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.
Integration of laminar bubbling flow with heat transfer equations in a novel internal jacket airlift bioreactor using microbubbles technology was examined in the present study. The investigation was accomplished via Multiphysics modelling to calculate the gas holdup, velocity of liquid recirculation, mixing time and volume dead zone for hydrodynamic aspect. The temperature and internal energy were determined for heat transfer aspect.
The results showed that the concentration of microbubbles in the unsparged area is greater than the chance of large bubbles with no dead zones being observed in the proposed design. In addition the pressure, due to the recirculation velocity of liquid around the draft
... Show MoreThe non static chain is always the problem of static analysis so that explained some of theoretical work, the properties of statistical regression analysis to lose when using strings in statistic and gives the slope of an imaginary relation under consideration. chain is not static can become static by adding variable time to the multivariate analysis the factors to remove the general trend as well as variable placebo seasons to remove the effect of seasonal .convert the data to form exponential or logarithmic , in addition to using the difference repeated d is said in this case it integrated class d. Where the research contained in the theoretical side in parts in the first part the research methodology ha
... Show MoreIn this paper we generalize some of the results due to Bell and Mason on a near-ring N admitting a derivation D , and we will show that the body of evidence on prime near-rings with derivations have the behavior of the ring. Our purpose in this work is to explore further this ring like behavior. Also, we show that under appropriate additional hypothesis a near-ring must be a commutative ring.
Background: Otitis media with effusion is characterized by accumulation of fluid in the middle ear in absence of acute inflammation and it is the most common cause of acquired hearing loss in children, and may negatively affect language development failure of medical treatment of middle ear effusion frequently require myringotomy and tympanostomy tube insertion.
Objectives: To determine tympanostomy tube complications of tube in children with chronic otitis media with effusion who were treated with Shah Grommet tube insertion.
Methods: The Medical records of 162 ears of 87 children (52 male and 35 female) were reviewed respectively, the patients ages wer
... Show MoreDocument clustering is the process of organizing a particular electronic corpus of documents into subgroups of similar text features. Formerly, a number of conventional algorithms had been applied to perform document clustering. There are current endeavors to enhance clustering performance by employing evolutionary algorithms. Thus, such endeavors became an emerging topic gaining more attention in recent years. The aim of this paper is to present an up-to-date and self-contained review fully devoted to document clustering via evolutionary algorithms. It firstly provides a comprehensive inspection to the document clustering model revealing its various components with its related concepts. Then it shows and analyzes the principle research wor
... Show MorePraise be to God, who is satisfied with Islam as our religion, “He opened a clear conquest for us,” and whoever works with us through the Shari’ah works and protects us. And that our master and Mawlana Muhammad His servant and Messenger is a prophet who has been merciful and compassionate. "
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The occupation of Iraq and the accompanying bone events, and the following severe obstacles, resulted in a set of problems that require legitimate stances, and satisfactory answers, remove confusion and delusion, amid the clash of opinions and contradictions of jurisprudence. Work and application.
Among the difficult problems that surfaced in light of the new political developments on the land of Iraq: (the ruling on dealing