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.
Advertisement on smart phone shopping apps are a new way of driving users to satisfy their needs and influence their purchasing decisions, In this way, the research could be aimed to know The role of the relationship between the motivations for audience exposure to shopping apps advertisement and purchasing decisions, In order to achieve the objectives of the research, the researcher adopted the survey method and used the questionnaire and the scale to collect data and information, The researcher chose the "random sample multi stages", The sample size was (475) respondents from Baghdad city center (18 years and above) women and men.
Poly-ether-ether-ketone (PEEK) was introduced in dentistry as an alternative to metal alloys.
To assess the effectiveness of PEEK-fixed retainers in preserving the stability of mandibular anterior and participant satisfaction as compared to the Dead-soft coaxial fixed retainer (DSC).
A single-centre, two-arm parallel groups
A new optoelectronic flow injection method is proposed for the determination of ferrous ions (Fe 2+ ) based on thiocyanate complexation to form a deep-red FeSCN 2+ complex.
Today's smart engineering systems are often faced with situations that are structurally uncertain, informationally incomplete, and non-probabilistically ambiguous, especially for electrical systems. ARDL models are limited in applications in complex computational environments where the uncertainty is due to vagueness, not randomness, and assume the exact parametric representation of the models and the structure of the stochastic uncertainty. This study proposes a new soft-computing paradigm using Fuzzy Autoregressive Distributed Lag (FARDL) models and compares the performance of the Linear Programming (LP) and Quadratic Programming (QP) estimation algorithms using large-scale parallel Monte Carlo simulations to overcome these drawba
... Show MoreIn this study, poly4-(nicotinamido)-4-oxo-2-butenoic acid (PNOE) was prepared by the electro polymerization of 4-(nicotinamido)-4-oxo-2-butenoic acid (NOE) monomer on a 316 stainless steel (St.St) which acts as an anticorrosion coating. Fourier transforms infrared (FTIR), atomic force microscopy (AFM), scanning electron microscopy (SEM), and cyclic voltammetry were used to diagnose the structure and the properties of the prepared polymer layer. The corrosion behavior of the uncoated and coated 316 St.St were evaluated by using an electro chemical polarization technique in 0.2 M hydrochloric acid solution as a corrosive medium at a temperature range of 293 to 323 K. Nano materials, such as nano ZnO and graphene were added in di
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