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.
Enhancement of heat transfer in the tube heat exchanger is studied experimentally by using discrete twisted tapes. Three different positions were selected for inserting turbulators along tube section (horizontal position by α= 00, inclined position by α= 45 0 and vertical position by α= 900). The space between turbulators was fixed by distributing 5 pieces of these turbulators with pitch ratio PR = (0.44). Also, the factor of constant heat flux was applied as a boundary condition around the tube test section for all experiments of this investigation, while the flow rates were selected as a variable factor (Reynolds number values vary from 5000 to 15000). The results s
... Show MoreObjective: To evaluate the functional outcome of percutaneous cross two K wires fixation for Gartland types II and III fractures of humerus. Methodology: This prospective study included80 patients with supracondylar humeral fracture, who underwent closed reduction and fixation by two crossed Kirschner wires. We included children with age < 15 years with closed fractures with Gartland types II and III, while the patient with vascular injury, open, irreducible fractures were excluded. The patients were following up for 6 months and assessed functionally by Flynn’s criteria. Results: The mean age of patients was 8.1 years. Trauma while child playing was the main mechanism of injury in 43 (59.8%) children and 46 (57.5%) fractures were of the
... Show MoreThis study accomplished to determine levels of salivary Alpha-Amylase (sAA) in Iraqi children with positive family history of hypertension, Hypertension was believed to be a risk factor in 18% of all deaths in 2010 (9.4 million globally). This study included one hundred children from primary school aged 6 to 13 years, with a focus in child welfare and family health history, with an emphasis on close relatives' hypertension reputations, with hypertension close relatives record categories identified by 1st and 2nd relatives, after documenting the full details, the burden was assessed for the children's families. The influence of age is confirmed by a correlation study of our own numbers, which shows a positive correlation. The disparity betwe
... Show MoreBackground: The prevention of the enamel demineralization at the periphery of the brackets is a significant challenge to orthodontic professionals. The aim of this clinical study was to compare the Streptococcus mutants count in the plaque surrounding two orthodontic adhesive types, Fuji Ortho LC and Enlight (Ormco). Materials and methods: A total of 13 patients (7 male and 6 female) needing fixed orthodontic appliance therapy were participated. A split mouth technique was followed with appliances bonded by two orthodontic adhesive types, Fuji Ortho LC and Enlight (Ormco). Saliva was collected before placement of appliances (T0) and again at three weeks (T1) and six weeks (T2) after placement of appliances. Plaque was collected from areas a
... Show MoreCrop diseases are usually caused by inoculum of pathogens which might exist on alternate hosts or weeds as endophytes. These endophytes, cum pathogens, usually confer some beneficial attributes to these weeds or alternate hosts from protection against herbivores, disease resistance, stress tolerance to secondary metabolites production. This study was therefore carried out to isolate potential crop pathogens which exist as endophytes on weed species in the University of Ilorin plantations. Green asymptomatic leaves were collected from 10 weed species across the plantations, and processed for their endophytic fungi isolation. Isolates were purified into pure cultures and used for molecular identification using the internal transcribed spac
... Show MoreIn this paper, the effect size measures was discussed, which are useful in many estimation processes for direct effect and its relation with indirect and total effects. In addition, an algorithm to calculate the suggested measure of effect size was suggested that represent the ratio of direct effect to the effect of the estimated parameter using the Regression equation of the dependent variable on the mediator variable without using the independent variable in the model. Where this an algorithm clear the possibility to use this regression equation in Mediation Analysis, where usually used the Mediator and independent variable together when the dependent variable regresses on them. Also this an algorithm to show how effect of the
... Show MoreHuman cystic echinococcosis caused by Echinococcus granulosus is one of most important and widespreadparasitic zoonoses in the world. The present study was aimed to identify the immunomodulatory activity ofaqueous extract of Cordia myxa fruit since this plant considers one of medically important plants, which is widely used for treatment of numerous diseases, that correlate with the effectiveness of immunized by hydatid cyst fluid antigen HCFAg. Forty Balb/c mice were divided into equal groups, first group was immunized with HCFAg, the second group was treated with aqueous extract of C. muxa fruit, the third group was immunized and treated, the fourth group was as a control. Delayed type hypersensitivity (DTH), Mitotic index (MI) and histop
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