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.
Generally, statistical methods are used in various fields of science, especially in the research field, in which Statistical analysis is carried out by adopting several techniques, according to the nature of the study and its objectives. One of these techniques is building statistical models, which is done through regression models. This technique is considered one of the most important statistical methods for studying the relationship between a dependent variable, also called (the response variable) and the other variables, called covariate variables. This research describes the estimation of the partial linear regression model, as well as the estimation of the “missing at random” values (MAR). Regarding the
... Show MoreThis work aims to investigate the integrated ultra-dense wavelength division multiplexing (UDWDM) and polarization division multiplexing (PDM) schemes incorporated in the free space optic (FSO) communication system. Erbium-doped fiber amplifiers (EDFAs) are used as post and pre-amplifiers in the proposed UDWDM–PDM–FSO system to boost the transmission power for increasing the distance. Thirty-two channels are transported over the FSO link to realize the total data transmission of 160 and 320 Gbps with 0.08 and 0.1 nm channel spacing, respectively. Results are also reported with non-return to zero modulation schemes. The performance of the proposed UDWDM–PDM–FSO transmission sys
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 MoreFive novel nickel, iron, cobalt, copper, and mercury complexes were synthesized from tetraazamacrocyclic Schiff base ligand (L), which were derived from 3-(4-(dimethyl amino) benzylidene) pentane-2,4-dione and 1,2- diaminocyclohexane in a 2:2 molar ratio. Many physico-chemical and spectroscopic techniques, including melting point, 1HNMR, 13CNMR, elemental analysis, molar conductance, magnetic susceptibility, UV-Vis, FT-IR, and thermogravimetric analysis (TGA), were used to characterize the Schiff base ligand and all metal complexes. The octahedral geometry of all the complexes [MLCl2] is confirmed by spectroscopic analyses. All substances' biological properties, such as their in vitro antioxidant activity or level of free radical scavenging
... Show MoreBackground Numerous studies indicated that workers in the health sector suffer from work stress, hassles, and mental health problems associated with COVID-19, which negatively affect the completion of their job tasks. These studies pointed out the need to search for mechanisms that enable workers to cope with job stress effectively. Objectives This study investigated psychological flow, mental immunity, and job performance levels among the mental health workforce in Saudi Arabia. It also tried to reveal the psychological flow (PF) and mental immunity (MI) predictability of job performance (JP). Method A correlational survey design was employed. The study sample consisted of 120 mental health care practitioners (therapists, psychologists, co
... Show MoreIn this work, an important sugar alkynyl ether has been synthesized in two subsequent steps starting from commercially available D-galactose (3). This kind of compounds is highly significant in the synthesis of biologically active molecules such as 1,2,3-triazole and isoxazoles. In the first step, galactose (3) was reacted with acetone in the presence of anhydrous copper (II) sulfate to produce 1,2:3,4-di-O-isopropylidene-α-D-galactose (4) in good yield. The latter was reacted with excess of 3-bromoprop-1-yne in DMF in the presence of NaOH pellets to afford the target molecule 5 in a very good yield. The temperature of this step is crucial in determining the reaction yi
... Show MoreDate stones were used as precursor for the preparation of activated carbons by chemical
activation with ferric chloride and zinc chloride. The effects of operating conditions represented
by the activation time, activation temperature, and impregnation ratio on the yield and adsorption
capacity towards methylene blue (MB) of prepared activated carbon by ferric chloride activation
(FAC) and zinc chloride activation (ZAC) were studied. For FAC, an optimum conditions of 1.25
h activation time, 700 °C activation temperature, and 1.5 impregnation ratio gave 185.15 mg/g
MB uptake and 47.08 % yield, while for ZAC, 240.77 mg/g MB uptake and 40.46 % yield were
obtained at the optimum conditions of 1.25 h activation time, 500
Denture bases are fabricated routinely using Poly(methyl methacrylate) (PMMA) acrylic resin. Yet, it is commonly known for its major drawbacks such as insufficient strength and ductility. The purpose of this study was to improve the performance of PMMA acrylic resin as a denture base material by reinforcement with surface treated lithium disilicate glass ceramic powder. The ceramic powder was prepared by grinding and sieving IPS e.max CAD MT blocks. Then, the powder was surface treated with an organosilane coupling agent (TMSPM) and added to PMMA in amount of 1%, 3%, 5% and 7% by weight. Characterizations of the powder was done by particle size analysis, XRD and FTIR. Transverse strength, Impact strength, Shore D hardness and surface roughn
... Show More