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 objective of the present study is to determine the nature and direction of the correlation between mathematical excellence and learning styles as defined by the Entwistle, model in fifth-grade scientific female students. The descriptive correlational approach was implemented by the two researchers to accomplish the research objectives. A scale was developed to assess the learning styles of female students in the sample in accordance with the Entwistle, model. : (Knowledge, understanding, application, analysis, synthesis, evaluation, systematic thinking, creativity), and the research community was determined by the female students of the scientific fifth grade in the morning preparatory and secondary schools of the General Direct
... Show MoreIn this paper, a cognitive system based on a nonlinear neural controller and intelligent algorithm that will guide an autonomous mobile robot during continuous path-tracking and navigate over solid obstacles with avoidance was proposed. The goal of the proposed structure is to plan and track the reference path equation for the autonomous mobile robot in the mining environment to avoid the obstacles and reach to the target position by using intelligent optimization algorithms. Particle Swarm Optimization (PSO) and Artificial Bee Colony (ABC) Algorithms are used to finding the solutions of the mobile robot navigation problems in the mine by searching the optimal paths and finding the reference path equation of the optimal
... Show MoreTirzepatide is a revolutionary and promising medication with a high impact in the treatment of Obesity and T2DM with their complications. Its efficacy was proven through different trials in achieving favorable weight loss and a significant reduction in glycemic index. It also treated a large diversity of related co-morbidities, including fatty liver, cardiovascular disease, dyslipidemia, and more. Tirzepatide is well tolerated, has a good safety profile, and is highly reliable and suitable for use in a population.
Background: Oral pyogenic granuloma (PG) is a clinicopathological entity that could develop due to the reaction to a variety of stimuli, such as low-grade local irritation, traumatic damage, and hormonal stimulation. There are two histopathological types of pyogenic granuloma; lobular type -capillary hemangioma (LCH) and non-lobular type; with PG,LCH has highly vascular, diffuse capillary growth while non- lobular variant mimicking granulation tissue with heavily inflammated stroma. The study aims were to review the clinical and histopathological spectrum of an oral pyogenic granuloma from different intraoral sites in order to avoid diagnostic pitfalls associated with similar morphological lesions and to determine
... Show MoreThe present research aims to study the effect of friction stir welding (FSW) parameters on temperature distribution and tensile strength of aluminum 6061-T6. Rotational and traverse speeds used were (500,1000,1400 rpm) and (14,40,112 mm/min) respectively. Results of mechanical tests showed that using 500rpm and 14mm/min speed give the best strength. A three- dimensional fully coupled thermal-stress finite element model via ANSYS software has been developed. The Rate dependent Johnson-Cook relation was utilized for elasto-plastic work deformations. Heat-transfer is formulated using a moving heat source, and later used the transient temperature outputs from the thermal analysis to determine equivalent stresses in the welde
... Show MoreNine new compounds of 2-amino-5-chlorobenzothiazole derivatives were synthesized. These new compounds were formed through the reaction of 2-amino-5-chlorobenzothiazole 1 with ethyl chloroacetate and KOH, which gave an ester derivative 2, followed by refluxing compound 2 with hydrazine hydrate to afford hydrazide derivative 3. The reaction of compound 3 with CS2 and KOH gave 1,3,4-oxadiazole-2-thiol derivative 4, and then the reaction of compound 2 with thiosemicarbazide to produce compound 5 then treated it with 4%NaOH led to ring closure to provide 1,2,4-triazole-3-thiol derivative
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