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.
This paper presents a modified training method for Recurrent Neural Networks. This method depends on the Non linear Auto Regressive (NARX) model with Modified Wavelet Function as activation function (MSLOG) in the hidden layer. The modified model is known as Modified Recurrent Neural (MRN). It is used for identification Forward dynamics of four Degrees of Freedom (4-DOF) Selective Compliance Assembly Robot Arm (SCARA) manipulator robot. This model is also used in the design of Direct Inverse Control (DIC). This method is compared with Recurrent Neural Networks that used Sigmoid activation function (RS) in the hidden layer and Recurrent Neural Networks with Wavelet activation function (RW). Simulation results shows that the MRN model is bett
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The current study aimed to identify the quality of health services provided by the Omani health sector through the comparison between public and private hospitals in Dhofar Governorate, Oman. A questionnaire has been developed to collect data from 360 patients who received health services in one public Hospital (Sultan Qaboos) and three private Hospitals (Badr Al-Sama, Lifeline, and Al-Hakeeim). The data were analyzed using independent samples T-Test and One Way ANOVA. The results of the study showed that the quality levels of health services offered in private hospitals were better than public hospitals. The study results also reveled that there are significant differences between public hospitals and private hos
... Show MoreBackground: This study evaluate the immunohistochemical expression profile of transforming growth factor beta-1 in inflamed gingival tissue of patients with gingivitis and chronic periodontitis compared to healthy subjects and, determine the correlation between this cytokine and the clinical periodontal parameters, intensity of inflammation and chronic periodontitis severity. Materials and methods: Gingival tissue specimens were taken from 23 chronic periodontitis patients, 20 gingivitis patients and 20 periodontally healthy subjects. The periodontal status was evaluated by dichotomous measurements of the clinical periodontal parameters (PLI, GI, BOP, PPD, CAL). The gingival specimens were fixed immediately in 10% formalin and processed ro
... Show MoreIn this study, 158 clinical samples were collected from hospitalized burn patients during the period from December 2012 to June 2013 in Karbala province\ Iraq. Bacterial isolates were identified using conventional biochemical tests and then identification was confirmed by using Vitek-2 compact system. Pseudomonas aeruginosa recovery was 60 isolates in this study. These isolates were analyzed for antibiotic susceptibility by the disk diffusion test (DDT) according to Kirby Bauer's method using seven clinically important antipseudomonal agents: carbapenems (Imipenem and Meropenem), pencillins (Piperacillin), cephalosporins (Ceftazidim), monobactam (Aztreonam), quinolones (Ciprofloxacin) and aminoglycosides (Gentamicin). The results of resista
... Show MoreAfter the spread of the function of the scenographer in the modern theater, his vision has become present in most of the theatrical works and because the director is the master of the work and the owner of the vision that appears in front of the audience, the overlap between the visions of each of them was required. This research is an attempt to detect the overlap and disengagement in the work of each of them.
The research is divided into a methodological framework that included the research problem, importance, limits, and purpose, and then the definition of terms. In the theoretical framework, the research dealt with two theoretical sections that pave the way for raising ideas related to this subject: the first section (scenography
Three different types of nozzles (different wear rate) were used in this study. They are classified depending on the severity of their wear to three groups: new, worn and damaged nozzles. Those nozzles were spraying with the same application rate (303 l/ha) on two-year field trials; this was achieved by changing the spraying pressure for each group of nozzles in order to get the same application rate. This practice is usually done by operators of sprayers, who calibrate the sprayers on the same application rate every year without changing the nozzles, so they tend to reduce the spraying pressure in order to compensate the flow rate increase due to the nozzles yearly wear. Two types of
Objective(s): To determine the impact of Chemotherapy upon the quality of life for patients with chronic myeloid
leukemia in Baghdad city.
Methodology: A descriptive study design was carried out The study was initiated from 30 January 2011 to October
2011.A purposive (non–probability) sample consisted of (130) patients with a chronic myeloid leukemia ,Who
attended to Baghdad Teaching Hospital and National Center for Research and Treatment of Hematology. The
sample criteria was the patients who were 18 years old and above, excluding the patients who suffered from
psychological problems and other chronic illnesses .A questionnaire was adopted and developed from European
Organization Research and treatment of Can
Congenital adrenal hyperplasia is a group of autosomal recessive disorders. The most frequent one is 21-hydroxylase deficiency. Analyzing
Background: Because of the disturbance in the pituitary gland, growth hormone (GH) secretion will be increased and, as a result, insulin-like growth factor 1 (IGF-1) secretion will be increase as well, leading to a chronic and rare disease called acromegaly disease. One of the most serious complications of acromycaly is diabetes. Insulin resistance, which causes diabetes, occurs in the body because of increased growth hormone secretion Objective: The aim of this work is to estimate some biochemical parameters. These parameters were not studied extensively in the literature such as BALP and LOX and the possibility of using LOX as a new biomarker for acromyalgic patients with diabetic. Patients and Methods: The study was performed on (25) mal
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