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.
Moisture damage is described as a reduction in stiffness and strength durability in asphalt mixtures due to moisture. This study investigated the influence of adding nano silica (NS) to the Asphalt on the moisture susceptibility of hot-mix-asphalt (HMA) mixtures under different aging conditions. NS was mixed with asphalt binder at concentrations of 2%, 4%, and 6% by weight of the binder. To detect the microstructure changes of modified Asphalt and estimate the dispersion of NS within the Asphalt, the field emission scanning electron microscope (FE-SEM) was used. To examine the performance of Asphalt mixed with NS at different aging stages (short-term and long-term aging), asphalt mixture tests such as Marshall stability,
... Show MoreBackground: Denture cleansing was an important step that could prevent the spread of infection and improve a patient's health, the durability of the dentures, and the overall quality of life; therefore, it was necessary to choose a suitable cleanser that, in addition to being effective, did not have an unfavorable effect on the qualities of the denture base resin itself when used for an extended period. For this purpose, this study aimed to evaluate the effect of tea tree oil (TTO) on Candida albicans adhesion and the surface roughness property of poly(methyl methacrylate) denture material after immersion in TTO. Methods: A total of 55 heat-cured acrylic resin specimens were used for C. albicans adherence and surface roughness tests. The
... Show MoreBackground: Frovatriptan succinate (FVT) is an effective medication used to treat migraines; however, available oral formulations suffer from low permeability; accordingly, several formulations of FVT were prepared. Objective: Prepare, optimize, and evaluate FVT-BE formulation to develop enhanced intranasal binary nano-ethosome gel. Methods: Binary ethosomes were prepared using different concentrations of phospholipid PLH90, ethanol, propylene glycol, and cholesterol by thin film hydration and characterized by particle size, zeta potential, and entrapment efficiency. Furthermore, in-vitro, in-vivo, ex-vivo, pharmacokinetics, and histopathological studies were done. Results: Regarding FVT-loaded BE, formula (F9) demonstrated the best paramet
... Show MoreSeawater might serve as a fresh‐water supply for future generations to help meet the growing need for clean drinking water. Desalination and waste management using newer and more energy intensive processes are not viable options in the long term. Thus, an integrated and sustainable strategy is required to accomplish cost‐effective desalination via wastewater treatment. A microbial desalination cell (MDC) is a new technology that can treat wastewater, desalinate saltwater, and produce green energy simultaneously. Bio‐electrochemical oxidation of wastewater organics creates power using this method. Desalination and the creation of value‐added by‐products are expected because of this ionic mov
Power-electronic converters are essential elements for the effective interconnection of renewable energy sources to the power grid, as well as to include energy storage units, vehicle charging stations, microgrids, etc. Converter models that provide an accurate representation of their wideband operation and interconnection with other active and passive grid components and systems are necessary for reliable steady state and transient analyses during normal or abnormal grid operating conditions. This paper introduces two Laplace domain-based approaches to model buck and boost DC-DC converters for electromagnetic transient studies. The first approach is an analytical one, where the converter is represented by a two-port admittance model via mo
... Show MoreSoil movement resulting due unsupported excavation nearby axially loaded piles imposes significant structural troubles on geotechnical engineers especially for piles that are not designed to account for loss of lateral confinement. In this study the field excavation works of 7.0 m deep open tunnel was continuously followed up by the authors. The work is related to the project of developing the Army canal in the east of Baghdad city in Iraq. A number of selected points around the field excavation are installed on the ground surface at different horizontal distance. The elevation and coordinates of points are recorded during 23 days with excavation progress period. The field excavation process was numerically simulated by using the finite
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