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 purpose of this paper is to gain a good understanding about wake region behind the car body due to the aerodynamic effect when the air flows over the road vehicle during its movement. The main goal of this study is to discuss the effect of the geometry on the wake region and the aerodynamic drag coefficient. Results will be achieved by using two different shapes, which are the fastback and the notchback. The study will be implemented by the Computational Fluid Dynamic (CFD) by using STAR-CCM+® software for the simulation. This study investigates the steady turbulent flow using k-epsilon turbulence model. The results obtained from the simulation show that the region of the air separation behind the vehicle
... Show MoreThe process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
... Show MoreThe study relied on data about the health sector in Iraq in 2006 in cooperation with the Ministry of Health and the Central Bureau of Statistics and Information Technology in 2007 Included the estimates of the population distribution of the Baghdad province and the country depending on the population distribution for 1997,evaluate the health sector which included health institutions, and health staff, and other health services. The research Aimis; Measurement an amount and size of the growth of health services (increase and decrease) and the compare of verified in Iraq and Baghdad, and evaluate the effectiveness of the distribution of supplies and health services (physical and human) of the size of the population distribution and
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There is poverty because of the difference in capacity and material resources, Previously poverty known on the basis of disparity between income and inadequate income. It realize later that fare wore effects of poverty is the erosion of human capital. The human poverty is the loss of food, education, health care and shelter.
In order to provide a database that target the poor , it have been propped a document on the features of poverty and the whereabouts of the poor and the rate of disparity between provinces.
Here the goal of the research is the identify the factors affecti
... Show MoreThe main purpose of the research is to study the significance of the event in the explicit source and its significance in the Mimi source and to explain the difference between them in the Holy Quran, especially since most linguists were not interested in what the Mime source indicates in the text, but focused on its form and form, as they defined it as the name Linguists and grammarians did not mention a difference in meaning between the explicit source and the Mimi source, and they interpret the second in the first sense, which led me to choose this topic, to know the significance of each source through Appeal to the maqam and occasion in a challenge D The exact meaning.
Background: Malignant lymphoma is the generic term given to tumors of the lymphoid system and specifically of lymphocytes and their precursor cells, While all lymphomas are malignant neoplasms, there is a wide spectrum of clinical behavior, with some following an indolent clinical course and others behaving in an aggressive manner (will causing death in a short time frame if left untreated). The metastatic process involves intravasation and extravasation of tumor cells, followed by reimplantation of tumor cells, formation of a new tumor stoma, Degradation of the extracellular matrix and components of the basement membrane by proteases facilitates the detachment of tumor cells, their crossing of tissue boundaries, and invasion into adjacent
... Show MoreA faunistic review of the genus Chaitophorus Koch, 1854, including four species in Iraq is given; the distribution data of each species and their hosts have been recorded. In this investigation the poplar leaf aphid Ch. populialbae (Boyer de Fonscolombe, 1841) is recorded here for the first time in Iraq on popular trees Populus euphratica Oliv. during the period from November 2016 to April 2017 in Baghdad province.
A brief description for apterous viviparous female of this species is given; and a key to the species of the genus Chaitophorus is constricted.
Abstract Drug addiction is considered a criminal behavior, which led the Iraqi legislator to prohibit and criminalize it, imposing penalties on those who use or even approach it. This aims to limit its presence in Iraq and reduce unethical behaviors, leveraging the divine prohibition to curb it. The legislator also encourages media organizations to raise awareness about the dangers of this substance, which has contributed to reducing the phenomenon of drugs in Iraq.
Background: The aim of this study was to evaluate and compare the apical microleakage around retrograde cavities prepared with ultrasonic technique and filled with (Biodentineâ„¢) Materials and methods: 40 extracted single rooted human permanent maxillary teeth with mature apices were selected. The roots were prepared chemo-mechanically using k-files with crown-down technique and then obturated with lateral condensation gutta-percha technique. Teeth were divided into four main groups according to the cavity preparation method either manual or ultrasonic technique: Group A (n=10): A class I retrograde cavity at root end was prepared with traditional handpeice equipped and placement of Biodentine with manual condensation. Group B (n=10):
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