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: evaluate the effects of three different intracoronal bleaching agents on the shear bond strengths (SBS) and failure site of stainless steel and monocrystalline (sapphire) orthodontic brackets bonded to endodontically treated teeth using light cured orthodontic adhesive in vitro. Materials and methods: Eighty extracted sound human upper first premolars were selected, endondontically treated and randomly divided equally (according to the type of the brackets used) into two main groups (n = 40 per group). Each main group were subdivided (according to the bleaching agent used) into four subgroups 10 teeth each; as following : control (un bleached) group, hydrogen peroxide group (Hp) 35%, carbamide peroxide group (CP) 37% group and s
... Show MoreThe 3D electro-Fenton technique is, due to its high efficiency, one of the technologies suggested to eliminate organic pollutants in wastewater. The type of particle electrode used in the 3D electro-Fenton process is one of the most crucial variables because of its effect on the formation of reactive species and the source of iron ions. The electrolytic cell in the current study consisted of graphite as an anode, carbon fiber (CF) modified with graphene as a cathode, and iron foam particles as a third electrode. A response surface methodology (RSM) approach was used to optimize the 3D electro-Fenton process. The RSM results revealed that the quadratic model has a high R2 of 99.05 %. At 4 g L-1 iron foam particles, time of 5 h, and
... Show MoreThis thesis aims to show the effects of the development of the traditional manual system of the tax accounting process to the electronic system by the activation of the tax identification numbers (TINs) mechanism. The impact of this development is facilitating the tax accounting process, tax fraudand thus increasing the tax outcome.To prove the research hypothesis, an electronic system was designed based on income tax report, estimation note of individuals, in additional to using Adobe Dreamweaver application to write PHP, HTML, Javascript, and CSS web languages to implement the proposed system. The research reached a set of conclusions, the most important of which is; not enough the communication methods between the Genera
... Show MoreMost of World nations are striving to provide the necessary needs to protect their economic properties assets against natural or abnormal disasters that may be inflicted on such property and the means that used by such countries to reduce the damages is insurance, whereas insurance as a system that collects and distributes different risks into the group thus to achieve a social symbiosis between individuals. The system works to transfer the risks from the individual to the group and then distributes the losses to all members of the group.
According to the importance of the insurance sector and the need to develop it as well as working on improving its performance, this search aims to identify the ac
... Show More(Thimma) in Arabic means compact, and immunity. (People of Thimma) are the free non-Muslim people under Muslim rule. This includes Heavenly Religions people, i. e., Christian and Jews).
They have been called (People of Thimma) because they had paid (Jizyah: tribute) so they became safe for their souls, honor, properties at the custody of Muslims.
Islamic law had posed (Jizyah: tribute) upon the Jews and Christians who were living under Muslim rule as a reaction of not embracing Islam Faith against securing their rights and freedom.
Freedoms secured by Islam for the (People of Thimma) had been many, including the right of faith, not coercing them to be Muslim, the right to live, to possess properties, protect and secure them, the
The life insurance companies need a sound system to use it in selecting Insurable risks so they can avoid or reduce possible losses that may be insured to a minimum levels , But the application within IRAQI INSURANCE COMPANY reflects that it still depends on a traditional ways in the procedures used to select that risks .
This research represents an attempt to put acceptable suggestions about developing a system for selecting insurable risks which used now by iraqi insurance company by recognizing the risks of life insurance , determining kinds of risks which can difined as normal and upnormal risks , rectification of the
... Show MoreOne of the issues that occupied the doctrinal mind and differed the attention of scientists is the question of (the quality of the composition of God), so each team of scientists went the doctrine that led him to his evidence.
I wanted through this research to stand on the truth of the matter according to what I reached after looking at the views of the people and their evidence and direct the dispute between scientists.
It was presented with an introduction that was an introduction to the issue, where it began with the introduction of the definition of attributes, and then began to define the composition and view the views of scientists and evidence, and then concluded it with a conclusion mentioning what I have reached.
The research aims to identify the level of balance in the architectural thought influenced by the rational type human consciousness, the materialistic based on the Empirical type, moral based on human experience as source of knowledge.
This was reflected in architecture in the specialized thought that the mind is the source of knowledge which explains the phenomena of life. The rational approach based on objectivity and methodology in (Form Production), the other approach is based on subjectivity in form production (Form Inspiration).
The research problem is that there is imbalance in the relationship between the rational side and the human experience in architecture, which led into imbalance between theo
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