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 mixed-spin ferrimagnetic Ising system consists of two-dimensional sublattices A and B with spin values and respectively .By used the mean-field approximation MFA of Ising model to find magnetism( ).In order to determined the best stabile magnetism , Gibbs free energy employ a variational method based on the Bogoliubov inequality .The ground-state (Phase diagram) structure of our system can easily be determined at , we find six phases with different spins values depend on the effect of a single-ion anisotropies .these lead to determined the second , first orders transition ,and the tricritical points as well as the compensation phenomenon .
Children who have a health problem need special requirements for their clothes. The purpose of the study is to design functional and aesthetic clothes to meet their needs. The research used the applied descriptive approach. The research sample comprised 120 women whose children suffered from hip dislocation. Designs for injured children presented and submitted to the arbitrators for evaluation regarding the functional and aesthetic aspects. The finding was achieving the design solutions. The most important recommendations are to increase attention to designing clothes to suit all the needs of society.
Background: Coronary artery disease remains the main cause of death despite several preventive programs. Epicardial adipose tissue is a visceral fat depot of the heart located along the large coronary arteries and on the surface of ventricles and apex. Intima media thickness is commonly recognized as the initial stage in the development of atherosclerosis. The development of ultrasound machines, advances in echocardiographic devices and high resolution transducers facilitate comprehensive analysis of epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT).
Aim: To investigate the relationship of echocardiographic epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT) with the severity of coro
The doping process with materials related to carbon has become a newly emerged approach for achieving an improvement in different physical properties for the obtained doped films. Thin films of CuPc: C60 with doping ratio of (100:1) were spin-coated onto pre-cleaned glass substrates at room temperature. The prepared films were annealed at different temperatures of (373, 423 and 473) K. The structural studies, using a specific diffractometry of annealed and as deposited samples showed a polymorphism structure and dominated by CuPc with preferential orientation of the plane (100) of (2θ = 7) except at temperature of 423K which indicated a small peak around (2θ = 3
Apple slice grading is useful in post-harvest operations for sorting, grading, packaging, labeling, processing, storage, transportation, and meeting market demand and consumer preferences. Proper grading of apple slices can help ensure the quality, safety, and marketability of the final products, contributing to the post-harvest operations of the overall success of the apple industry. The article aims to create a convolutional neural network (CNN) model to classify images of apple slices after immersing them in atmospheric plasma at two different pressures (1 and 5 atm) and two different immersion times (3 and again 6 min) once and in filtered water based on the hardness of the slices usin
Almost all thermal systems utilize some type of heat exchanger. In a lot of cases, evaporators are important for systems like organic Rankine cycle systems. Evaporators give a share in a large portion of the capital cost, and their cost is significantly attached to their size or transfer area. Open-cell metal foams with high porosity are taken into consideration to enhance thermal performance without increase the size of heat exchangers. Numerous researchers have tried to find a representation of the temperature distribution closer to reality due to the different properties between the liquid and solid phases. Evaporation heat transfer in an annular pipe of double pipe heat exchanger (DPHEX) filled with cooper foam is investigated numerical
... Show MoreObjective: To compare two positioning approaches in the surgical treatment of unstable intertrochanteric femoral fractures fixed by proximal femoral nailing, the supine versus lateral decubitus position Methodology: This randomized prospective comparative study on 26 patients with unstable intertrochanteric fractures was carried out from January 2020 and June 2022. We randomly divided patients into two groups: group A (13 patients) were operated using the traction table in the supine position for implant insertion, and group B (13 patients) were operated using the lateral decubitus position. We compared both groups regarding the setup time, operative time, tip-to-apex distance, collodiaphyseal angle, time for fluoroscopic time expo
... Show MoreThis work is concerned with the vibration attenuation of a smart beam interacting with fluid using proportional-derivative PD control and adaptive approximation compensator AAC. The role of the AAC is to improve the PD performance by compensating for unmodelled dynamics using the concept of function approximation technique FAT. The key idea is to represent the unknown parameters using the weighting coefficient and basis function matrices/vectors. The weighting coefficient vector is updated using Lyapunov theory. This controller is applied to a flexible beam provided with surface bonded piezo-patches while the vibrating beam system is submerged in a fluid. Two main effects are considered: 1) axial stretching of the vibrating beam that leads
... Show MoreIn light of the increasing importance of interim financial statements they provided these lists of information that enables users of accounting information to make wise investment decisions and predict the company's activities in light of changes the updated rather than wait until the end of the year and accessing information provided by the annual financial statements. In light of this research has come to the most important set of conclusions the adoption of interim financial information has been audited by the external auditor to the availability of basic qualitative characteristics in the accounting information contained in the (appropriate and timely manner, reliability and comparability) and this in turn leads to the impact on reli
... Show More