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.
In this paper two modifications on Kuznetsov model namely on growth rate law and fractional cell kill term are given. Laplace Adomian decomposition method is used to get the solution (volume of the tumor) as a function of time .Stability analysis is applied. For lung cancer the tumor will continue in growing in spite of the treatment.
A numerical method for the calculation of the three-dimensional wake rollup behind symmetric wings with ground effect and its aerodynamic characteristics for steady low subsonic flow have been developed. A non-planar quadrilateral vortex-ring method with vortex wake relaxation iterative scheme for lifting surfaces is obtained. A computer program was build to treat wings with breaks, span wise trailing edge flaps, local dihedral angle, camber, twist and ground effect. Forces and moments are obtained from vector product of local velocity and vortex strength multiplied by density. The program has been validated for a number of configurations for which experimental data is available. Good agreement has been obtained for these configurations. Al
... Show MoreWe have studied new subclass B (A, B,γ) over multivalent functions. We have present some effects because of the category B (A, B,γ). We bear mentioned simple properties, convolution properties, incomplete sums, weighted mean, arithmetic mean, linear combination, inclusion rapport and neighborhood properties, software concerning fractional calculus then vile residences because of both the classes…
The present investigation focuses on the response of simply supported reinforced concrete rectangular-section beams with multiple openings of different sizes, numbers, and geometrical configurations. The advantages of the reinforcement concrete beams with multiple opening are mainly, practical benefit including decreasing the floor heights due to passage of the utilities through the beam rather than the passage beneath it, and constructional benefit that includes the reduction of the self-weight of structure resulting due to the reduction of the dead load that achieves economic design. To optimize beam self-weight with its ultimate resistance capacity, ten reinforced concrete beams having a length, width, and depth of 2700, 100, and
... Show MoreIn this paper, we study, in details the derivation of the variational formulation corresponding to functional with deviating arguments corresponding to movable boundaries. Natural or transversility conditions are also derived, as well as, the Eulers equation. Example has been taken to explain how to apply natural boundary conditions to find extremal of this functional.
The purpose of this paper is to solve the stochastic demand for the unbalanced transport problem using heuristic algorithms to obtain the optimum solution, by minimizing the costs of transporting the gasoline product for the Oil Products Distribution Company of the Iraqi Ministry of Oil. The most important conclusions that were reached are the results prove the possibility of solving the random transportation problem when the demand is uncertain by the stochastic programming model. The most obvious finding to emerge from this work is that the genetic algorithm was able to address the problems of unbalanced transport, And the possibility of applying the model approved by the oil products distribution company in the Iraqi Ministry of Oil to m
... Show MoreA new panel method had been developed to account for unsteady nonlinear subsonic flow. Two boundary conditions were used to solve the potential flow about complex configurations of airplanes. Dirichlet boundary condition and Neumann formulation are frequently applied to the configurations that have thick and thin surfaces respectively. Mixed boundary conditions were used in the present work to simulate the connection between thick fuselage and thin wing surfaces. The matrix of linear equations was solved every time step in a marching technique with Kelvin's theorem for the unsteady wake modeling. To make the method closer to the experimental data, a Nonlinear stripe theory which is based on a two-dimensional viscous-inviscid interac
... Show MoreDue to the vast using of digital images and the fast evolution in computer science and especially the using of images in the social network.This lead to focus on securing these images and protect it against attackers, many techniques are proposed to achieve this goal. In this paper we proposed a new chaotic method to enhance AES (Advanced Encryption Standards) by eliminating Mix-Columns transformation to reduce time consuming and using palmprint biometric and Lorenz chaotic system to enhance authentication and security of the image, by using chaotic system that adds more sensitivity to the encryption system and authentication for the system.
In this paper, a discretization of a three-dimensional fractional-order prey-predator model has been investigated with Holling type III functional response. All its fixed points are determined; also, their local stability is investigated. We extend the discretized system to an optimal control problem to get the optimal harvesting amount. For this, the discrete-time Pontryagin’s maximum principle is used. Finally, numerical simulation results are given to confirm the theoretical outputs as well as to solve the optimality problem.