139 research outputs found
Allelic Variants of CYP2C9 and VKORC1 Genes and their Relation to Warfarin Metabolism in Patients Under Warfarin Therapy in Gaza Strip
No full textBackground: Warfarin is the most widely prescribed oral anticoagulant for thromboembolic therapy, patient management is difficult because of significant differences in metabolic rates as a result of allelic variation in its metabolizing enzyme. CYP2C9 gene encoding the enzyme that catalyzes the conversion of Warfarin to inactive metabolites, and the VKORC1 gene encoding the enzyme responsible for reducing vitamin K 2,3-epoxide to the enzymatically activated form. Three single nucleotide polymorphisms (SNPs), two in the CYP2C9 gene and one in the VKORC1 gene, have been found to play key roles in determining the effect of Warfarin therapy on coagulation. The presence of CYP2C9*2 and CYP2C9*3 variant alleles decrease the enzymatic activity which cause the elongation of half-life and reduced rate of clearance of Warfarin. Objectives: The aim of this study was to determine the allelic varints of CYP2C9 gene (alleles *1, *2 and *3) and VKORC1 (alleles 1639-G and 1639-A) in Gaza strip, and to determine the relation between the Warfarin anticoagulation and the genotype of the two genes CYP2C9 and VKORC1. Methods: Whole blood samples were collected from 101 patients under Warfarin therapy who visited anti-coagulation clinics of Alshifa and Gaza European hospitals then subjected to DNA extraction. Allelic variants of CYP2C9 and VKORC1 genes were determined by PCR-RFLP technique. Also sodium citrated whole blood samples were collected and plasma were separated for the determination of their Prothrombin time/international normalized ratio (PT/INR) level in order to establish a relationship between the CYP2C9 and VKORC1 allelic variants and the Warfarin anticoagulation. Results: It was found that none of the patients who are receiving the Warfarin has achieved the therapeutic range during the first month of Warfarin medication. There is a statistically significant difference in average INR between patients who have homozygote or heterozygote CYP2C9*2 and that who have the wild type CYP2C9*1/*1 and VKORC1(G/G) genotypes (3.1±1.29) and (2.05±0.92) respectively (P-Value=0.02, 95% C.I.), but when comparing the average actual weekly dose of Warfarin between the two groups it was found that there is no statistically significant difference (49.38±20.99 mg/week) and (48.45±14.22) respectively (P-Value=0.89, 95% C.I.). According to VKORC1 gene, it was found that there is no statistically significant difference in the average INR between patients who have homozygote or heterozygote VKORC1-1639A and that who have VKORC1(G/G) genotype (2.48±1.61) and (2.34±1.12) respectively (P-Value= 0.67, 95% C.I.), but there is a statistically significant difference in the average weekly dose between the two groups (40.36±14.04 mg/week) and (48.71±15.96 mg/week) respectively (P-Value=0.01, 95% C.I.). Also when averages of INR were compared between patients who have at least one copy of VKORC1-1639A allele and those who have CYP2C9*1/*1 and VKORC1(G/G), it was found that there is no statistically significant difference between the two means (2.4±1.23) and (2.05±0.92) respectively (P-Value=0.24, 95% C.I.), but there is a statistically significant difference in the average weekly dose of Warfarin between the two groups (40.63±14.13) and (48.45±14.22) respectively (P-Value=0.04, 95% C.I.). Conclusion: We conclude that the presence of at least one copy of CYP2C9*2 or VKORC1-1639A alleles or both is observed to be a cause for an increased sensitivity to Warfarin therapy and increased INR level. Therefore we recommend testing for these alleles as a part of the patient management
Business process improvement using multi-objective optimisation
No full textBusiness process redesign and improvement has become an increasingly attractive subject in the wider area of business process intelligence. Although there have been many attempts to establish a business process redesign framework, there is little work on the actual optimisation of business processes with given objectives. Furthermore, most of the attempts to optimise a business process are manual and do not involve a formal automated methodology. This paper proposes a process improvement approach for automated multi-objective optimisation of business processes. The proposed framework uses a generic business process model that is formally defined. The formal definition of business processes is necessary to ensure that the optimisation will take place in a clearly defined, repeatable and verifiable way. Multi-objectivity is expressed in terms of process cost and duration as two key objectives for any business process. The business process model is programmed and incorporated into a software optimisation platform where a selection of multi-objective optimisation algorithms can be applied to a business process design. This paper outlines a case study of business process design that is optimised by the state-of-the-art multi-objective optimisation algorithm NSGA2. The results indicate that, although business process optimisation is a highly constrained problem with fragmented search space, a number of alternative optimised business processes that meet the optimisation criteria can be produced. The paper also provides directions for future research in this area
