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.
Safety programmes are considered one of the means to protect workers from different accidents and injuries and also to protect all assets including machines equipment and various materials. In spite of world state interests in occupational safety, this subject didn't get the required attention by senior staff of management at most of our country construction factories and the application of safety programmes still limited and in active. In order to a achieve the goal of the study, scientific method has been pursued to obtain the necessary information related to this study through tours to related companies and their construction factories and review literature that deal with occupational safety subject and their programmes and cost, in a
... Show MoreStatic and dynamic circumstances confirm that seepage is water movement through the earth dam’s embankment’s voids from upstream to downstream. Seepage is a quantity of fluid that has seeped through the permeable material or as the infiltration downward and lateral movement of water into soil or substrata from a source of supply such as a reservoir of a dam. In case of an earthquake strikes saturated soils, the water-filled pore spaces collapse, reducing the soil’s overall volume. The water pressure between individual soil grains is increased as a result of this action, and the grains can then move freely in the watery matrix. This reduces the soil’s resistance to shear str
Stable isotope (?18O, ?D) values were determined along with the chemical compositions at 10 different locations along the Tigris river between Baghdad-Ammara cities of Iraq. The physico-chemical parameters and isotopic data were measured. The sampling site represents 34 % of total Tigris river in the republic of Iraq. The systematically increased in values of stable isotope as move from the downstream of the river and the most significantly appears at Kut lake. This increase occurs as a result of several factors, viz. (a) evaporation occurs low water level in the river and its tributaries, and (b) return flow water to the river from irrigation water in groundwater systems. The change in ion distribution and in the isotopic values related di
... Show MoreBackground: Health information systems in most countries are inadequate in providing the needed management support and the current health information systems are therefore widely seen as management obstacles rather than as tools,Objectives: the current study is an attempt to assess the behavioral and organizational determinants of health information system performance in Iraq.Methods: A cross-sectional study was conducted by interviewed a total of 189 respondents selected from six Iraqi governorates. The Organizational and Behavioral Assessment Tool was used to measure the behavioral and organizational determinants of health information system performance, it is one of the PRISM package tools that are used to assess the health informatio
... Show MoreAmebiasis, related to the pathogenic parasite Entamoeba histolytica, is a prominent cause of diarrhea globally. Amebiasis is primarily a disease of impoverished communities in developing nations, although it has recently arisen as a significant infection among returning tourists and immigrants. Severe cases are linked to a high case fatality rate. Although polymerase chain reaction (PCR)-based diagnosis is becoming more widely available, it is still underutilized. Treatment with nitroimidazoles is now suggested, however novel parasite medication research is a top priority. To avoid problems, amebiasis should be considered before corticosteroid therapy. Because there is no effective vaccination, sanitation and availability to clean w
... Show MoreAbstract:
The Iraqi economy faces complex economic challenges that threaten the prospects for growth and stability in the short and medium term, The decrease in oil revenues on which Iraq is based in financing its total expenditure, both operational and investment, led to the emergence of a deficit in the government budget, As the global oil price crisis affected the revenues of the Iraqi government negatively, especially as this negative impact coincided with the increase in military spending resulting from Iraq's war against terrorism, Which led to the Iraqi government to implement austerity measures were to reduce public spending on several projects, which are less important compared to projects that a
... Show MoreBackground: The need of the patient for a more reasonable esthetic orthodontic intervention has risen nowadays. Thus, orthodontists make use of esthetic orthodontic materials like brackets, ligature elastics, and arch wires. The esthetic brackets come as different forms of materials, such as ceramic brackets, which have their stainability remaining as the most important consideration for the patients and the orthodontists. This study aimed to compare the staining effects of various staining materials, including black tea, cigarette smoke and Pepsi, as well as the time effect on the color stability of sapphire ceramic brackets bonded with three kinds of light cure orthodontic adhesives: Transbond, Resilience and Enlight. Materials and Met
... Show MoreThis study examined the adsorption behavior of anionic dye (orange G) from aqueous solution onto the raw and activated a mixture of illite, kaolinite and chlorite clays from area of Zorbatiya (east of Iraq).The chemical treatment involved alkali and acid activation. The alkali activation obtained by treated the raw clay (RC) with 5M NaOH (ACSO) and the acid activation founded by treated it with 0.25M HCl (ACH) and 0.25M (ACS). The thermal treatment carried out by calcination the produce activated clay at 750oC for acid activation and 105oC for alkali activation. Batch
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