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 aimed to examine the phonological processing profile for students with and without reading disabilities in cycle 1 schools of basic education in the Governorate of Muscat, Sultanate of Oman. The study participants included 306 students, 165 students with reading disabilities and 141 students without reading disabilities. The Comprehensive Test of Phonological Processing (CTOPP) and Working Memory Test (WMT) were administered to the participants. The results of the study showed that the mean score of students without reading disabilities was higher than that of students of reading disabilities in all measures of phonological processing, and that there are statistically significant differences on the case of students in all
... Show MoreThree scolopacids out of 150 are found infected with Haemoproteus scolopaci Galli-
Valerio 1929 and H. tringae n. sp. A detailed description of the new taxon is presented along
with a comparison of the diagnostic measurements between the two species.
To finalize any construction investment project, it would be necessary to identify the most significant problems and obstacles that lead to project reluctance and stalling. Unexpected events and conflicts may have disrupted these strategies and impacted project development. Due to the high initial investment costs of construction projects, crises can have an immediate impact, resulting in significant financial losses. The 2014 financial crisis was one of the most prominent crises that Iraq faced, which prompted the researcher to identify and evaluate those obstacles through this research and questionnaires using Pareto scientific theory to exclude factors that do not contribute to project lag. It was discovered that 28 o
... Show MoreBuzurgan oil Field which is located in south of Iraq has been producing oil for five decades that caused production to drop in many oil wells. This paper provides a technical and economical comparison between the ESP and gas lift in one oil well (Bu-16) to help enhancing production and maximize revenue. Prosper software was used to build, match and design the artificial lift method for the selected well, also to predict the well behavior at different water cut values and its effect on artificial lift method efficiency. The validity of software model was confirmed by matching, where the error difference value between actual and calculated data was (-1.77%).
The ESP results showed the durability of ESP regarding th
... Show MoreBackground: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca
... Show MoreThe main function of a power system is to supply the customer load demands as economically as possible. Risk criterion is the probability of not meeting the load. This paper presents a methodology to assess probabilistic risk criteria of Al-Qudus plant before and after expansion; as this plant consists of ten generating units presently and the Ministry Of Electricity (MOE) is intending to compact four units to it in order to improve the performance of Iraqi power system especially at Baghdad region. The assessment is calculated by a program using Matlab programming language; version 7.6. Results show that the planned risk is (0.003095) that is (35 times) less than that in the present plant risk; (0.1091); which represents respectable imp
... Show MoreBackground: This study evaluated the influence of different fiber formulations incorporation in resin composite on cuspal deflection (CD) of endodontically-treated teeth with mesio-occluso-distal (MOD) cavities. Materials and Methods: Thirty-two freshly extracted maxillary premolar teeth received MOD cavity preparation followed by endodontic treatment using single cone obturation technique, and divided into: Group I: direct composite resin only using a centripetal technique, Group II: direct composite resin with short fiber-reinforced composite (everX Flow), Group III: direct composite resin with leno wave ultra-high molecular weight polyethylene (LWUHMWPE) fibers placed on the cavity floor, and Group IV: direct composite resin with LWUHMWP
... Show MoreBackground. Dental implantation has become a standard procedure with high success rates, relying on achieving osseointegration between the implant surface and surrounding bone tissue. Polyether ether ketone (PEEK) is a promising alternative to traditional dental implant materials like titanium, but its osseointegration capabilities are limited due to its hydrophobic nature and reduced surface roughness. Objective. The aim of the study is to increase the surface roughness and hydrophilicity of PEEK by treating the surface with piranha solution and then coating the surface with epigallocatechin-3-gallate (EGCG) by electrospraying technique. Materials and Methods. The study includes four groups intended to investigate the effect of pir
... Show MoreBackground. Aneurysms of the distal anterior cerebral artery (DACA) are uncommon; they often form near the pericallosal-callosomarginal junction and are typically small. To our knowledge, giant DACA aneurysms developing from the more distant parts of the anterior cerebral artery (ACA), A4-5, have been described only once in the literature. Case description. A 66-year-old gentleman reported with a brief loss of consciousness followed by weakness in his right lower leg. The patient was admitted with a Glasgow Coma Score (GCS) of 15. A computed tomography (CT) scan of the head revealed a left hyperdense mass in the frontal parasagittal supracallosal region. Contrast MRI revealed a heterogeneously enhancing mass measuring 35x30x25 mm. C
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