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 negotiation phase is gaining great importance in investment loans due to the magnitude of the amounts awarded and the need to obtain adequate lending guarantees and the development of better conditions, and this requires that negotiating policy with fixed principles that balance between meeting the demands of customers and maintain market share and achieve profits and avoid defaults and losses the bank, and so I have touched Find the concept of investment loans and procedures for granting and the concept of the negotiation process for the granting of loans. The practical side to ensure the preparation of examination form consists of questions commensurate with the methodology developed by the researchers, were directed to the officia
... Show MoreThe forensic evidence important for the sources of legislation after the book of God Almighty and the Sunnah of the purified, including what is agreed upon in the protest, which is the book and the Sunnah and consensus, and what is different in the protest, such as measurement and approval and say companions and interests sent, and that the approval of the evidence that did not agree Accordingly, the terms of the fundamentalists differed and their definition differed with the similarity between each other, and the approval in some schools is an argument is not considered as the Shaafa'is, so it may correspond to measurement with them, but the approval at the tap and those who agree is a hidden measurement is likely to clear measurement,I
... Show MoreObjective: To evaluate and compare the effect of mechanical surface treatment (groove, aluminum oxide particles)
with 45 degree bevel type of joint on tensile bond strength of acrylic specimens repaired by two curing methods
(microwave and water both).
Methodology: Eighty specimens (80) were prepared from pink heat cure acrylic resin. They were divided into two
main groups (40 specimen repaired by microwave energy and 40 specimens repaired by water bath method).Each
group can be divided into four subgroups of ten according to the surface treatment. The control group A was left
intact, group B received no surface treatment, group C and D received surface treatment by (groove, 50 m aluminum
oxide particles). Specimens
Iodine-doped polythiophene thin films are prepared by aerosol assisted plasma jet polymerization at atmospheric pressure and room temperature. The doping of iodine was carried out in situ by employing iodine crystals in thiophene monomer by weight mixing ratios of 1%, 3%, 5% and 7%. The chemical composition analyses of pure and iodine-doped and heat-treated polythiophene thin films are carried out by FTIR spectroscopy studies. The optical band gaps of the films are evaluated from absorption spectrum studies. Direct transition energy gaps are determined from Tauc plots. The structural changes of polythiophene upon doping and the reduction of optical band gap are explained on the basis of the results obtained from FTIR spectroscopy, UV–V
... Show MoreMM Abdulwahhab, kufa Journal for Nursing sciences, 2017 - Cited by 1
In this paper, the speed control of the real DC motor is experimentally investigated using nonlinear PID neural network controller. As a simple and fast tuning algorithm, two optimization techniques are used; trial and error method and particle swarm optimization PSO algorithm in order to tune the nonlinear PID neural controller's parameters and to find best speed response of the DC motor. To save time in the real system, a Matlab simulation package is used to carry out these algorithms to tune and find the best values of the nonlinear PID parameters. Then these parameters are used in the designed real time nonlinear PID controller system based on LabVIEW package. Simulation and experimental results are compared with each other and showe
... Show MoreHeavy metals contamination in aquatic ecosystems is considered one of the most important threats of aquatic life. Submerge aquatic plants Ceratophyllum demersum in its non living form used for the removal of trace elements. This article studied the ability of the fine powder of C.demersum for the removal of some heavy metals (HM) like copper, cadmium, lead and chrome from aqueous solution with in variable experimental factors. The study occupy two treatments the first included different hydrogen ions pH within a range of 4, 5,6and 8 with a constant HM concentration (1000 ppm).While the second treatment represented by using variable HM concentrations within a range of (250,500,750and 1000 ppm) with a constant pH=7.In both treatments the a
... Show MoreZ-scan has been utilized for studying the non-linear properties and optical limiting behaviors of the dye Copper Phthalocyanine thin films. The refractive index is negative, which indicates a self-defocusing behavior and non-linear absorption coefficient (