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.
One of the most important problems in the oil production process and when its continuous flow, is emulsified oil (w/o emulsion), which in turn causes many problems, from the production line to the extended pipelines that are then transported to the oil refining process. It was observed that the nanomaterial (SiO2) supported the separation process by adding it to the emulsion sample and showed a high separation rate with the demulsifiers (RB6000) and (sebamax) where the percentage of separation was greater than (90 and 80 )% respectively, and less than that when dealing with (Sodium dodecyl sulfate and Diethylene glycol), the percentage of separation was (60% and 50%) respectively.
The high proportion
... Show MoreObjective(s): The main aim of the study is to determine the level of burden on mothers toward children with anorectal malformation.
Methodology: A descriptive study was carried out at Welfare Pediatric Teaching Hospital and Central Pediatric Teaching Hospital in Baghdad City. From November 15th, 2017 to April 29th, 2018. Convenient sample comprised of (140) children mothers with anorectal malformation were interviewed for the study. The instrument of study is composed of six domains related mothers' burden toward psychosocial burden as a result of child with anorectal malformation. Validity of the study instrument was determined through a panel of experts and the reliability of the questionnaire is determined in a pilot study among (1
This paper introduces a non-conventional approach with multi-dimensional random sampling to solve a cocaine abuse model with statistical probability. The mean Latin hypercube finite difference (MLHFD) method is proposed for the first time via hybrid integration of the classical numerical finite difference (FD) formula with Latin hypercube sampling (LHS) technique to create a random distribution for the model parameters which are dependent on time [Formula: see text]. The LHS technique gives advantage to MLHFD method to produce fast variation of the parameters’ values via number of multidimensional simulations (100, 1000 and 5000). The generated Latin hypercube sample which is random or non-deterministic in nature is further integ
... Show MoreBackground: Synthetic hydroxyapatite,(Ca10(PO4)6(OH2) can directly bond to bones without infection and fibrous encapsulation, thus is regarded as bioactive and biocompatible. The aim of the study was the estimation of microarchitecture bone parameters include bone mass (gm/cm2) cortical bone width (mm), thread width (mm), marrow space star volume analysis (V*m) and osteoblast, osteocyte cell number. Materials and methods: Ninety-six (96) commercially pure titanium CpTi) used in this study, (48) implants were coated with HA by dipping coating and (48) implants were used as control. They were inserted in (32) Newzland white rabbits and followed for 2 & 6 weeks. Mechanical torque removal test and histomorphometric analysis of bone microarchit
... Show MoreOne of the most popular causes for implant infection is dental plaque bacteria. Previous studies have shown the bactericidal effect of CO2 laser irradiation on bacteria associated with soft tissue surrounding the implant materials. No published studies have examined the effect of irradiation by CO2 laser on Streptococcus oralis and Staphylococcus aureus.The aim of this study was to evaluate the bactericidal effect of CO2 laser on bacteria that are causing dental implant infections. This study was carried out on two isolates of bacterial species out of 25 samples, isolated from patients having soft tissue infections around the dental implant. These two pure isolates including Streptococcus oralis and Staphylococcus aureus were identified
... Show MoreIn this paper, we introduce the concept of cubic bipolar-fuzzy ideals with thresholds (α,β),(ω,ϑ) of a semigroup in KU-algebra as a generalization of sets and in short (CBF). Firstly, a (CBF) sub-KU-semigroup with a threshold (α,β),(ω,ϑ) and some results in this notion are achieved. Also, (cubic bipolar fuzzy ideals and cubic bipolar fuzzy k-ideals) with thresholds (α,β),(ω ,ϑ) are defined and some properties of these ideals are given. Relations between a (CBF).sub algebra and-a (CBF) ideal are proved. A few characterizations of a (CBF) k-ideal with thresholds (α, β), (ω,ϑ) are discussed. Finally, we proved that a (CBF) k-ideal and a (CBF) ideal with thresholds (α, β), (ω,ϑ) of a KU-semi group are equivalent relations.
Sickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti
... Show MoreTetralogy of Fallot (TOF) is the most prevalent cyanotic congenital heart disease, for which surgical correction remains the definitive treatment. Balloon dilatation of the pulmonary artery provides recognised immediate palliative benefits in selected TOF patients. Nonetheless, optimal patient selection and midterm outcomes remain subjects of ongoing debate. This study aimed to assess midterm results following pulmonary valvoplasty at 6 months period in children with TOF focusing on defining factors that affect response to palliative therapy