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 necessary optimality conditions with Lagrange multipliers are studied and derived for a new class that includes the system of Caputo–Katugampola fractional derivatives to the optimal control problems with considering the end time free. The formula for the integral by parts has been proven for the left Caputo–Katugampola fractional derivative that contributes to the finding and deriving the necessary optimality conditions. Also, three special cases are obtained, including the study of the necessary optimality conditions when both the final time and the final state are fixed. According to convexity assumptions prove that necessary optimality conditions are sufficient optimality conditions.
... Show MoreSolar photovoltaic (PV) has many environmental benefits and it is considered to be a practical alternative to traditional energy generation. The electrical conversion efficiency of such systems is inherently limited due to the relatively high thermal resistance of the PV components. An approach for intensifying electrical and thermal production of air-type photovoltaic thermal (PVT) systems via applying a combination of fins and surface zigzags was proposed in this paper. This research study aims to apply three performance enhancers: case B, including internal fins; case C, back surface zigzags; and case D, combinations of fins and surface zigzags; whereas the baseline smooth duct rep
Background: zirconium (Zr) implants are known for having an aesthetically pleasing tooth-like colour Unlike the grey cervical collar that develops over time when titanium (Ti) implants are used in thin gingival biotypes. However, the surface qualities of Zr implants can be further improved. This present study examined using thermal vapour deposition (TVD) to coat Zr implants with germanium (Ge) to improve its physical and chemical characteristics and enhance soft and hard tissue responses. Materials and methods: Zr discs were divided into two groups; the uncoated (control) group was only grit-blasted with alumina particles while the coated (experimental) group was grit-blasted then coated with Ge via TVD. Field emission scanning ele
... Show MoreThe present study aims to study the content and spatial distribution of lead (Pb) contamination in the soils of some Baghdad cities (Middle of Iraq). Twenty soil samples were randomly collected from different land-use in the studied area at a depth between 5 to 30 cm. Ten samples are collected from Al-Rissafa side areas (Adhamiya, Al-Wazeeria (Battery Manufacturer), Shikh Omer, Ziyouna, Karada, Shaab, Sadr city, Al-Za’franiya, Al-Dora expressway, and Alselikh ) and other ten samples are collected from Al-Krakh side areas Al-Dora, Al-Masafi junction, Al-Dora, Sayidia, Al-Salam university college, Al-Bayaa (Industrial District), Jehad, Amirya, Abu Ghraib, Al-hurriya, and Kadhimiya. The soil samples have been analyzed for the lead (P
... Show MoreInsurance companies seeking to develop programs to promote and market their services and to increase its customer through the use of modern technical marketing and reduce its dependence on agents and take advantage of work of the banks by alliances with them and including reinforcing get the parties to competitive advantages in the financial market , the insurance services intangible service stops marketed over the insurance awareness and requires exceptional promotional efforts. &nbs
... Show MoreThe increase in the Iraqi population put pressure on urban cities as there were no new cities built since the 1980s due to the wars and the economic blockade imposed in 1991 and the deteriorating security situation after 2003, where the population in 2018 reached about forty million people. Iraq also suffered during the past decades from problems and challenges in many respects that affected the local environment, and the constructed buildings had a role in increasing these impacts, so the Ministry of Housing worked to issue the Iraqi Green Architecture Code in 2019 to reduce damage to the environment and use resources more efficiently. And because the constructed buildings were not constructed according to green standards, including Bas
... Show MoreNew simple and sensitive spectrophotometric methods for the determination of paracetamol in aqueous medium were developed. The first method is based on coupling of paracetamol with p-amino-2-hydroxy sodium benzoate (AHB) in the presence of sodium periodate, as oxidizing agent, to form a brownish-orange compound which shows a λmax at 470 nm. The molar absorptivity (εmax) of the colored product was found to be (3371) l. mole1. cm-1 and Sandel’s index 0.0449 μg. cm-2. The method follows Beer’s law in the concentration range of 12.5-500.0 μg of paracetamol in a final volume of 25 ml (0.5-20.0) μg. ml-1 with relative standard deviation percent (RSD%) ranged between 0.26-4.71% and accuracy, expressed by recovery percent, 95-106% for five
... Show MoreThis research aims to find how three different types of mouthwashes affect the depth of artificial white spot lesions. Teeth with various depths of white spot lesions were immersed in either splat mouthwash, Biorepair mouthwash, Sensodyne mouthwash, or artificial saliva (control)twice daily for one minute for 4 weeks and 8 weeks at 37°C. After this immersion procedure, lesion depth was measured using a diagnosed pen score. A one-way analysis of variance, Dunnett T3 and Tukey's post hoc α = .05 were used to analyze the testing data. Splat mouthwash enhanced the WSL remineralization and made the lowest ΔF compared with other mouthwashes in shallow and deep enamel after 4 and 8 weeks of treatment. In the repair groups, after 4 weeks
... Show MoreBackground: Insulin resistance is associated with metabolic syndrome , type 2 diabetes and representing a risk factor for cardiovascular disease . This relationship may be modulated to some extent by age related changes in sex hormone status.. In particular, reduced total testosterone (TT) levels have been associated with insulin resistance and subsequent risk for developing type 2 diabetes. Aim of study: we examined whether low total testosterone level were associated with insulin resistance in young adult men. Methods: a total of 83 men (young adult men) divided into 2 group : (group1 ) 49 men with a risk factor for insu
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