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 purpose of this research is to implement the orthogonal polynomials associated with operational matrices to get the approximate solutions for solving two-dimensional elliptic partial differential equations (E-PDEs) with mixed boundary conditions. The orthogonal polynomials are based on the Standard polynomial (
the Objective of study is to measure the quality of medical service level, in the Iraq public hospitals ,presented by special words ,private hospitals, and compare between them, by knowing the level of recipients satisfaction of medical service for all dimensions of quality service, and then measuring satisfaction with the quality of medical service as a whole for both of them, which have been prepared in questionnaire form, included two main directions, first to determine the level of satisfaction when, recipients of medical service is not dimensions quality of service in accordance with the Scale Servqual by (Parasurman et .al 1988), consisting of five di
... Show MoreLearning Disabilities are described as a hidden and puzzling disability. Children with these difficulties have the potential to hide weaknesses in their performance because they are a homogenous group of disorders that consist of obvious difficulties in acquiring and using reading, writing, Mathematical inference. Thus, the research aims to identify the disabilities of academic learning in (reading, writing, mathematics), identify the problems of behavior (general, motor, social). Identify the relationship among behaviour problems. The research also aims to identify the counseling needs to reduce the behavioral problems. The researcher adopted the analytical descriptive method by preparing two main tools for measuring learning disabiliti
... Show MoreClobetasol propionate (CP) is a super potent corticosteroid widely used to treat various skin disorders such as atopic dermatitis and psoriasis. However, its utility for topical application is hampered due to its common side effects, such as skin atrophy, steroidal acne, hypopigmentation, and allergic contact dermatitis. Microsponge is a unique three-dimensional microstructure particle with micro and nano-meters-wide cavities, which can encapsulate both hydrophilic and lipophilic drugs providing increased efficacy and safety. The aim of the current study is to prepare and optimize clobetasol-loaded microsponges. The emulsion solvent diffusion method is used for the preparation of ethylcellulose (EC)-based microsponges. The impact of
... Show MoreGeotechnical engineers have always been concerned with the stabilization of slopes. For this purpose,
various methods such as retaining walls, piles, and geosynthetics may be used to increase the safety factor of slopes prone to failure. The application of stone columns may also be another potential alternative for slope stabilization. Such columns have normally been used for cohesive soil improvement. Most slope analysis and design is based on deterministic approach i.e a set of single valued design parameter are adopted and a set of single valued factor of safety (FOS) is determined. Usually the FOS is selected in view of the understanding and knowledge of the material parameters, the problem geometry, the method of analysis and the
The Makhoul Dam project proposed to be established is considered one of the strategic projects in Iraq as it works to insurance large quantity of water spare in flood seasons, increase the storage capacity of the dams in Iraq, as well as increase food security. The Makhool Dam is located on Tigris River in Salah al-Din Governorate, and 8 km south of the meeting point of the Tigris River with the Lower Zab River. The lake area is about 256 km2. In this research, a mathematical model was prepared by using HEC-RAS Two Dimension Software to analyze the velocity patterns and water depths inside makhool dam reservoir at the highest operational water elevation, based on the designs prepared
Recently, there has been a notable surge in interest surrounding entrepreneurial orientation and strategic entrepreneurship. These concepts are particularly relevant due to their modern characteristics that aid in adapting to the environment. They also play a crucial role in improving production, service, and technological processes to sustain value, minimize competition, and drive ongoing enhancements, ultimately leading to a position of leadership within public companies. Therefore, the primary focus of this research was to examine the influence of entrepreneurial orientation on achieving strategic entrepreneurship. This influence is further mediated by the presence Iraqi Ministry of Agric
... Show MoreThe study aimed to prepare rehabilitation exercises using some rubber ropes for people with partial rupture of the anterior cruciate ligament, to recognize their effect on the recovery of motor tides and to reduce the pain of those with partial rupture of the anterior cruciate ligament of the knee joint, and adopted the experimental method by designing the experimental and controlled groups on a sample of those with partial rupture of the anterior cruciate ligament of men (30-35) One year of those who attend the Physiotherapy Center/Rafidain University College of 12 injured were deliberately selected from their community of origin by (100%), and after determining the measuring tools and preparation of exercises applied with rubber r
... Show MoreAt the end of 2019, a new form of Coronavirus (later dubbed COVID-19) emerged in China and quickly spread to other regions of the globe. Despite the virus’s unique and unknown characteristics, it is a widely distributed infectious illness. Finding the geographical distribution of the virus transmission is therefore critical for epidemiologists and governments in order to respond to the illness epidemic rapidly and effectively. Understanding the dynamics of COVID-19’s spatial distribution can help to understand the pandemic’s scope and effects, as well as decision-making, planning, and community action aimed at preventing transmission. The main focus of this study is to investigate the geographic patterns of COVID-19 disseminat
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