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 study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
... Show MoreThe rapid development of telemedicine services and the requirements for exchanging medical information between physicians, consultants, and health institutions have made the protection of patients’ information an important priority for any future e-health system. The protection of medical information, including the cover (i.e. medical image), has a specificity that slightly differs from the requirements for protecting other information. It is necessary to preserve the cover greatly due to its importance on the reception side as medical staff use this information to provide a diagnosis to save a patient's life. If the cover is tampered with, this leads to failure in achieving the goal of telemedicine. Therefore, this work provides an in
... Show MoreThis study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
... Show Moreاسهم تطور ادوات الاسواق المالية والتغيرات العالمية كالعولمة المالية وتحرير الاسواق المالية العالمية في احداث العديد من الازمات ومنها الازمة المالية الدولية التي تعد من اكثر الظواهر ملازمة للاسواق المالية على الرغم من التطورات التي تشهدها تلك الاسواق نتيجة تطور ادواتها المالية وانفتاحها على بعضها البعض. وتتعرض الاسواق المالية الدولية والناشئة (Emerging Market) منها بشكل خاص ا
... Show MoreCrime is a threat to any nation’s security administration and jurisdiction. Therefore, crime analysis becomes increasingly important because it assigns the time and place based on the collected spatial and temporal data. However, old techniques, such as paperwork, investigative judges, and statistical analysis, are not efficient enough to predict the accurate time and location where the crime had taken place. But when machine learning and data mining methods were deployed in crime analysis, crime analysis and predication accuracy increased dramatically. In this study, various types of criminal analysis and prediction using several machine learning and data mining techniques, based o
A novel welded demountable shear connector for sustainable steel-concrete composite structures is proposed. The proposed connector consists of a grout-filled steel tube bolted to a compatible partially threaded stud, which is welded on a steel section. This connector allows for an easy deconstruction at the end of the service life of a building, promoting the reuse of both the concrete slabs and the steel sections. This paper presents the experimental evaluation of the structural behavior of the proposed connector using a horizontal pushout test arrangement. The effects of various parameters, including the tube thickness, the presence of grout infill, and the concrete slab compressive strength, were assessed. A nonlinear finite element mode
... Show MoreNanofluid treatment of oil reservoirs is being developed to enhance oil recovery and increase residual trapping capacities of CO2 at the reservoir scale. Recent studies have demonstrated good potential for silica nanoparticles for enhanced oil recovery (EOR) at ambient conditions. Nanofluid composition and exposure time have shown significant effects on the efficiency of EOR. However, there is a serious lack of information regarding the influence of temperature on nanofluid performance; thus the effects of temperature, exposure time and particle size on wettability alteration of oil-wet calcite surface were comprehensively investigated; moreover, the stability of the nanofluids was examined. We found that nanofluid treatment is more efficie
... Show MoreObjective: The present study aimed to determine the association of quality of life with the resilience of intensive care unit (ICU) nurses. Methods and Materials: A cross-sectional study was performed, including 105 ICU nurses from five hospitals in Iraq, using a convenience sample method. Data were gathered through a self-administered questionnaire that includes three sections: the demographics, the Brooks Quality of Nursing Work Life survey, and the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Findings: The QWL of the ICU nurses was moderately satisfied (mean = 161.42), and the level of resilience was moderate (mean = 26). A statistically significant positive correlation between QWL and resilience. Conclusion: Strategies
... Show MoreBackground: The aim of this study was to comparatively evaluate the push out bond strength (PBS) of root canal fillings using four different obturation techniques (single cone (SC), cold lateral compaction (CLC), continuous wave (CW), and carrier based gutta percha (CBG)). Materials and Methods: Forty mandibular premolar decoronated and instrumented with rotary ProTaper to F3 then teeth were divided randomly into 4 groups of 10 teeth for each as follow: group (I) single- cone obturation with matched-taper gutta-percha, group (II) cold lateral compaction technique, group (III) continuous wave of obturation technique, and group( IV) carrier based gutta-percha technique. Zinc oxide eugenol (ZOE) sealer was used as a root canal sealer for the
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