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.
Multilevel models are among the most important models widely used in the application and analysis of data that are characterized by the fact that observations take a hierarchical form, In our research we examined the multilevel logistic regression model (intercept random and slope random model) , here the importance of the research highlights that the usual regression models calculate the total variance of the model and its inability to read variance and variations between levels ,however in the case of multi-level regression models, the calculation of the total variance is inaccurate and therefore these models calculate the variations for each level of the model, Where the research aims to estimate the parameters of this m
... Show MoreIn our time, not too long ago, the universities of the world have been fast to take care of the study of an innovative type of technical and human studies, called the science of "comparative literature". Comparative research studies have grown and flourished rapidly in response to the demands of both mental and artistic life. This shows the increasing awareness at both the modern national and the international levels in order to develop through connecting with the international intellectual, nental and artistic currents to nurture ethics and originality. Comparative studies show that the beginning of the comparative literature goes back to the time when the Latin literature was connected to the Greek literature and th
... Show MoreBackground:Nocturnal Enuresis is a common problem affecting 20% of five years old children and up to 2% of adolescent and young adult. Although it is a self limiting benign condition, it has social and psychological impact on the child and his family. Many pathophysiological theories had been suggested, but none is confirmed. Hypercalciuria has been suggested to be associated with higher incidence of nocturnal enuresis. Objectives:The aim of our study to test the value of Ca/Cr ratio, on random urine sample, in diagnosing hypercalciuria in enuretic children. Type of study: Cross sectional study.Methods:Forty four enuretic children were enrolled in this study and forty five children without nocturnal enuresis were taken as control group.
... Show MoreSediment accumulated in sewers is a major concern source as it induces numerous operational and environmental problems. For instance, during wet weather flow, the re-suspension of this sediment accompanied by the combined sewer overflow may cause huge pollutant load to the receiving water body. The characteristics of the sewer sediment are important as it shapes its behaviour and determines the extent of the pollution load. In this paper, an investigation of sewer sediment and its characterization is done for a case study in Baghdad city. Sediment depth covers more than 50% of the sewer cross-sectional area; several operational causes are comprised to cause this huge depths of sediment depositions. The testing and analysis of the s
... Show MoreHepatitis, a condition of liver’s inflammation that can be self-limiting or, in certain chances, it may lead to liver cancer, fibrosis or cirrhosis. Hepatitis viruses mainly cause hepatitis in the world. People with hepatitis C have predominant chances to develop diabetes as HCV virus participates in causing type 2 diabetes. HCV virus causes pathogenesis in two ways: it either directly destroys the β cells of pancreas or contributes to the specific autoimmunity of β cells. The present cross sectional study was done in Wazirabad Tahsil of Gujranwala District to analyze the percentage of patients suffering from hepatitis C who had the risk of diabetes mellitus. For this research work, demographic information and data about any other me
... Show MoreThe five-a- Side Soccer for simple mental disability is as interesting and caring as many other sporting events. Therefore, the researchers believe that their basic skills tests are compatible with then level of the tested individuals in terms of age and mental ability. As a means of selecting those who are qualified to practice this game in a simple way, the problem of research has been identified in the design and standardization of two scoring skills that belong to this category and are approved by the training staff during the initial selection process. The research community is determined by people with mental disabilities who belong to the governmental and private institutes and the Special Olympics Union in Baghdad and for the year 2
... Show MoreIn the present research a new test rig has been proposed to be suitable for different cyclic loads such as cyclic bending, cyclic torsion, proportional and non proportional loads. In this work the efforts were concentrated on the cyclic bending loads concerning cracked pipes with or without internal pulsing pressure to study crack propagation in small bore pipes (up to 1'') for transverse or inclined cracks. The rig simulates the real service conditions under different stresses by means the least dangerous case will be suggested, so the experiments were considered for copper pipe, and the results have been tabulated and drawn to demonstrate the crack growth behavior as well as to justify the outcomes practically, consequently the durabil
... Show MoreThe addition of new reactive sites on the surface area of the inert sand, which are represented by layered double hydroxide nanoparticles, is the primary goal of this work, which aims to transform the sand into a reactive material. Cetyltrimethylammonium bromide (CTAB) surfactant is used in the reaction of calcium extracted from solid waste-chicken eggshells with aluminum prepared from the cheapest coagulant-alum. By separating amoxicillin from wastewater, the performance of coated sand named as "sand coated with (Ca/Al-CTAB)-LDH" was evaluated. Measurements demonstrated that pH of 12 from 8, 9, 10, 11, and 12, CTAB dosage of 0.05 g from 0, 0.03, 0.05, and 0.1 g, ratio of Ca/Al of 2 from 1, 2, 3, and 4, and mass of sand of 1 g/50 mL from
... Show MoreSultan Said bin Sultan bin Ahmed bin Said Al-Busaidi (1223-1273 AH / 1806-1856 AD) was able to rule Oman and Zanzibar in a unified Arab-African state during his reign. However, it was separated for several reasons. Thus, the study aims to clarify the efforts made by Sultan Said for annexing Zanzibar to Oman, establishing the Arab-African Sultanate, and shedding light on the role played by Britain in dividing the Arab-African Sultanate and separating Zanzibar from the Omani rule in (1275 AH-1861 AD). The study has adopted the historical descriptive analytical approach. The study has reached several conclusions, such as: The economic motivators were the most important factors that pushed Sultan Said to move his capital from Muscat to
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