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.
Three-dimensional cavity was investigated numerical in the current study filled with porous medium from a saturated fluid. The problem configuration consists of two insulated bottom and right wall and left vertical wall maintained at constant temperatures at variable locations, using two discretized heaters. The porous cavity fluid motion was represented by the momentum equation generalized model. The present investigation thermophysical parameters included the local thermal equilibrium condition. The isotherms and streamlines was used to examine energy transport and momentum. The meaning of changing parameters on the established average Nusselt number, temperature and velocity distribution are highlighted and discussed.
The study addresses the problem of stagnation and declining economic growth rates in Arab countries since the eighties till today after the progress made by these countries in the sixties of the last century. The study reviews the e
... Show MoreObjective: To evaluate the functional outcome of percutaneous cross two K wires fixation for Gartland types II and III fractures of humerus. Methodology: This prospective study included80 patients with supracondylar humeral fracture, who underwent closed reduction and fixation by two crossed Kirschner wires. We included children with age < 15 years with closed fractures with Gartland types II and III, while the patient with vascular injury, open, irreducible fractures were excluded. The patients were following up for 6 months and assessed functionally by Flynn’s criteria. Results: The mean age of patients was 8.1 years. Trauma while child playing was the main mechanism of injury in 43 (59.8%) children and 46 (57.5%) fractures were of the
... Show MoreHuman cystic echinococcosis caused by Echinococcus granulosus is one of most important and widespreadparasitic zoonoses in the world. The present study was aimed to identify the immunomodulatory activity ofaqueous extract of Cordia myxa fruit since this plant considers one of medically important plants, which is widely used for treatment of numerous diseases, that correlate with the effectiveness of immunized by hydatid cyst fluid antigen HCFAg. Forty Balb/c mice were divided into equal groups, first group was immunized with HCFAg, the second group was treated with aqueous extract of C. muxa fruit, the third group was immunized and treated, the fourth group was as a control. Delayed type hypersensitivity (DTH), Mitotic index (MI) and histop
... Show MoreTheoretical and experimental investigations of free convection through a cubic cavity with sinusoidal heat flux at bottom wall, the top wall is exposed to an outside ambient while the other walls are adiabatic saturated in porous medium had been approved in the present work. The range of Rayleigh number was and Darcy number values were . The theoretical part involved a numerical solution while the experimental part included a set of tests carried out to study the free convection heat transfer in a porous media (glass beads) for sinusoidal heat flux boundary condition. The investigation enclosed values of Rayleigh number (5845.6, 8801, 9456, 15034, 19188 and 22148) and angles of inclinations (0, 15, 30, 45 and 60 degree). The numerical an
... Show More