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.
Incremental Sheet Metal Forming (ISMF) is a modern sheet metal forming technology which offers the possibility of manufacturing 3D complex parts of thin sheet metals using the CNC milling machine. The surface quality is a very important aspect in any manufacturing process. Therefore, this study focuses on the resultant residual stresses by forming parameters, namely; (tool shape, step over, feed rate, and slope angle) using Taguchi method for the products formed by single point incremental forming process (SPIF). For evaluating the surface quality, practical experiments to produce pyramid like shape have been implemented on aluminum sheets (AA1050) for thickness (0.9) mm. Three types of tool shape used in this work, the spherical tool ga
... Show MoreIn this research we have tackled the role of Talent management (as a private variable) within (the Talent attraction, the Talent management performance, Talent development and Talent retention) on strategic performance reinforcement ( accredited variable) within its dimensions ( financial perspective, costumer perspective, internal operations perspective and learning and development perspective). The research conducted on sample of some college teachers from two of Sumer's colleges. The research problem represented by the broad organization's competition as well as universities; which led these colleges to investigate it's skillful human staff to meet it's strategic performance.
To meet the aims of
... Show MoreFree Piston Engine Linear Generator (FPELG) is a modern engine and promising power generation engine. It has many advantages compared to conventional engines such as less friction, few numbers of parts, and high thermal efficiency. The cycle-to-cycle variation one of the big challenges of the FPELG because it is influence on the stability and output power of the engine. Therefore, in this study, the effect of ignition time on combustion characteristics is investigated. The single-cylinder FPELG with spark ignition (SI) combustion type by using compressed natural gas (CNG) fuel type was set to run. LabVIEW is used to run the engine and control of input parameters. All experimental data
Background: This study aimed to compare the surface microhardness (MH) and mineral content of white spot lesions(WSLs) after using bioactive glass (BAG)casein phosphopep-tides-amorphous calcium phosphate(CPP-ACP),and nanohydroxyapatite(Nano-HAP) under pHcycling. Material and method:18 sound maxillary first premolar were used for the study.10 were selected for the vickers microhardness test, For Energy-dispersive X-ray spectroscopy analysis (EDX), the remaining 8 premolar teeth were used, 40 sections of enamel blocks (Four from each tooth) were produced from the middle part of the buccal and palatal surfaces of teeth for MH test while 48 sections of enamel blocks (Six from each tooth) were produced for EDX analysis. Enamel slabs were divi
... Show MoreIntroduction: Although it is discouraged, community pharmacy customers can obtain oral corticosteroids (OCSs) without prescriptions from some community pharmacies in Iraq. Medication abuse is defined as the use of medication for non-medical reasons. Objectives: The study aimed to determine demographics, beliefs, and perceptions associated with the abuse of oral corticosteroids for non-illness reasons among community pharmacy customers. Methods: This cross-sectional study was conducted in fall 2018 in four provinces in Iraq. Customers of 19 community pharmacies asking for OCSs for themselves without a prescription were administered a paper survey. This study used the Theory of Reasoned Action (TRA) to measure the relation
... Show MoreBackground: Wounds are any disruption to the normal anatomic structure of tissue which leads to the loss of epithelial continuity with or without a loss of underlying connective tissue, as well as the anatomic and functional integrity of the living tissue . Wound healing is a complex process with overlapping phases haemostasis, inflammation, proliferation and maturation/matrix Remodeling. Each phase of wound healing requires different management strategies, and inappropriate treatment can delay wound healing. The aim of wound treatment is a rapid wound closure and re-establish tissue function,chia seeds oil are widely used herbal medicines because of their anti-inflammatory and antioxidant capacity as they considerd agood source of polyunsa
... Show MoreLow-intensity laser irradiation has been explored as an alternative, non-invasive method to encourage chronic wounds to heal. This study aimed to evaluate the effects of low level laser therapy (biostimulation) using semiconductor diode laser with wavelength (785 nm) on the enhancement of chronic wound healing. Fifty patients with chronic wounds were selected to be treated with Low Level Laser Therapy. Their ages ranged between 1 to 76 years. The wound sites were distributed in the lower limb, upper limb, trunk , perineum and head (70%,14%,12%,2%,2%, respectively). Application of laser therapy by noncontact method few millimeters from the skin for 15 minutes per one session twice weekly for two months ; ie,16 sessions for each patient. R
... Show MoreThe research aims to achieve market share requirements and reach the targeted competitive price through the application of management accounting techniques represented by continuous improvement technique and target costing under an Activity Based Cost (ABC) system and Activity Based Management (ABM), In Muthanna Cement Company to reach the rationalization of the cost of the product and maintain the required quality and improve the profitability of the company.
The problem of research has emerged in the inability of local firms to enter into effective competition with other companies operating in the same economic sector, Because of the high cost of its products, Which led to the sale of the product at prices below its cost, and t
... Show MoreIn this research a local adsorbent was prepared from waste tires using two-step pyrolysis method. In the carbonization process, nitrogen gas flow rate was 0.2L/min at carbonization temperature of 500ºC for 1h. The char products were then preceded to the activation process at 850°C under carbon dioxide (CO2) activation flow rate of 0.6L/min for 3h. The activation method produced local adsorbent material with a surface area and total pore volume as high as 118.59m2 /g and 0.1467cm3/g, respectively. The produced . local adsorbent (activated carbon) was used for adsorption of lead from aqueous solution. The continuous fixed bed column experiments were conducted. The adsorption capacity performance of prepared activated carbons in this work
... Show MoreThese days, it is crucial to discern between different types of human behavior, and artificial intelligence techniques play a big part in that. The characteristics of the feedforward artificial neural network (FANN) algorithm and the genetic algorithm have been combined to create an important working mechanism that aids in this field. The proposed system can be used for essential tasks in life, such as analysis, automation, control, recognition, and other tasks. Crossover and mutation are the two primary mechanisms used by the genetic algorithm in the proposed system to replace the back propagation process in ANN. While the feedforward artificial neural network technique is focused on input processing, this should be based on the proce
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