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.
ABSTRACT Background: Generally, the facial esthetics depends on the esthetic appearance of the maxillary anterior teeth. The purposes of this study were to analyse the macro-aesthetic appearance of the face and the micro-aesthetic appearance of the maxillary anterior teeth to establish the normative values for class I normal occlusion and to detect possible gender differences. Materials and methods: The sample consisted of 120 Iraqi adults (60 males and 60 females) aged (18-23) years. Each individual was clinically examined, then with cephalostat based head position, extraoral and intraoral photographs were taken for each subject. The facial and dental measurements were measured using AutoCad program 2014. Descriptive statistics was obtaine
... Show MoreUniversity campuses in Iraq are substantial energy consumers, with consumption increasing significantly during periods of high temperatures, underscoring the necessity to enhance their energy performance. Energy simulation tools offer valuable insights into evaluating and improving the energy efficiency of buildings. This study focuses on simulating passive architectural design for three selected buildings at Al-Khwarizmi College of Engineering (AKCOE) to examine the effectiveness of their cooling systems. DesignBuilder software was employed, and climatic data for a year in Baghdad was collected to assess the influence of passive architectural strategies on the thermal performance of the targeted buildings. The simulations revealed that the
... Show MoreObjective)s): To evaluate the quality of life for adult clients with hypermobility syndrome at private clinics in Baghdad City. Methodology: A cross-sectional study used a purposive ‘’non-probability’’ sample of (75) adult clients with Hypermobility Syndrome (HMS) male and female who age (25-64) years. The data were collected through the utilization of standard developed questionnaire of the world health organization (WHO). Data collected by interview with each client who is involved in the study. Each interview takes approximately (20) minutes. Results: The study revealed that there is an effect of hypermobility syndrome on the quality of life, which recorded fair level in general. The study also reported that there is an effect
... Show MoreTwenty bacterial isolates were identified as Staphylococcus aureus collected from wounds and catheters related infections. A capsulated S. aureus isolate was chosen after performing serum soft agar test, for this study Neutropenic mice were challenged with capsulated S. aureus ,and the effect of G-CSF with or without moxifloxacin was studied. The results indicated that the addition of G-CSF to moxifloxacin therapy have a synergistic effect in the killing of the bacteria, while when each G-CSF and moxifloxacin were used seperately have a similar effect on bacterial killing. It was found that the moxifloxacin has the same activity as G_CSF but is less costly than the latter one.
The effects of T-shaped fins on the improvement of phase change materials (PCM) melting are numerically investigated in vertical triple-tube storage containment. The PCM is held in the middle pipe of a triple-pipe heat exchanger while the heat transfer fluid flows through the internal and external pipes. The dimension effects of the T-shaped fins on the melting process of the PCM are investigated to determine the optimum case. Results indicate that while using T-shaped fins improves the melting performance of the PCM, the improvement potential is mainly governed by the fin’s body rather than the head. Hence, the proposed T-shaped fin did not noticeably improve melting at the bottom of the PCM domain; additionally, a flat fin is ad
... Show MoreThe research aims to determine the effectiveness of auditing in light of the relationship between the governance of investment policy and the cost of debt in companies listed on the Iraqi Stock Exchange. The problem of the research is to raise the question about the effect of the governance of investment policy and the cost of debt on the effectiveness of auditing and auditors. During the research, the most important of them were: the existence of an impact relationship on the effectiveness of auditing through the relationship between the governance of investment policy and the cost of debt. The companies listed in the Iraqi Stock Exchange lack an effective proposed guide or framework dealing with the governance of investment policy desp
... Show MoreIn this study, geopolymer mortar was designed in various experimental combinations employing 1% micro steel fibers and was subjected to different temperatures, according to the prior works of other researchers. The geopolymer mortar was developed using a variety of sustainable material proportions (fly ash and slag) to examine the influence of fibers on its strength. The fly ash weight percentage was 50%, 60%, and 70% by slag weight to study its effect on the geopolymer mortar's properties. The optimal ratio produced the most significant results when mixed at a 50:50 ratio of fly ash and slag with 1% micro steel fibers at curing temperature 240oC for 4 hours through two days. The compressive strength of the geopolymer mortar increas
... Show MoreThe particle-hole state densities have been calculated for 232Th in
the case of incident neutron with , 1 Z Z T T T T and 2 Z T T .
The finite well depth, surface effect, isospin and Pauli correction are
considered in the calculation of the state densities and then the
transition rates. The isospin correction function ( ) iso f has been
examined for different exciton configurations and at different
excitation energies up to 100 MeV. The present results are indicated
that the included corrections have more affected on transition rates
behavior for , , and above 30MeV excitation energy
The influence of fear on the dynamics of harvested prey-predator model with intra-specific competition is suggested and studied, where the fear effect from the predation causes decreases of growth rate of prey. We suppose that the predator attacks the prey under the Holling type IV functional response. he existence of the solution is investigated and the bounded-ness of the solution is studied too. In addition, the dynamical behavior of the system is established locally and globally. Furthermore, the persistence conditions are investigated. Finally, numerical analysis of the system is carried out.
Recently, environmental noise has arisen from various sources, such as those from exhaust mufflers of combustion engines found in cars, trucks, or power generators, which produce significant noise during their operation. Controlling the radiated noise from these mufflers is a major factor in improving acoustic comfort and minimizing the impact on the surrounding communities. Numerous research has been presented for this reason by modification of the internal structure of the exhaust muffler. The main objective of this work is to reduce the noise level emitted from exhaust mufflers. This can be achieved by adjusting structure parameters to attenuate the surrounding environment's radiated noise. Analysis of pressure-wave propagation h
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