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: Acute appendicitis is the most common surgical abdominal emergency with a life time prevalence of 1 to 7 individuals. Because the clinical diagnosis of acute appendicitis remains a challenge to surgeons, so different aids were introduced like different scoring systems, computer aided programs, ultrasonography, computerized tomography, Magnetic resonance imaging, Gastrointestinal tract contrast studies and laparoscopy to improve the diagnostic accuracy.
Objective: To evaluate ultrasound in the diagnosis of acute appendicitis in those patients clinically diagnosed with histopathology as gold standard.
Methods: A cross sectional study carried in Al-kindy Teaching
... Show MoreIntended for getting good estimates with more accurate results, we must choose the appropriate method of estimation. Most of the equations in classical methods are linear equations and finding analytical solutions to such equations is very difficult. Some estimators are inefficient because of problems in solving these equations. In this paper, we will estimate the survival function of censored data by using one of the most important artificial intelligence algorithms that is called the genetic algorithm to get optimal estimates for parameters Weibull distribution with two parameters. This leads to optimal estimates of the survival function. The genetic algorithm is employed in the method of moment, the least squares method and the weighted
... Show MoreCurrent design codes and specifications allow for part of the bonded flexure tension reinforcement to be distributed over an effective flange width when the T-beams' flanges are in tension. This study presents an experimental and numerical investigation on the reinforced concrete flanged section's flexural behavior when reinforcement in the tension flange is laterally distributed. To achieve the goals of the study, numerical analysis using the finite element method was conducted on discretized flanged beam models validated via experimentally tested T-beam specimen. Parametric study was performed to investigate the effect of different parameters on the T-beams flexural behavior. The study revealed that a significant reduction in the
... Show MoreThe 3-parameter Weibull distribution is used as a model for failure since this distribution is proper when the failure rate somewhat high in starting operation and these rates will be decreased with increasing time .
In practical side a comparison was made between (Shrinkage and Maximum likelihood) Estimators for parameter and reliability function using simulation , we conclude that the Shrinkage estimators for parameters are better than maximum likelihood estimators but the maximum likelihood estimator for reliability function is the better using statistical measures (MAPE)and (MSE) and for different sample sizes.
Note:- ns : small sample ; nm=median sample
... Show MoreThe concept of self is considered one of the important dimensions in the human personality, because feeling of self is an important characteristic in this phase from the psychological point of view.
The first source which forms the concept of self is the physical image, where the built and appearance of the body is considered among the vital matters which determine the person's image of himself/herself.
The current research aims to:
1) Identify the level of physical self concept at the kindergarten children.
2) Identify the level of psychological self concept at the kindergarten children.
3) Iden
... Show MoreThis research was aimed to study the exposure of Razzazah Lake to major hydrological changes in recent years as a result of natural climatic changes and drought, high evaporation in lake due to stop discharge from Habbaniyah Lake by Al- majera channel. During 2019, we collected surface water samples at three locations, and three samples from groundwater, in addition one samples from each location Imam Ali Drop and Sewage water of Karbala. The Results show that the heavy isotopes in lake and groundwater well are enriched during the warm period, and depleted during the cold period. Chemically, The dominant cations and anions in Al-Razzaza lake water are mainly of in Order Ca > Na > Mg and Cl>SO4 and the water
... Show MoreObjective: The study aim to evaluate secondary schools students' exposure to risk factors in Al-Najaf City. Methodology: Descriptive study conducted in Al- Najaf City/Iraq on students at secondary schools, those aged (12-24) years old, for the period from the 13ed of November 2015 and up to 4ed of August 2015. The sample included secondary school from those schools . Data is collected through a constructed questionnaire, reliability and students (intermediate and secondary) (540) student; (270) male and (270) females who are selected randomly content validity process has been determined for the instrument. Dat
Objective Using two complementary techniques of virus detection human papillomavirus (HPV)[capture of hybrids (CH) and polymerase chain reaction (PCR)], relate the cytological study and/or cervical biopsy with high-risk HPV (HPV-HR) genotypes presence, as well as relating their viral load (VL). Methods About 272 women, who presented most cell alterations compatible with lesions cervical HPV, which has been detected in all high risk by the CH method and HPV genotype detection by PCR. Results In 22% of the patients it was not detected HPV DNA. Genotype 16 and/or 18 was prevalent and was found in 33% of the 212 women studied, meanwhile, mixed infections were found by several genotypes in 25%. In as for the histological lesions found, in 61 pat
... Show MoreWith the increasing rates of cancer worldwide, a great deal of scientific discourse is devoted to arguments and statements about cancer and its causes. Scientists from different fields try to seize any available chance to warn people of the risk of consuming and exposing to carcinogens that have, unfortunately, become essential parts of modern life. The present paper attempts to investigate the proximization strategy through which scientists construct carcinogen risk to enhance people’s preventive actions against these carcinogens. The paper targets the construction which depends on producing the conflict between the values of the people themselves and the contrasting values assigned to carcinogens. To achieve this aim, Cap’s (2
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