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 : Diabetes mellitus, also known as blood sugar, is a series of metabolic disorders described by high blood glucose levels (hyperglycemia), low blood glucose (hypoglycemia), or both, resulting from defects in insulin production, insulin action, or both. Numerous studies have shown that interleukin (IL-6) acts on skeletal muscle cells , liver cells, and pancreas cells to influence glucose balance and metabolism, which directly or indirectly contributes to the development of diabetes. Research in this area is crucial because diabetes is recognized as a major risk factor for many diseases like Diabetic retinopathy, Diabetic nephropathy, Diabetic Neuropathy , heart disease and others. Patients and methods : In this study, we
... Show MoreThe interest in Multi social skills and self-concept is extremely important for many of the scholars of education and psychology has taken a great deal in their writings and their interests as they see that social skills training is to make sure of the same, and that whenever enable the individual from acquiring social skills whenever asserted itself.The research aims know social skills and self-concept and their relationship to the children Riyadh age (4-6 years), and the research sample consisted of(200) boys and girls from kindergarten in the city of Baghdad Bjanbey Rusafa second and Karkh second.And to the objectives of the research realized the researcher has built two measures of social skills a
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This research aims to identify the challenges faced by families of children with intellectual disabilities and to identify the impact of the challenges facing them on the mental health of their children with intellectual disabilities. Based on the following questions: What is the nature of the challenges faced by families of children with disabilities and how do these challenges affect the mental health of their children with intellectual disabilities? The study was conducted on a sample of four families of six children with intellectual disabilities, depending on the degree and type of disability. To achieve the study's objectives, the qualitative approach was used, Because of the importance of accessin
... Show MoreAfter the success of the reforms Keynesian save the capitalist system from collapse and to apply the concepts of state intervention in economic activity in order to revive aggregate demand to achieve the purposes of macro-economic policies which draw their scope of economic (John Keynes) theory of effective demand, which created the new role of the state away from the classical concepts. Valley transmission role of the State of (State Guardian) to the process of state overlapping that increased and social functions have become responsible for raising the standard of living of classes with limited incomes, in particular, and the rest of the classes in general, through the expansion of the delivery of public servic
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In this research will be treated with a healthy phenomenon has a significant impact on different age groups in the community, but a phenomenon tonsillitis where they will be first Tawfiq model slope self moving averages seasonal ARMA Seasonal through systematic Xbox Cengnzla counter with rheumatoid tonsils in the city of Mosul, and for the period 2004-2009 with prediction of these numbers coming twelve months, has found that the specimen is the best representation of the data model is the phenomenon SARMA (1,1) * (2,1) 12 from the other side and explanatory variables using a maximum temperature and minimum temperature, sol
Drilling with casing (DWC) can be considered as a modern drilling technique in which both of drilling and casing operations done in the same time by using the casing to transfer the hydraulic and mechanical power to the bit instead of traditional drilling string. To overcome oil well control, minimizing the total cost through enhancing drilling efficiency, drilling with casing was proposed as an enabling technology.
Two surface sections (17 1/2 - and 12 1/4- inch) were drilled successfully in Rumaila oil field with casing strings which reached 655m and 1524m measured depths respectively.
By using DWC technique, the total drill/case phase time was reduced up to 20% comparing to conventional
... Show MoreBackground: The Initial (primary) stability is one of the factors that play an important role in the success of the dental implants. The purpose of this study was to evaluate the initial stability of dental implant with horizontal plate by using five analytical tests: insertion torque, removal torque, resonance frequency analysis, push-in test and pull-out test. Materials and methods: Two different lengths of dental implants (5mm and 10mm) were tested in this study; each dental implant was 4mm in diameter with a square threads shape of 1mm pitch and 0.5mm depth. The crestal area was 4.2mm diameter contained a right angle margin circumferential ring while the apical area was tapered with two self-tapping grooves. In this study, the initial s
... Show MoreThe current study has sought to identify the levels of the compound thinking among secondary school students basing and relying on the opinions of Lipman who sees that the compound thinking consists of creative thinking and critical thinking, In accordance with this point of view, researchers have resorted to build scale of the critical thinking in its final form of (28) item additionally to the adoption of Torrance for the creative thinking which was translated by sayed. Khairallah in 1981 after confirming psychometric Properties Of both scales and then collect scores of both scales and be the final score represented the level of the compound thinking that has been shown by the results of secondary school students they have no skill of
... Show MoreThe construction industry in Iraq suffers from many problems, perhaps the most important of which is the delay in time and the increase in costs. Therefore, it was necessary to try to adopt a new methodology that would help in overcoming these problems. It was suggested to combine building information modeling with the agile management approach because this technique and methodology is modern and helps in reducing time and cost and improving quality. This paper aims to know the status of using Building Information Modeling (BIM) and Agile Project management (APM) in Iraq and to shed light on the merging of this integration, explaining the benefits, difficulties, and workflow practices, finding the most influencing factors on the tim
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