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.
The study objectives were to 1) explore the real-world experience of hospital pharmacists with the differences in effectiveness safety, and interchangeability between biosimilar medicines and their reference biological counterparts, 2) reveal pharmacist recommendations to enhance the safety of biopharmaceutical medicines in public hospitals.
The study has a mixed-method design where the core component was qualitative (interviews) and the supplemental component was quantitative (adverse drug reaction, ADR, reports). This qualitative component included semi-structured (mostly face-to-face) interviews involving hospital pharmacists from different hospitals with experience with biological or biosimilar medicines. The interviews were c
... Show MoreHepatitis B infection is a prominent infectious disease caused by hepatitis B virus (HBV), which infect liver and is considered as the main cause of liver cirrhosis, fibrosis and liver cancer worldwide. A pro-inflammatory cytokine Interleukin32 is believed to have a role in chronic HBV infections. Since its role in CHB infections is remain unclear, this study was done to detect IL-32 gene expression in CHB patients in order to identify its exact role. A total number of 110 blood samples were collected from Gastroenterology and Hepatology Teaching Hospital in Baghdad Medical City from CHB patients for both males and females with different age groups according to the research ethics form then sent to Central Public Health Laboratory (CPHL),
... Show MoreThis study includes the application of non-parametric methods in estimating the conditional survival function of the Beran method using both the Nadaraya-Waston and the Priestley-chao weights and using data for Interval censored and Right censored of breast cancer and two types of treatment, Chemotherapy and radiation therapy Considering age is continuous variable, through using (MATLAB) use of the (MSE) To compare weights The results showed a superior weight (Nadaraya-Waston) in estimating the survival function and condition of Both for chemotherapy and radiation therapy.
The disposal of textile effluents to the surface water bodies represents the critical issue especially these effluents can have negative impacts on such bodies due to the presence of dyes in their composition. Biological remediation methods like constructed wetlands are more cost-effective and environmental friendly technique in comparison with traditional methods. The ability of vertical subsurface flow constructed wetlands units for treating of simulated wastewater polluted with Congo red dye has been studied in this work. The units were packed with waterworks sludge bed that either be unplanted or planted with Phragmites australis and Typha domingensis. The efficacy of present units was evaluated by monitoring of DO, Temperature, COD
... Show MoreThe objective of the study: To diagnose the reality of the relationship between the fluctuations in world oil prices and their reflection on the trends of government spending on the various economic sectors.
The research found: that public expenditures contribute to the increase of national consumption through the purchase of consumer goods by the state for the performance of the state's duties or the payment of wages to employees in the public sector and thus have a direct impact on national consumption
The results of the standard tests showed that there is no common integration between the oil price fluctuations and the government expenditure on the security sector through the A
... Show MoreSeveral correlations have been proposed for bubble point pressure, however, the correlations could not predict bubble point pressure accurately over the wide range of operating conditions. This study presents Artificial Neural Network (ANN) model for predicting the bubble point pressure especially for oil fields in Iraq. The most affecting parameters were used as the input layer to the network. Those were reservoir temperature, oil gravity, solution gas-oil ratio and gas relative density. The model was developed using 104 real data points collected from Iraqi reservoirs. The data was divided into two groups: the first was used to train the ANN model, and the second was used to test the model to evaluate their accuracy and trend stability
... Show MoreThe research aimed to measure the reality of monetary policy and its role in neutralizing the impact of fluctuations in total domestic oil prices, through the most important monetary policy variable (money supply). An example of this is using a simple technique in the previous example, turning it into a straightforward user interface by (Judd and Kunee). After estimating the impact of the policy with the domestic gross domestic oil prices in Iraq, the effect of fluctuations in the domestic gross domestic oil prices in the simple regression model, while the morale of oil prices was not proven with a negative sign, while the morale of money supply and their impact on the increase of the domestic was proven in the multiple regressio
... Show MoreBackground: Complete seal of the root canal system following its chemo-mechanical debridement plays a pivotal role for achieving successful endodontic treatment. This can be established by reducing the gaps between the core filling material and root canal wall. Aim: To assess and compare the dislocation resistance of root canals obturated with GuttaFusion® and TotalFill BC sealer versus single cone obturation technique and TotalFill BC sealer after instrumentation of the canals with WaveOne, ProTaper Next and ProTaper Universal system. Material and Method: Sixty extracted human permanent mandibular premolars were conducted in the current study. The teeth were decorated and left the root with 15mm length; the roots were divided randoml
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