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 changes that have occurred in the business environment and scientific and technological progress, as well as the complexity of administrative problems resulting from its practice of various activities, have led to an increase in the responsibilities entrusted to it, and for the purpose of achieving its strategic objectives, which has made the pillars of corporate governance an inevitable matter required by the nature of modern scientific management of the governorate, the success that companies seek is based on the fertile environment and the dialectical relationship between the individual and the company, and to achieve this success there must be a compatible and harmonious audit environment between the internal and external
... Show MoreImproving the environment is a mission that should be conducted by three associates; public authorities, environmentalists and the community. The ignorance of environmental education in Iraq has resulted to an almost environmentally illiterate community, demanding well planned programs to raise their environmental; awareness and education. On the other hand, the decision makers should be well informed about the citizens' environmental preferences to be able to set their priorities for the civil services. Merging the Iraqi citizens in listing their environmental priorities is one of many other approaches for "Environment Education" programs. Globally, such methods have proven to be effective and resulted to widespread understandin
... Show MoreIndustry represents a cornerstone of the process of economic development and a measure of progress and contribute to increased prosperity and high standard of living.
The researcher analyzed the productivity indicators in industrial facilities large and small at several time periods ranging from 1970 to 2009, according to the economic situation that prevailed in each period.
Different impact of periods under discussion, it made Iraq the cash surpluses during the period 70-1980 then the effects of the war after 1980 and the economic blockade since 1990, and the subsequent events of the year
... Show MoreGas compressibility factor or z-factor plays an important role in many engineering applications related to oil and gas exploration and production, such as gas production, gas metering, pipeline design, estimation of gas initially in place (GIIP), and ultimate recovery (UR) of gas from a reservoir. There are many z-factor correlations which are either derived from Equation of State or empirically based on certain observation through regression analysis. However, the results of the z-factor obtained from different correlations have high level of variance for the same gas sample under the same pressure and temperature. It is quite challenging to determine the most accurate correlation which provides accurate estimate for a range of pressures,
... Show MoreHealth literacy is an important method used by the authorities to strengthen the health system. The aim of this study is to assess the knowledge of some basic health principles among women of different educational states. This is a crosssectional study, performed from December 2014 until January 2016, Baghdad. All candidates were: females > 18 years, neither medical staff nor students. They were divided into two groups: educated and uneducated. The sample included 213 women, there were 112 educated and 101 uneducated women. Regarding educated group, accurate answers regarding route of transmission of typhoid fever was 73.2% in educated subjects vs. 49.5% in uneducated subjects. Main source of information for both groups was p
... Show MoreLinear programming currently occupies a prominent position in various fields and has wide applications, as its importance lies in being a means of studying the behavior of a large number of systems as well. It is also the simplest and easiest type of models that can be created to address industrial, commercial, military and other dilemmas. Through which to obtain the optimal quantitative value. In this research, we dealt with the post optimality solution, or what is known as sensitivity analysis, using the principle of shadow prices. The scientific solution to any problem is not a complete solution once the optimal solution is reached. Any change in the values of the model constants or what is known as the inputs of the model that will chan
... Show MoreA numerical method is developed to obtain two-dimensional velocity and pressure distribution through a cylindrical pipe with cross jet flows. The method is based on solving partial differential equations for the conservation of mass and momentum by finite difference method to convert them into algebraic equations. This well-known problem is used to introduce the basic concepts of CFD including: the finite- difference mesh, the discrete nature of the numerical solution, and the dependence of the result on the mesh refinement. Staggered grid implementation of the numerical model is used. The set of algebraic equations is solved simultaneously by “SIMPLE” algorithm to obtain velocity and pressure distribution within a pipe. In order to
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The great scientific progress has led to widespread Information as information accumulates in large databases is important in trying to revise and compile this vast amount of data and, where its purpose to extract hidden information or classified data under their relations with each other in order to take advantage of them for technical purposes.
And work with data mining (DM) is appropriate in this area because of the importance of research in the (K-Means) algorithm for clustering data in fact applied with effect can be observed in variables by changing the sample size (n) and the number of clusters (K)
... Show MoreThis paper presents seven modified Adomian Decomposition Method (ADM) techniques for efficiently solving initial value problems, especially those involving non-homogeneous and nonlinear differential equations. While the classical ADM is effective for linear homogeneous cases, it has difficulties solving more complex problems. The proposed modifications—from MADM1 to MLADM—include Maclaurin and Taylor expansions, Laplace transforms, and single-step iterations.• These modifications enhance convergence, reduce complexity, and improve accuracy.• Each method offers specific advantages, such as accelerating convergence (MADM2, RADM4), simplifying computation (TSADM5), and achieving higher accuracy (MLADM).• Numerical examples confirm th
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