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.
Cryptographic applications demand much more of a pseudo-random-sequence
generator than do most other applications. Cryptographic randomness does not mean just
statistical randomness, although that is part of it. For a sequence to be cryptographically
secure pseudo-random, it must be unpredictable.
The random sequences should satisfy the basic randomness postulates; one of them is
the run postulate (sequences of the same bit). These sequences should have about the same
number of ones and zeros, about half the runs should be of length one, one quarter of length
two, one eighth of length three, and so on.The distribution of run lengths for zeros and ones
should be the same. These properties can be measured determinis
Improving the quality of health services in the health sector is an important and necessary matter that must be taken care of and improved, and this study seeks to demonstrate the role of quality costs in improving the quality of health services and achieving a high level of quality to satisfy the beneficiaries and to provide health services of good quality, and the research concluded that the main point of service provision Good health is the costs of prevention and evaluation (costs of quality conformity) and attention to it, and that technical competition contributes greatly to the development of the level of quality, as well as the use of health and medical staff with competent expertise, and that the costs of internal failure and th
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In The Bluest Eye (1970), the American-African writer, Toni Morrison explores how
Western standards of ideal beauty are created and propagated with and among the black
community. The novel not only portrays the lives of those whose dark skinned and Negroid
features blight their lives; it also shows how the standard of white beauty, when imposed on
black youth, can drastically damage one’s self-love and esteem which usually occurs when
beauty goes unrecognized. Morrison in this novel focuses on the damage that the black
women characters suffer through the construction of femininity in a racialised society where
whiteness is used as a standard of beauty.
The study analyzed the current situation of public hospitals in the capital of Baghdad exclusively and diagnosed the resources available; especially after the high demand for these hospitals as a result of the citizen’s need to review the hospital to take care of them, especially after the Corona pandemic. Eight major hospitals in Baghdad were selected to determine the current reality of providing fire safety tools or equipment and what are the preventive measures needed to reduce it. The results after practical study showed many defects and weaknesses in the current situation due to their reliance on the traditional management to manage and provide all preventive measures and safet
In The Bluest Eye (1970) , Toni Morrison addresses a timeless problem of white racial dominance in the United States and points to the impact it has on the life of black females growing up in the 1930's. Morrison in this novel explores how Western standards of ideal beauty are created and propagated with and among the black community. The novel not only portrays the lives of those whose dark skinned and negroid features blight their lives; it also shows how the standards of white beauty are imposed on black youth to cause a damage of one's self-love and esteem which usually occurs when beauty goes unrecognized
Background: Cervical lymph nodes are prone to involved by a number of pathologic processes. They are common sites for lymphoma, metastasis, and reactive enlargement in a number of conditions. Aims of the study:-Clinical evaluation of patients with cervical lymphadenopathy. Differentiation between benign and malignant lymph nodes by means of ultra sounds (US) and Correlate the US findings with cytological and/or histopathological findings of cervical lymph nodes. Subjects, Materials and Methods:-The present study was carried out over a period of 6 months and included 81 patients of different age groups presenting with cervical lymphadenopathy. Each patient was examined clinically, then comprehensive sonographic examination of the neck for
... Show MoreBackground: Plants used in folk medicine for
the treatment of peptic ulcer diseases is a very
promising approach to overcome the limitations of
classical medicines.
Aim: To explore the efficacy of medicinal
plants, namely turmeric, garlic and marshmallow,
in eradication of H. pylori.
Methods: This prospective study was carried out
on 225 of well-known dyspeptic patients who were
divided into four groups; a control group (received
classical medical therapy) and three other groups
that received one of the three medicinal plants,
plus the same therapy used in the control group.
The follow up was done by using a questionnaire
form, endoscopic examination, and determination
of serum levels of anti
The aim of this study is modeling the transport of industrial wastewater in sandy soil by using finite element method. A washing technique was used to remove the industrial wastewater from the soil. The washing technique applied with an efficient hydraulic gradient to help in transport of contaminant mass by advection. Also, the mass transport equation used in modeling the transport of industrial wastewater from soil includes the sorption and chemical reactions. The sandy soil samples obtained from Al-Najaf Governorate/Iraq. The wastewater contaminant was obtained from Al- Musyiebelectricity power plant. The soil samples were synthetically contaminated with four percentages of 10, 20, 30 and 40% of the contaminant and these percentages calc
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