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 Numerous studies indicated that workers in the health sector suffer from work stress, hassles, and mental health problems associated with COVID-19, which negatively affect the completion of their job tasks. These studies pointed out the need to search for mechanisms that enable workers to cope with job stress effectively. Objectives This study investigated psychological flow, mental immunity, and job performance levels among the mental health workforce in Saudi Arabia. It also tried to reveal the psychological flow (PF) and mental immunity (MI) predictability of job performance (JP). Method A correlational survey design was employed. The study sample consisted of 120 mental health care practitioners (therapists, psychologists, co
... Show MoreIn this paper, the proposed phase fitted and amplification fitted of the Runge-Kutta-Fehlberg method were derived on the basis of existing method of 4(5) order to solve ordinary differential equations with oscillatory solutions. The recent method has null phase-lag and zero dissipation properties. The phase-lag or dispersion error is the angle between the real solution and the approximate solution. While the dissipation is the distance of the numerical solution from the basic periodic solution. Many of problems are tested over a long interval, and the numerical results have shown that the present method is more precise than the 4(5) Runge-Kutta-Fehlberg method.
This study aimed to evaluate the effectiveness of a novel concrete-encased column (CE) using small circular steel tubes filled with cementitious grouting material (GFST) as the primary reinforcement instead of traditional steel bars. The research involved three different types of reinforcement: conventional steel bars, concrete-filled steel tubes with 30% of the reinforcement ratio of steel bars, and concrete-filled steel tubes with the same reinforcement ratio as steel bars. Twenty-four circular concrete columns were tested and categorized into six groups based on the type of reinforcement employed. Each group comprised four columns, with one subjected to concentric axial load, two subjected to eccentric axial load (with eccentrici
... Show MoreDate stones were used as precursor for the preparation of activated carbons by chemical
activation with ferric chloride and zinc chloride. The effects of operating conditions represented
by the activation time, activation temperature, and impregnation ratio on the yield and adsorption
capacity towards methylene blue (MB) of prepared activated carbon by ferric chloride activation
(FAC) and zinc chloride activation (ZAC) were studied. For FAC, an optimum conditions of 1.25
h activation time, 700 °C activation temperature, and 1.5 impregnation ratio gave 185.15 mg/g
MB uptake and 47.08 % yield, while for ZAC, 240.77 mg/g MB uptake and 40.46 % yield were
obtained at the optimum conditions of 1.25 h activation time, 500
Denture bases are fabricated routinely using Poly(methyl methacrylate) (PMMA) acrylic resin. Yet, it is commonly known for its major drawbacks such as insufficient strength and ductility. The purpose of this study was to improve the performance of PMMA acrylic resin as a denture base material by reinforcement with surface treated lithium disilicate glass ceramic powder. The ceramic powder was prepared by grinding and sieving IPS e.max CAD MT blocks. Then, the powder was surface treated with an organosilane coupling agent (TMSPM) and added to PMMA in amount of 1%, 3%, 5% and 7% by weight. Characterizations of the powder was done by particle size analysis, XRD and FTIR. Transverse strength, Impact strength, Shore D hardness and surface roughn
... Show MoreBackground: A great dental and biomedical interest had been paid to silver nanoparticles because of their antimicrobial activity. Objective: To evaluate the antimicrobial and cytotoxic activity of a newly developed Nano-silver fluoride that was synthesized from moringa oleifera leaf extract against S. mutants. Material and method: The green synthesis method was used to prepare Nano-silver fluoride from moringa oleifera leaf extract. The minimum inhibitory concentration and the minimum bactericidal concentration were evaluated using brain heart infusion plates, while the cytotoxicity was evaluated by the hemolytic activity. Results: Nano-silver fluoride had a bactericidal and bacteriostatic effect (MIC was 60 ppm a
... Show MoreNine new compounds of 2-amino-5-chlorobenzothiazole derivatives were synthesized. These new compounds were formed through the reaction of 2-amino-5-chlorobenzothiazole 1 with ethyl chloroacetate and KOH, which gave an ester derivative 2, followed by refluxing compound 2 with hydrazine hydrate to afford hydrazide derivative 3. The reaction of compound 3 with CS2 and KOH gave 1,3,4-oxadiazole-2-thiol derivative 4, and then the reaction of compound 2 with thiosemicarbazide to produce compound 5 then treated it with 4%NaOH led to ring closure to provide 1,2,4-triazole-3-thiol derivative
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