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: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia.
Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in
... Show MoreBackground: Polycystic ovary syndrome is a heterogeneous disorder and its etiology appears to be complex and multifactorial; characterized by hyperandrogenism, chronic anovulation and infertility. It’s associated with evidence of low-grade chronic inflammation, as indicated by the presence of elevated levels of high sensitive C- reactive protein levels, interleukin-6 and tumor necrosis factor-α. The source of excess circulating tumor necrosis factor-α in obese Polycystic ovary syndrome patient is likely to be the adipose tissues while in lean women increased visceral adiposity has been proposed as a source of excess tumor necrosis factor-α.Objectives: to evaluate the levels of high sensitive C- reactive protein, tumor necrosis facto
... Show MoreThe air flow pattern in a co-current pilot plant spray dryer fitted with a rotary disk atomizer was determined experimentally and modelled numerically using Computational Fluid Dynamics (CFD) (ANSYS Fluent ) software. The CFD simulation used a three dimensions system, Reynolds-Average Navier-Stokes equations (RANS), closed via the RNG k −ε turbulence model. Measurements were carried out at a rotation of the atomizer (3000 rpm) and when there is no rotation using a drying air at 25 oC and air velocity at the inlet of 5 m/s without swirl. The air flow pattern was predicted experimentally using cotton tufts and digital anemometer. The CFD simulation predicted a downward central flowing air core surrounded by a slow
... Show MoreThe effect of superficial gas velocity within the range 0.01-0.164 m/s on gas holdup (overall, riser and down comer), volumetric oxygen mass transfer coefficient, liquid circulation velocity was studied in an internal loop concentric tubes airlift reactor (working volume 45 liters). It was shown that as the usg increases the gas holdup and also the liquid circulation velocity increase. Also it was found that increasing superficial gas velocity lead to increase the interfacial area that increases the overall oxygen mass transfer coefficient. The hydrodynamic experimental results were modeled with the available equations in the literature. The predicted data gave an acceptable accuracy with the empirical data.
The final
... Show MoreRealizing the full potential of wireless sensor networks (WSNs) highlights many design issues, particularly the trade-offs concerning multiple conflicting improvements such as maximizing the route overlapping for efficient data aggregation and minimizing the total link cost. While the issues of data aggregation routing protocols and link cost function in a WSNs have been comprehensively considered in the literature, a trade-off improvement between these two has not yet been addressed. In this paper, a comprehensive weight for trade-off between different objectives has been employed, the so-called weighted data aggregation routing strategy (WDARS) which aims to maximize the overlap routes for efficient data aggregation and link cost
... Show MoreMechanical degradation hampers the practical usage of polymers for turbulent drag reduction
application. Mechanical degradation refers to the chemical process in which the activation energy of
polymer chain scission is exceeded by mechanical action on the polymer chain, and bond rupture
occurs. When a water-soluble polymer and surfactant are mixed in water solution, the specific structures
(aggregates) are formed, in which polymer film is formed around micelle. In this work, Xanthan gum (XG) –
Sodium lauryl ether sulfate (SELS) complex formation and its effect on percentage viscosity reduction
(%VR) was studied. It was found that SELS surfactant reduced the mechanical degradation of XG much
more efficiently than th
The petroleum industry, which is one of the pillars of the national economy, has the potential to generate vast wealth and employment possibilities. The transportation of petroleum products is complicated and changeable because of the hazards caused by the corrosion consequences. Hazardous chemical leaks caused by natural disasters may harm the environment, resulting in significant economic losses. It significantly threatens the aim for sustainable development. When a result, determining the likelihood of leakage and the potential for environmental harm, it becomes a top priority for decision-makers as they develop maintenance plans. This study aims to provide an in-depth understanding of the risks associated with oil and gas pipeli
... Show More