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 the current paper, the effect of fear in three species Beddington–DeAngelis food chain model is investigated. A three species food chain model incorporating Beddington-DeAngelis functional response is proposed, where the growth rate in the first and second level decreases due to existence of predator in the upper level. The existence, uniqueness and boundedness of the solution of the model are studied. All the possible equilibrium points are determined. The local as well as global stability of the system are investigated. The persistence conditions of the system are established. The local bifurcation analysis of the system is carried out. Finally, numerical simulations are used t
Background: Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by bilateral stenosis starting at the supraclinoid internal carotid artery (ICA), with the development of a collateral network of vessels. It is an established cause of stroke in the pediatric age group. Despite its increasing prevalence in various parts of the world, it remains largely underrecognized in the Middle East, particularly in Iraq. This is the first case of MMD in an Iraqi patient undergoing surgery. Case description: A 12-year-old boy presents with a 3-months history of progressive behavioural changes. MRI revealed diffuse infarcts of different ages. MRA and CT angiography revealed extensive asymmetrical steno-occlusive changes of t
... Show MoreRealizing robust interconnectivity in a rapidly changing network topology is a challenging issue. This problem is escalating with the existence of constrained devices in a vehicular environment. Several standards have been developed to support reliable communication between vehicular nodes as the IEEE 1609 WAVE stack. Mitigating the impact of security/mobility protocols on limited capability nodes is a crucial aspect. This paper examines the burden of maintaining authenticity service that associated with each handover process in a vehicular network. Accordingly, a network virtualization-based infrastructure is proposed which tackles the overhead of IEEE 1906 WAVE standard on constrained devices existed in vehicular network. The virtualized
... Show MoreNitrogen (N) fertilizer rate is important for high yield and good quality of potato tubers. In this dissertation, I seek to study the response of different potato cultivars under different N fertilizer rates and how that can impact tuber quality, examine the performance of active optical sensors in improving a potato yield prediction algorithm, and evaluate the ability of active optical sensors (GreenSeeker (GS) and Crop Circle (CC)) to optimize a N recommendation algorithm that can be used by potato growers in Maine. This research was conducted at 11 sites over a period of two years (2018–2019) in Aroostook County, Maine; all sites depended on a rainfed system. Three potato cultivars, Russet Burbank, Superior, and Shepody, were planted u
... Show MoreCollective C2 transitions in 32S are discussed for higher
energy configurations by comparing the calculations of transition
strength B(CJ )with the experimental data. These configurations
are taken into account through a microscopic theory including
excitations from the core orbits and the model space orbits with nħω
excitations.
Excitations up to n=10 are considered. However n=6 seems to
be large enough for a sufficient convergence. The calculations
include the lowest seven 2+0 states of 32S.
In this work we reported the synchronization delay in
semiconductor laser (SL) networks. The unidirectional
configurations between successive oscillators and the correlation
between them are achieved. The coupling strength is a control
parameter so when we increase coupling strength the dynamic of the
system has been change. In addition the time required to synchronize
network components (delay of synchronization) has been studied as
well. The synchronization delay has been increased by mean of
increasing the number of oscillators. Finally, explanation of the time
required to synchronize oscillators in the network at different
coupling strengths.
Crop yield prediction is a critical measurement, especially in the time when parts of the world are suffering from farming issues. Yield forecasting gives an alert regarding economic trading, food production monitoring, and global food security. This research was conducted to investigate whether active optical sensors could be utilized for potato (Solanum tuberosum L.) yield prediction at the mid.le of the growing season. Three potato cultivars (Russet Burbank, Superior, and Shepody) were planted and six rates of N (0, 56, 112, 168, 224, and 280 kg ha−1), ammonium sulfate, which was replaced by ammonium nitrate in the 2nd year, were applied on 11 sites in a randomized complete block design, with four replications. Normalized difference ve
... Show MoreThe study aims to identify the neurological perfectionism of talented girls with disabilities and do a case study for one of these girls. The sample of the study consisted of (11) female students at the university level, 5 females with disability and (6) normal female-students. The sample also included (19) secondary school female students in Tabuk region, including 10 students with visual disability and (9) normal students. The case study was limited to one case of mentally superior girls (talented) with kinetic disability. The researcher adopted the descriptive methodology (case study), he used neurological perfectionism scale, Salah Mekhemar interview, Stanford interfacial intelligence scale fifth picture, case study form. The re
... Show MorePlentiful of healthcare practice is based on a disease/treatment approach rather than a prevention one. That is, the predominant focus is on treating existing symptoms and conditions that bring the patient to healthcare setting. There is no doubt about the significance of this approach for acute conditions, but there is some question whether this is the most efficient and effective way of distributing healthcare for increasing number of diseases and limited resources.
The evidences from everywhere have showed the profound cost benefit of prevention in healthcare practice. Healthy community, therefore, is the ultimate aim in any health services planning. The priority of care giver is shifted now to promote health and prevent
... Show More<p>In the mobile phone system, it is highly desirable to estimate the loss of the track not only to improve performance but also to achieve an accurate estimate of financial feasibility; the inaccurate estimate of track loss either leads to performance degradation or increased cost. Various models have been introduced to accurately estimate the path loss. One of these models is the Okomura / Hata model, which is recommended for estimating path loss in cellular systems that use micro cells. This system is suitable for use in a variety of environments. This study examines the comparison of path loss models for statistical analysis derived from experimental data collected in urban and suburban areas at frequencies of 150-1500 MHz
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