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: Curve of Spee (CS) is an anteroposterior anatomical curve established by the occlusal alignment of the teeth viewed in the sagittal plane. This occlusal curvature has clinical importance in orthodontics and other fields of dentistry. This study aimed to evaluate the relationship between the CS and dentofacial morphology of different skeletal patterns in both genders. Materials and Methods: Eighty six Iraqi Arab subjects (44females,42 males ) their age ranged from 17 -30 years, classified into: Skeletal I with normal occlusion(15 females and 15 males), skeletal II with CI II div 1 malocclusion (15 females and 15 males) and skeletal III with CI III malocclusion (14 females and 12 males). Forty one variables measured us
... Show MoreQuality of e-service is one of the critical factors that decide the success or failure of organizations. It may increase competitive advantages as well as enhance the relationships with the customers. Achieving high e-service quality and user satisfaction are challenging since they depend fundamentally on user perception and expectation which can be tricky at times. To date, there is no agreement as to what service quality is, and how it should be measured, whether it is a function of statistical measures of quality including physical defects or managerial judgment, or it is a function of customer perception about the services. This paper deep-dived the quality of e-services offered b
Background: Worldwide gastric cancer is the fifth most common cancer with poor prognosis. In early stages, it is hard to distinguish gastric cancer from benign gastric diseases, resulting in delayed diagnosis. There is a need to develop a biomarker for differentiating between gastric cancer and benign gastric diseases. Serum cholinesterase is synthesized in liver and released into plasma, and it has an important role in oncogenesis.
Objectives: To determine the correlation between serum cholinesterase activity and gastric cancer, in comparison to benign gastric diseases.
Subjects and Methods: A case control study carried out at Medical City Direct
... Show MoreThis study aims to measure the basic foundations of organizational health in the General Company for Food Products and to indicate the extent of its presence or not within the company under investigation.
This research was completed using a descriptive and analytical approach using a sample of 97 employees from the General Company for Petroleum Products. Calculating the arithmetic mean, standard deviation, coefficient of variation, and confirmatory factor analysis are all part of the data processing process.
Monetary policy occupies a prominent role in achieving monetary stability by adjusting the growth rates of the number of available means of payment in line with changes in the size of the gross domestic product in the country and expressed by the monetary stability coefficient agreed upon by the International Monetary Fund, a term that hides the fact that there is a rate of change in the volume of commodity or real production which expresses the levels of aggregate supply in the economy, which corresponds to the quantities of cash in circulation, which represent a net purchasing power and stimulate aggregate demand, which completes the picture of the existence of the market mechanism, expressed by the monetary or economic stability
... Show MoreThe research dealt with the effect of the tax examiner's efficiency in detecting tax evasion, as the research problem dealt with tax evasion, especially in Iraq, for many reasons and factors, including those related to tax administration represented in administrative corruption and the complexity of procedures in the tax accounting process and failure to achieve justice in the tax treatment, including the taxpayer himself, as he tries to evade for reasons Related to the level of tax awareness, loss of confidence in the tax administration, and reasons related to the state's inability to manage the services file well and its ability to achieve the set goals, This reflected negatively on the emergence of some of the consequences of
... Show MoreIt is found that hypersensitive teeth have a larger number and wider patent tubules than those of non-sensitive teeth. Objective: The aim of this study is to compare between the effects of diode laser at different power densities, with and without sodium fluoride on the sealing of exposed dentinal tubules and dentin permeability. Materials and methods: 118 teeth were used. Samples were divided into three major groups. The first consisted of 100 teeth used for permeability test. The second consisted of 16 teeth for measuring external surface temperature elevation while irradiation. The third, in turn, consisted of one pair of teeth observed under SEM for dentine surface morphology analysis. Results: For dentin permeability measurement, th
... Show MoreBegging is an ancient social phenomenon since the Man's creation. It was simple at its beginning to get a living and the family needed, but presently, this simple social phenomenon converted to a big phenomenon which controlled by competent groups away from the values and principles. Their doings are far from humanity representing by the cutting of a hand or a foot and facial distortion or removed eye as a way of attracting people's emotions to get material and incorporeal helps; these doings became a trade which is exchanged by slave traders. Furthermore, different illegal and greedy methods were followed as a way of blackmailing others; contrariwise other cases of begging are doing by a people who real poor and needy. In this case, the
... Show MoreIn this paper, we establish the conditions of the occurrence of the local bifurcations, such as saddle node, transcritical and pitchfork, of all equilibrium points of an eco-epidemiological model consisting of a prey-predator model with SI (susceptible-infected) epidemic diseases in prey population only and a refuge-stage structure in the predators. It is observed that there is a transcritical bifurcation near the axial and free predator equilibrium points, near disease-free equilibrium point is a saddle-node bifurcation and near positive (coexistence) equilibrium point is a saddle-node bifurcation, a transcritical bifurcation and a pitchfork bifurcation. Further investigations for Hopf bifurcation near coexistence equilibrium point
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