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.
Purpose: aims the study to show How to be can to enhance measurement management by incorporating a risk-based approach and the six sigma method into a more thorough assessment of metrological performance. Theoretical framework: Recent literature has recorded good results in analyzing the impact of Six Sigma and risk management on the energy sector (Barrera García et al., 2022) (D'Emilia et al. 2015). However, this research came to validate and emphasize the most comprehensive assessment of metrological performance by integrating Risk management based approach and Six Sigma analysis. Design/methodology/approach: This study was conducted in Iraqi petroleum refining companies. System quality is measured in terms of sigmas, and t
... Show MoreLong-term use of non-steroidal anti-inflammatory drugs (NSAIDs) mostly associated with renal and hepatic adverse effects, and the adjunct use of compounds with potent protective effects, like silymarin, may be one of the choices to avoid these effects. This project was designed to evaluate the protective effect of silymarin against the suspected renal and hepatic injury induced with long term use of NSAIDs; 220 patients with osteoarthritis were randomized into 5 groups and treated with either silymarin 300mg/day alone, piroxicam 20mg/day alone, meloxicam 15mg/day alone or the combination of each of them with silymarin for 8 weeks. The renal and hepatic functions were evaluated before starting treatment and after 8 weeks including assessm
... Show MoreBackground: Cardiovascular disease (CVD) is an important complication of type 2 diabetes mellitus (T2DM). Oxidative stress plays a major role in the development of CVD. Saliva has a diagnostic properties aiding in the detection of systemic diseases. This study aimed to assess the association between salivary oxidative stress markers and the risk of vascular disease (VD) in T2DM patients. Materials and Methods: One hundred T2DM patients and fifty apparently healthy males were enrolled in this study. Saliva sample was collected for assessment of oxidative stress markers including: lipid peroxidation plasma thiobarbituric acid-reactive substances (TBARS), uric acid (UA) and total antioxidant capacity (TAC) levels. Arterial stiffness index (ASI
... Show MoreThe current research aims to study the extent to which the Independent High Electoral Commission applies to information security risk management by the international standard (ISO / IEC27005) in terms of policies, administrative and technical procedures, and techniques used in managing information security risks, based on the opinions of experts in the sector who occupy positions (General Manager The directorate, department heads and their agents, project managers, heads of divisions, and those authorized to access systems and software). The importance of the research comes by giving a clear picture of the field of information security risk management in the organization in question because of its significant role in identifying risks and s
... Show MoreIn this work, the occurrence conditions of both local Bifurcation and persistence were studied, Saddle-node bifurcation appears near fourth point, near the first point, the second point and the third point a transcritical bifurcation occurred but no pitchfork bifurcation happened near any of the four equilibrium points. In addition to study conditions for Hopf-bifurcation near positive stable point that is the fourth point. Besides discuss persistence occurrence as globally property of the food chain of three species include prey, first predator and top predator with impact of toxin in all species and harvesting effect on the predator’s only. Numerical results for the set of hypothe
In this research study Hardness (shore D), Water absorption,
Flexural, Impact Test, and Fracture Toughness of polymer nano
composites. The polymer nano composites based on unsaturated
polyester resin reinforced with Kevlar fibers (K.F). The samples are
attended by hand lay – up method according to (Rule mixture) for
various volume fractions of unsaturated polyester resin, fiber and
carbon nanotube. The polyester resin was matrix strengthened with
3% volume fraction from Kevlar fiber and (0.5%, 1%, 1.5%, 2%)
volume fractions of carbon nanotube. The water absorption, hardness
(shore D), flexural test, impact test and toughness fracture properties
were studied. Results showed that the water absorption increas
The global trend towards the use of fair value accounting is increasing, so the current study aimed to maximize the impact of fair value application on achieving relevance and representation faithfulness of accounting information in accordance with the common conceptual framework. To achieve the objective of this study, the researcher has determined in the theoretical framework the relationship of fair value with the characteristics of relevance and representation faithfulness of accounting information and the extent of achieving these characteristics, as well as conducting a field study by preparing a questionnaire distributed to a sample of academics (50) and auditors (50) with a total number of selected participants (100) of acad
... Show MoreBackground: Acute appendicitis is regarded as one of the most common inflammation that needs surgical intervention. Different scoring systems have been used for diagnosing of acute appendicitis. ALVARADO score is one of the most widely used score in diagnosing of acute appendicitis, but the accuracy of the latter is insufficiently low in Middle-East patients. Thus a new scoring system called RIPASA score has been designed for diagnosing of acute appendicitis in those patients. The aim of this study is to use RIPASA score and compare its result with ALVARADO score in diagnosing of acute appendicitis.
Subjects and Methods: The study includes 200 patients with symptoms and signs of
... Show MoreFrictional resistance occurs whenever sliding happens, negatively impacting treatment outcomes and duration. It is a clinical challenge and must be dealt with efficiently to achieve the best orthodontic results. Aims of this study: compare and evaluate the static frictional forces under the wet condition to mimic the oral environment produced by using a polycrystalline ceramic bracket, monocrystalline ceramic bracket, 0.014 of an inch nickel-titanium (Rhodium coated archwires, and ilusio aesthetic archwires), and 0.019 x 0.025 of an inch stainless steel (Rhodium coated archwires, and ilusio aesthetic archwires). Ninety-six aesthetic brackets (48 monocrystalline and 48 polycrystalline brackets) were used and stored in different incub
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