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.
Background: Studying and investigating the transverse strength(Ts), impact strength(Is), hardness (Hr) and surface roughness(Ra) of conventional and modified autopolymerizing acrylic resin with different weight percentages of biopolymer kraftlignin, after curing in different water temperatures; 40°C and 80°C. Material and Methods: Standard acrylic specimens were fabricated according to ADA specification No.12 for transverse strength, ISO 179 was used for impact testing, Shore D for hardness and profilometerfor surface roughness. The material lignin first dispersed in the monomer, then the powder PMMA is immediately added. Ligninadded in different weight percentages. Then cured using pressure pot (Ivomet) in two temperatures;40°C a
... Show MoreABSTRACT Background: Color changes that are detectable to human eye can affect the esthetic appearance of ceramic veneers. The purpose of this study was to evaluate and compare the effect of artificial accelerated aging on the color of ceramic veneers cemented with different resin cements. Materials and Methods: Sixty discs were prepared with 0.5 mm thickness, 30 discs made from IPS e.max press (Ivoclar Vivadent) and 30 discs were made from VITA Enamic (VITA Zahnfabrik). The discs were cemented with three resin cements: Variolink Veneer MV 0 shade (Ivoclar Vivadent), Rely X veneer Translucent shade (3M ESPE) and NX3 Nexus Clear shade (Kerr Corporation) with 0.1 mm thickness. The spectrophotometer Easyshade Advance was used to measure the co
... Show Moreهدفت الدراسة إلى التعرف على مستوى تقييم الإعلاميين العراقيين المقيمين في الأردن لتغطية الإصلاحات السياسية و الاقتصادية في العراق من قبل الفضائيات العراقية. و هدفت كذلك إلى التعرف على الف
Hamiltonians, momentum operators, and other quantum-mechanical perceptible take the form of self-adjoint operators when understood in quantized physical schemes. Unbounded and self-adjoint recognition are required in the situation of positive measurements. The selection of the proper Hilbert space(s) and the selection of the self-adjoint extension must be made in order for this to operate. In this effort, we define a new extension positive measure depending on the measurable field of nonzero positive self-adjoint operator in unbounded Hilbert space of analytic functions of complex variables. Consequently, we define an extension norm in the same space. We show several new properties of the suggested operator and its adjoin operator. These pr
... Show MoreBackground Alloys with the addition of zirconium and niobium eliminate the adverse effects of aluminum and vanadium on the nervous system, the possibility of metallosis and the initiation of diseases (including cancers or Alzheimer›s disease). In addition, they have better corrosion resistance, and a Young›s modulus value similar to longitudinal bone tissue. Therefore, only choosing appropriate materials does not guarantee proper functioning of the implants, the surfaces of the implants also have to be suitable to meet the requirements. The laser surface hardening process modifies the surface properties by imparting microstructural changes, whereas surface remelting induces changes in the surface topography, roughness, wettability and w
... Show MoreEvolution has become a feature of this era because of the speed that makes it open multiple horizons and many to identify everything that is new in different areas and also characterized by the competitive position of emotional attitudes changing depending on the positions of winning and defeat, and the use of training methods are the most important pillars of the game of wrestling, The methods contribute to raising the level of the wrestler and refining his physical and skill potential. The problem of the research is that the shooting exercises from above the chest are very important in Roman wrestling and can be terminated by the player. Through very personal interviews for coaches and concluded that there is a weakness in the level of fl
... Show MoreMethotrxate (MTX) has become the standard of care and first-line therapy for patients who have RA and consider as a gold standard of treatment for RA. The role of MTX in the treatment of RA has now been well established. The use of MTX treatment of RA inhibits proliferation of the lymphocytes, reduces signs and symptoms this disease, reduces progression damage of the joints and improves quality of life outcome. Progranulin (PGRN) acts a role in autoimmune inflammatory, has important function in several processes including immune response. Present study has conducted to find the effect of MTX drugs as a therapeutic target for RA patients because of its ability to bind with tumor necrosis factor receptor (TNFR), with progranulin, obestatin an
... Show MoreBeta thalassemia major (BTM) is a genetic disorder that has been linked to an increased risk of contracting blood-borne viral infections, primarily due to the frequent blood transfusions required to manage the condition. One such virus that can be transmitted through blood is the Human Parvovirus B19 (B19V). The aim of this study was to investigate the frequency and molecular detection of B19V. This study included 60 blood donors as controls and 120 BTM patients. B19V was identified by serology, which measured B19-IgG and B19-IgM antibodies. Nested Polymerase Chain Reaction (nPCR) was employed to target the VP1/VP2 structural proteins. The results showed that B19V seropositivity represents 27.5% (33 out of 120) in BTM patients, and
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