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 purpose of this study was to assess the relation among the ramal length and width with various cervical and cranio-facial measurements for a sample of Iraqi adults with different skeletal classes. Materials and method: The sample composed of 71 Iraqi adults (36 females and 35 males) with an age ranged between 17-30 years and had different skeletal mal-relations using SNA, SNB and ANB to differentiate between them and assorting them into CL.I, CL.II and CL.III mal-relation. Each individual was subjected to clinical examination and digital true lateral cephalometric radiograph that had been analyzed using AutoCAD 2007 software computer program to determine sixteen linear and ten angular measurements. Descriptive statistics wer
... Show MoreThe arrival of Russian President Vladimir Putin to power in the Russian Federation is an important factor in delineating a new approach to Russian policy towards regions that have great strategic importance affecting its national security. Therefore, NATO's progress eastward towards these regions prompts Russia to delineate a new strategy to confront this progress as well as preserving its control in the near neighboring regions represented by the countries of Eastern Europe, especially after the changes that occurred in those regions following the color revolutions that swept the region, such as the first application of this Russian policy in 2014, through the annexation of Crimea, and the latest military operations in Ukraine i
... Show MoreNanopesticides are novel plant protection products offering numerous benefits. Because nanoparticles behave differently from dissolved chemicals, the environmental risks of these materials could differ from conventional pesticides. We used soil–earthworm systems to compare the fate and uptake of analytical‐grade bifenthrin to that of bifenthrin in traditional and nanoencapsulated formulations. Apparent sorption coefficients for bifenthrin were up to 3.8 times lower in the nano treatments than in the non‐nano treatments, whereas dissipation half‐lives of the nano treatments were up to 2 times longer. Earthworms in the nano treatments accumulated approximately 50% more b
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 MoreTransient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic pressure sinusoidal amplitude range and
... Show MoreTransient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic pressure head , , , , and ), sinusoidal amplitude range of
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