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: Economic Globalization affects work condition by increasing work stress. Chronic work stress ended with burnout syndrome.
Objectives: To estimate the prevalence of burnout syndrome and the association of job title, and violence with it among physicians in Baghdad, and to assess the burnout syndrome at patient and work levels by structured interviews.
Subjects and Methods: A cross section study was conducted on Physicians in Baghdad. Sampling was a multistage, stratified sampling to control the confounders in the design phase. A mixed qualitative and quantitative
... Show MoreBackground: Economic Globalization affects work condition by increasing work stress. Chronic work stress ended with burnout syndrome. Objectives: To estimate the prevalence of burnout syndrome and the association of job title, and violence with it among physicians in Baghdad, and to assess the burnout syndrome at patient and work levels by structured interviews. Subjects and Methods: A cross section study was conducted on Physicians in Baghdad. Sampling was a multistage, stratified sampling to control the confounders in the design phase. A mixed qualitative and quantitative approach (triangulation) was used. Quantitative method used self-administered questionnaires of Maslach Burn out Inventory. Qualitative approach used an open-end
... Show MoreEchinococcosis is a zoonotic disease caused by the larval stage of the tapeworm Echinococcus granulosus. This disease is an important public health and a significant economic issue in Iraq, where the lungs and livers are the popular places of infection. The aim of the current study focused on using the molecular techniques in the detection of an E. granulosus strain that causes cystic echinococcosis to human, sheep and cattle in Thi-Qar province, Iraq. In the current study, thirty isolates of E. granulosus were collected from 10 human hydatid cysts through surgery done at Al-Hussein Imam Teaching Hospital in Thi-Qar province and 10 sheep with 10 cattle hydatid cysts were obtained from the slaughterhouse in Thi-
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... Show MoreThis research investigates the subject of the impact of wars (as a manifestation of crisis) on architecture, and the extent of continuing wars physical and moral results of wars, even after the end of the cause of the crisis. The impact of different rebuilding which exposed to the effects of the war seems different in crisis regions.
The problem of research is about the uncertainty of the impact of the way chooses for reconstructing the buildings after wars in the continuity of the crisis of war. The goals of this research are to clarify the influence of methods of reconstruction of buildings in a city chosen which is Beirut, on the continuation of the war crisis with the argument of demolishing and rebuilding newly or keeping tr
... Show MoreThe present work included study of the effects of weather conditions such as solar radiation and ambient temperature on solar panels (monocrystalline 30 Watts) via proposed mathematical model, MATLAB_Simulation was used by scripts file to create a special code to solve the mathematical model , The latter is single –diode model (Five parameter) ,Where the effect of ambient temperature and solar radiation on the output of the solar panel was studied, the Newton Raphson method was used to find the output current of the solar panel and plot P-V ,I-V curves, the performance of the PV was determined at Standard Test Condition (STC) (1000W/m2)and a comparison between theoretical and experimental results were done .The best efficiency
... Show MoreThe problem of Bi-level programming is to reduce or maximize the function of the target by having another target function within the constraints. This problem has received a great deal of attention in the programming community due to the proliferation of applications and the use of evolutionary algorithms in addressing this kind of problem. Two non-linear bi-level programming methods are used in this paper. The goal is to achieve the optimal solution through the simulation method using the Monte Carlo method using different small and large sample sizes. The research reached the Branch Bound algorithm was preferred in solving the problem of non-linear two-level programming this is because the results were better.
Background: Infection with Toxoplasma gondii (T. gondii) leads to activation of T-helper cells (Th-1 and Th-2) which are involved in the synthesis and release of different cytokines which may lead to endothelial dysfunction. Objectives: To evaluate the endothelial function in patients with acute toxoplasmosis. Methods: This case-control study involved 31 patients with toxoplasmosis aged 19 - 47 years matched with 20 healthy subjects. Anti-T. gondii antibody (IgG, IgM, IgA) was determined by direct antigen-antibody reaction. Interleukin-6(IL-6), endothelin-1 (ET-1) and human malondialdehyde (MDA) serum levels were measured. Results: IgM, IgG and IgA levels were high in the infected patients compared with controls (P < 0.01). Furthermore, IL-
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