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 current research aims to identify: 1) the challenges facing blended education from the point of view of teachers of students with disabilities. 2) The challenges facing blended education from the point of view of teachers of students with disabilities according to the gender variable (males-females). 3) The challenges facing blended education from the point of view of teachers of students with disabilities, according to the academic qualifications of graduates
(institute-bachelors-masters). 4) The challenges facing blended education from the point of view of male and female teachers, according to the functional service period with students with disabilities (less than 8 years - from 9 to 15 years - 16 years and above). 5) the
... Show MoreWhen the flange of a reinforced concrete spandrel beam is in tension, current design codes and specifications enable a portion of the bonded flexure tension reinforcement to be distributed over an effective flange width. The flexural behavior of the RC L-shaped spandrel beam when reinforcement is laterally displaced in the tension flange is investigated experimentally and numerically in this work. Numerical analysis utilizing the finite element method is performed on discretized flanged beam models validated using experimentally verified L-shaped beam specimens to achieve study objectives. A parametric study was carried out to evaluate the influence of various factors on the beam’s flexure behavior. Results showed that
... Show MoreThis study aims to investigate the effect of changing skins material on the strength of sandwich plates with circular hole when subjected to mechanical loads. Theoretical, numerical and experimental analyses are done for sandwich plates with hole and with two face sheet materials. Theoretical analysis is performed by using sandwich plate theory which depends on the first order shear deformation theory for plates subjected to tension and bending separately. Finite element method was used to analyse numerically all cases by ANSYS program.
The sandwich plates were investigated experimentally under bending and buckling load separately. The relationship between stresses and the ratio of hole diameter to plate width (d/b) are built, by
... Show MoreThe current research is a spectroscopic study of Coumarin 334 dissolved in methanol. The range of concentrations of the prepared stock solution was (3.39x10-9 to 2.03x10-8) M. Some optical characteristics of this dye were investigated such as absorbance and transmission spectra, absorption coefficient, refractive and extinction coefficients, oscillation and dispersion energies, and energy band gap. The absorbance spectra were recorded at 452 nm using Broad Band Cavity Enhanced Absorption Spectroscopy (BBCEAS) which depends on increasing the path length of the traveling light from the source to the detector. The minimum absorbance amount was 0.07 with a low concentration of 3.39x10-9 M. As a result, the ot
... Show MoreThe research aims to find out the impact of Lee’s cognitive strategy on the achievement of fifth-grade literary students in the module of history. The research community consists of the secondary female day schools of Al-Karkh Al-Oula Directorate General of Education. The size of the research sample comprises (45) female students of the fifth grade of the literary brunch, (21) students for the experimental group and (24) students for the control group. The researchers have chosen an experimental design with partial control to suit the current research and its goal. They used a unified tool to measure the achievement of female students, which consisted of (50) items characterized by sincerity and they extracted the stability of t
... Show MoreThis paper describes the first occurrence of the monogenetic trematode Silurodiscoides
mediacanthus (Achmerow, 1952) in Iraq from gills of the cyprinid fish Barbus luteus from
Diyala river, Diyala province, Iraq. The description and measurements of this parasite were
given. In addition, key for the identification of the three species of Silurodiscoides, so far
recorded from freshwater fishes of Iraq, is included.