present study aims to validate the relationship between the following ERCC2 single nucleotide polymorphisms (rs13181, rs149943175, rs530662943, and rs1799790) and CRC susceptibility. A t
... Show MoreIn this study the prevalence of acute, sub-acute and chronic toxoplasmosis were monitored in a group of Iraqi pregnant women according to the anti-T.gondii antibodies (IgG and IgM), as well as the levels of both progesterone and estrogen hormones were measured using mini-VIDAS®technique. This study demonstrated that there was high prevalence of chronic toxoplasmosis (31.70%) when it compared with acute and sub-acute type, results also showed that the acute toxoplasmosis always related with low concentration of both progesterone and estrogen which were (5.35 ± 7.15 ng/ml) and (70.66 ± 51.08 pg/ml) respectively
Steady natural and mixed convection flow in a square vented enclosure filled with water-saturated aluminum metal foam is numerically investigated. The left vertical wall is kept at constant temperature and the remaining walls are thermally insulated. Forced convection is imposed by providing an inlet at cavity bottom surface, and a vent at the top surface. Natural convection takes place due to the temperature difference inside the enclosure. Darcy-Brinkman-Forchheimer model for fluid flow and the two-equation of the local thermal non-equilibrium model for heat flow was adopted to describe the flow characteristics within the porous cavity. Numerical results are obtained for a wide range of width of the inlet as a fraction
... Show MoreIntegration of laminar bubbling flow with heat transfer equations in a novel internal jacket airlift bioreactor using microbubbles technology was examined in the present study. The investigation was accomplished via Multiphysics modelling to calculate the gas holdup, velocity of liquid recirculation, mixing time and volume dead zone for hydrodynamic aspect. The temperature and internal energy were determined for heat transfer aspect.
The results showed that the concentration of microbubbles in the unsparged area is greater than the chance of large bubbles with no dead zones being observed in the proposed design. In addition the pressure, due to the recirculation velocity of liquid around the draft
... Show More