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 challenges facing today's multi-customer and this is due to the multiplicity of products and speed in launching new products so search came to reveal the reveal the of the new product classification standards through a relationship (good products, low interest products, useful products and products desired) and the customer emotionally blackmail through deportation (fear, obligation and guilt). dentified the problem of the research in several questions focused on the nature of the relationship between the variables of research, and for that outline supposedly to search it expresses the head of one hypothesis and branched out of which four hypotheses subset, but in order to ensure the validity of the ass
... Show MoreA skip list data structure is really just a simulation of a binary search tree. Skip lists algorithm are simpler, faster and use less space. this data structure conceptually uses parallel sorted linked lists. Searching in a skip list is more difficult than searching in a regular sorted linked list. Because a skip list is a two dimensional data structure, it is implemented using a two dimensional network of nodes with four pointers. the implementation of the search, insert and delete operation taking a time of upto . The skip list could be modified to implement the order statistic operations of RANKand SEARCH BY RANK while maintaining the same expected time. Keywords:skip list , parallel linked list , randomized algorithm , rank.
Hair is an excellent indicator for abnormal concentration of toxic elements , In this study a random samples from girls hair of 12 cm long were irradiated by a flux of neutrons (4x10^ n/ cm^.s) obtained from an Am-Be neutron source of 5-Ci activitity . The y-ray activity measurements were carried out by using a " 5x5 " well- type Nal (Tl) detector. The study indicates clearly that the maximum concentration of elements was at about 7 cm hair length.
In this paper, the process for finding an approximate solution of nonlinear three-dimensional (3D) Volterra type integral operator equation (N3D-VIOE) in R3 is introduced. The modelling of the majorant function (MF) with the modified Newton method (MNM) is employed to convert N3D-VIOE to the linear 3D Volterra type integral operator equation (L3D-VIOE). The method of trapezoidal rule (TR) and collocation points are utilized to determine the approximate solution of L3D-VIOE by dealing with the linear form of the algebraic system. The existence of the approximate solution and its uniqueness are proved, and illustrative examples are provided to show the accuracy and efficiency of the model.
Mathematical Subject Classificat
... Show MoreIn this paper, the general framework for calculating the stability of equilibria, Hopf bifurcation of a delayed prey-predator system with an SI type of disease in the prey population, is investigated. The impact of the incubation period delay on disease transmission utilizing a nonlinear incidence rate was taken into account. For the purpose of explaining the predation process, a modified Holling type II functional response was used. First, the existence, uniform boundedness, and positivity of the solutions of the considered model system, along with the behavior of equilibria and the existence of Hopf bifurcation, are studied. The critical values of the delay parameter for which stability switches and the nature of the Hopf bifurcat
... Show MoreObjectives: The study aimed to determine the effect of chemotherapy on the life style of patients who
receive chemotherapy.
Methodology: A descriptive study was conducted in Specialty Surgery Teaching Hospital, Al-yamok
Teaching Hospital, and Radiation and Nuclear Medicine Hospital in Baghdad for the period from May
2007 to October 2008. A purposive "non-probability" sample of (loo) patients with bladder cancer
who receive chemotherapy where concerned in this study.
A questionnaire fom was constnicted for the purpose of the study and it was comprised of
two parts. The questiormaire consists of (125) items. They include (1) demographic information (2)
assessment of lifestyle dimension. The content validity of the q
The business environment is witnessing great and rapid developments due to the economic and technological development that has caused damage to human beings, which requires the need to reduce this damage and work to protect the environment and participate in supporting the social aspects. This requires economic resources to be realized by the economic units. Economic development in preserving the environment that has caused damage and supporting the social aspects that preserve human rights, enhance their position and satisfy their needs in society. Global professional organizations, the United Nations and stakeholder representatives have been issuing the Global Reporting Initiative (GRI) to find guidelines for the preparation of
... Show MoreA set of ten drug compounds containing an amino group in the structure were determined theoretically. The parameters were entered into a model to forecast the optimal values of practical (log P) medicinal molecules. The drugs were evaluated theoretically using different types of calculations which are AM1, PM3, and Hartree Fock at the basis set (HF/STO-3G). The Physico-chemical data like (entropy, total energy, Gibbs Free Energy,…etc were computed and played an important role in the predictions of the practical lipophilicity values. Besides, Eigenvalues named HOMO and LUMO were determined. Linearity was shown when correlated between the experimental data with the evaluated physical properties. The statistical analysis was used to analy
... Show MoreLocal and global bifurcations of food web model consists of immature and mature preys, first predator, and second predator with the current of toxicity and harvesting was studied. It is shown that a trans-critical bifurcation occurs at the equilibrium point
Background: Knee osteoarthritis (KOA) is a common joint disorder leading to considerable pain and locomotor disability in lower limb function. Locomotor disability, which is difficulty in activities of daily living related to lower limb function, can be the consequence of KOA, so early diagnosis and management may improve quality of life.
Objective: To assess the contribution of radiological osteoarthritis of the knees to disability in the activities of daily living related to lower limb function.
Methods: One hundred twenty Iraqi KOA patients (104 females and 16 males) who were attending to Rheumatology Unit, Full history was taken and complete clinical exami
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