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.
Abstract:
Objective: To self-evaluate the effect of SBAR (Situation, Background, Assessment, and Recommendation) educational program on nurse and midwives practices in maternal health report documentation accuracy.
Methods: A quasi- experimental design was carried with the application of pre- post test for nurses and midwives’ knowledge and practices regarding SBAR communication tool. The study was held in Al-Elwia maternity teaching hospital, Al –Karckh maternity hospital and Al-Yarmouk teaching Hospital. purposive sample as it was convenient with inclusion criteria consisted of (84) nurse and midwives. The questionnaire comprised of demographic data, nurses- midwives practices of SBAR using (5) level Likert scale for assessme
In this study, manganese dioxide (MnO₂) nanoparticles (NPs) were synthesized via the hydrothermal method and utilized for the adsorption of Janus green dye (JG) from aqueous solutions. The effects of MnO₂ NPs on kinetics and diffusion were also analyzed. The synthesized NPs were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), energy-dispersive X-ray analysis (EDX), and Fourier-transform infrared spectroscopy (FT-IR), with XRD confirming the nanoparticle size of 6.23 nm. The adsorption kinetics were investigated using three models: pseudo-first-order (PFO), pseudo-second-order (PSO), and the intraparticle diffusion model. The PSO model provided the best fit (R² = 0.999), indicating that the adsorpti
... Show MoreIndustrial development has recently increased, including that of plastic industries. Since plastic has a very long analytical life, it will cause environmental pollution, so studies have resorted to reusing recycled waste plastic (sustainable plastic) to produce environmentally friendly concrete (green concrete). In this research, producing environmentally friendly load-bearing concrete masonry units (blocks) was considered where five concrete mixtures were compressed at the blocks producing machine. The cement content reduced from 400 kg/m3 (B-400) to 300 kg/m3 (B-300) then to 200 kg/m3 (B-200). While (B-380) was produced using 380 kg/m3 cement and 20 kg/m3 nano-sil
... Show MoreIn recent years, various methods have been developed to enhance the characteristics of asphalt pavement in order to face the continuous challenges of increasing traffic loads and changing climate conditions. One of the most popular and successful methods is modifying the asphalt mixtures or asphalt binder with the addition of polymers. Therefore, two types of Polyethylene (PE) polymer, High-Density PE (HDPE) and Low-Density PE (LDPE), are used in this research. Two methods were applied to prepare PE-modified asphalt mixtures: Semi-Wet Method (S-WM) and Dry Method (DM). The findings of the investigation indicated that the addition of PE polymer can reduce the wear loss of aggregate. In general, the experimental results revealed that asphalt
... Show MoreA novel technique for nanoparticles with a chemical method and impact for resistance bacteria methicillin-resistant Staphylococcus aureus (MRSA), UV-visible analysis confirmed the by Fourier transform infrared spectroscopy (FT-IR) and Energy dispersive X-Ray (EDX), Scanning electron microscope (SEM) and X-ray diffraction pattern estimation antimicrobial excellent antibacterial activity against MRSA (with zone of inhibition of 11 ± 02 mm , 9 ± 01 mm,8 ± 03 mm and 7.5 ± 02 mm and 6.5 ± 02 mm) at different concentrations (0.5 ,0.25, 0.125, 0.0625, 0.03125) mg/ml while good activity was 16 ± 03 mm at 17 ± 02 mm zone at 0.25, 0.125 mg/mL, respectively. The increase in microorganism resistance to antibiotics a couple of have caused
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