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: The bone mineral density of the lumbar vertebra has been assessed according to the results of the Dual-Energy X-Ray Absorptiometry (DEXA). Although anemia is known to affect bone mineral density, at the present time, it is not clear which vertebra is more affected by this disease. Objective: To evaluate the effects of anemia on the bone mineral density of the lumbar vertebra in comparison with a normal subject and determine which part of the lumbar vertebra is more affected by anemia. Methods: All 205 participants in this study complained of bone pain (90 males and 105 females). 95 patients, including both sexes, suffered from anemia. Additionally, the study included 110 seemingly healthy volunteers as the control group
... Show MoreBackground: Polymethyl methacrylate (PMMA) is the most commonly used material in denture fabrication. The material is far from ideal in fulfilling the mechanical requirements, like low impact and transverse strength, poor thermal conductivity. The purpose of this study was to evaluate the effect of addition a composite of surface treated Nano Aluminum oxide (Al2O3) filler and plasma treated polypropylene fiber (PP) on some properties of denture base material. Materials and methods: One hundred fifty prepared specimens were divided into 5 groups according to the tests, each group consisted of 30 specimens and these were subdivided into 3 groups (unreinforced heat cured acrylic resin as control group),reinforced acrylic resin with( 0.5%wt Nan
... Show MoreThe current study includes 144 samples were 106 bacterial samples belonging to the clinical sources, 38 bacterial samples belonging to the environmental sources to investigate the presence of bacteria P. aeruginosa. The results of diagnosis clarified that there are 45 bacterial isolates belonging to the bacterium P. aeruginosa The examination of the sensitivity of all bacterial isolates was done for elected 45 isolation towards the 11 antibiotic by spread method on the dishes. The results showed that the resistance ratio toward Cefixim, Cefotaxim, Tetracycline, Amoxicillin, Cloxacillin, Methicillin, Erythromycin and Naldixic acid was 77.7, 73.3, 84.4, 82.2, 80, 77.7, 77.7 and 73.3 respectively, While most isolates were sensitive to all o
... Show MoreIn light of the increasing importance of interim financial statements they provided these lists of information that enables users of accounting information to make wise investment decisions and predict the company's activities in light of changes the updated rather than wait until the end of the year and accessing information provided by the annual financial statements. In light of this research has come to the most important set of conclusions the adoption of interim financial information has been audited by the external auditor to the availability of basic qualitative characteristics in the accounting information contained in the (appropriate and timely manner, reliability and comparability) and this in turn leads to the impact on reli
... Show MoreThis paper presents a comparative study between different oil production enhancement scenarios in the Saadi tight oil reservoir located in the Halfaya Iraqi oil field. The reservoir exhibits poor petrophysical characteristics, including medium pore size, low permeability (reaching zero in some areas), and high porosity of up to 25%. Previous stimulation techniques such as acid fracturing and matrix acidizing have yielded low oil production in this reservoir. Therefore, the feasibility of hydraulic fracturing stimulation and/or horizontal well drilling scenarios was assessed to increase the production rate. While horizontal drilling and hydraulic fracturing can improve well performance, they come with high costs, often accounting for up t
... Show MoreAsbestos is a hazard pollutant to human health, exposure to asbestos cause serious health effects and wide range of asbestos-related diseases such as asbestosis, lung cancer and malignant mesothelioma and it has been classified as carcinogen by the World Health Organization WHO which cause a carcinogenic effects. Fibers of asbestos are mainly released from friction product in brakes and clutch linings and from reinforce agent in the asbestos cement industry. The aim of this was to evaluate the levels of asbestos fibers in surroundings air of some dense traffic points in Baghdad, through winter 2020. Materials and Methods: Samples of airs was carried out by directing air flow to a mixed cellulose ester membrane filter mounted on an open face
... Show MoreDelays and disruption are a common issue in both community and personal building programs The problem exists all throughout the world, but it is particularly prevalent in Iraq, where millions of dollars are squandered each time as a outcome. Delays and interruptions may have serious consequences not just for Iraq's construction plans, but also for the country's economic and social status. While numerous studies have been conducted to investigate the factors driving delays and disruption in Iraqi construction projects, slight consideration has been given to by what means project management implements and approaches have affected the occurrence of project delays and disruption. After analyzing the crucial reasons for delays and instability in
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