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 research aims to identify the effectiveness of violence by parents in the consolidation of positive values among students. Additionally, the research aims to identify the differences in violence levels among students regarding their gender (males & females). The study was limited to the intermediate school students in Baghdad city / Karkh2 for the academic year 2017-2018. The results showed that males are more violent than females do and that discrimination led to experience violence more than other methods. The researcher recommends the need to create a positive atmosphere within the school context. For future studies, the researcher suggests conducting a study to identify the violence and its relation to some personal character
... Show MoreOne of the most important enhanced oil recoveries methods is miscible displacement. During this method preferably access to the conditions of miscibility to improve the extraction process and the most important factor in these conditions is miscibility pressure. This study focused on establishing a suitable correlation to calculate the minimum miscibility pressure (MMP) required for injecting hydrocarbon gases into southern Iraq oil reservoir. MMPs were estimated for thirty oil samples from southern Iraqi oil fields by using modified Peng and Robinson equation of state. The obtained PVT reports properties were used for tunning the equation of state parameters by making a match between the equation of state results with experimenta
... 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 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
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The effect of physical and mental health on the feelings of personal welfare are known as health-related quality of life. Infection with hepatitis B virus is a major global health problem. Health-related quality of life was emerged as an important consideration in the care of patients with chronic hepatitis B infection. The aim of the current study was to measure health-related quality of life among a sample of chronic hepatitis B patients in AL-Najaf city/Iraq. The current study was cross-sectional study carried out on (104) already diagnosed chronic viral hepatitis B patients who attended the Gastroenterology and Hepatology Center/Al-Sader Medical City/Najaf during November 2018 to May
... Show MoreOsteoporosis (OP) is a systemic skeletal disorder that is characterized by reduced bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. The most frequent osteoporotic fractures are fractures of the hip, wrist, and spine. The exact causes of OP are still unknown; several factors contribute to the disorder. Subjects and Methods: This study consists of patient groups, this group (Group A) was composed of 80 postmenopausal women with OP and osteopenia and the patient group was subdivided into two group; First group (GroupA1) was composed of 50 postmenopausal women with OP and the second group (Group A2) composed of (30) Postmenopausal Women with oste
... Show MorePituitary adenomas are the anterior pituitary tumors. Patients with an Aryl Hydrocarbon Receptor-Interacting Protein (AIP) mutation (AIP- mut) tend to have more aggressive tumors occurring at a younger age. Single nucleotide polymorphisms (SNPs) in many studies have been related to metabolic comorbidities in the general population. Study aims investigated the role of AIP gene SNPs with susceptibility to acromegaly pituitary- adenoma, with levels of LH, FSH, TSH, Testosterone, IGF1,GH, FT4 , Prolactin hormones and blood sugar levels. The study was conducted on a group of acromegaly patients, including 50 patients) both Genders( with hyperplasia of the ends, and apparently healthy control group. Genotyping of
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