Determination of Hepatitis C Virus Genotypes in Gaza Strip
No full textHepatitis C virus is a heterogeneous virus with 6 major genotypes and more than 50 subtypes. The present work aims to determine the commonest HCV genotypes in chronic patients ofGazastrip,Palestine. This study highlights the prognostic potential of determining the HCV genotype for patients as an integral part of their diagnostic and therapeutic regimen, and thus may be helpful in tailoring the therapy for HCV patients based on their virus genotype. If taken in conjunction with other factors important in therapy HCV genotyping will reduce the expenses of treatment when the duration of therapy is accordingly optimized, and thus allowing a larger number of patients to be considered for the therapy. Genotyping of HCV may also be useful for identifying some important origins of transmission and risk factors of the virus inGazastrip. The chronic HCV patients participating in the study were interviewed, and a questionnaire was completed and serum samples were obtained from each of them. The samples were analyzed to justify the presence of HCV RNA by reverse transcriptase polymerase chain reaction (RT/PCR), and the PCR products of 92 positive samples were purified and submitted for sequencing and genotype determination. ALT level was determined for each sample. The results of this study showed that genotype 1 and 4 and their subtypes 1a, 1b, 4a and 4c/d are the major common HCV genotypes in Gaza strip. Genotype 4 and its subtypes are the predominant ones. Genotype 1 and its subtypes collectively contributed to 28.3% of the cases, while genotype 4 and its subtypes collectively contributed to 64.1% of the cases. Mixed infection with the two genotypes was also seen among 7.6% of the cases. Travelling, surgery and blood transfusion in an endemic HCV area are the major roots of HCV transmission inGazastrip although other routs exist. The results also show that genotype 1 infections are more serious than genotype 4 infections and associated with significantly higher ALT levels in patients' blood. The education level, infection date and hemodialysis don’t show any significant relation to the HCV genotype and subtypes. The results of this study contribute to the identification of sources of outbreaks, risk factors and control strategy of HCV. The results will also help tailor treatment schedules as well as to monitor response to antiviral treatment
تحديد الطرز الجينية للبكتريا الملوية البوابية وتحديد مدى مقاومتها للكلاريثرومايسين للمرضى المصابين في قطاع غزة - فلسطين
No full textHelicobacter pylori is the most widely spread bacteria world wide, it infects more than half of the world population. It is associated with many different gastric and extra-gastric diseases. The bacterium was classified by the international agency for cancer research and the WHO as a definite class I carcinogen in 1994. The wide range of its pathogenicity may be due to host, environmental, and bacterial virulence factors. Some genes like the cagA and vacA are responsible for the pathogenicity of the organism. The vacA gene exhibits a highly mosaic and recombination between two different regions, the signal and the mid region which may be associated with the highly difference in associated disease in association with the host and environmental factors. Clarithromycin is the key component of treatment where the resistance to this antibiotic results in treatment failure. Therefore, the aim of this study was to determine the genotypes of vacA and cagA, and to evaluate clarithromycin resistance in H. pylori infected patients in Gaza strip. In order to achieve this goal, two different biopsy samples from different sites of the antrum were collected from 94 patients where just one biopsy sample was collected from seven patients. The first biopsy sample was extracted for PCR to determine the vacA and cagA genotypes. (The second biopsy was formalin-fixed and paraffin-embedded, five - 4 µ thick slides were used for FISH for clarithromycin resistance evaluation, the other two slides were used for Giemsa stain and Haematoxyline & Eosin stain for identification of H. pylori and histopathological assessment). Clinical diagnosis and clinical information were recorded from the index for every patient. The results of the study showed that the most predominant vacA was s2m2 (43.2%), and the gene cagA was present in 30.8% of infected cases. The frequency of mutations were found (3.9%: A2143G), (3.9%: A2144G), (0.0%: A2143C) and 19.6% were not typed by the most common three mutations (A2143G, A2144G and A2143C ) or the wild type. There is no statistically significant relationship between the H. pylori infection or genotypes of H. pylori and the clinical diagnosis of gastroscope. The results revealed that there was statistically significant correlation between H. pylori infection, and the degree of mucosal inflammation (P = 0.004). There is also statistically significant correlation between H. pylori infected patients and Whitehead degree of gastritis index (P = 0.032). Moreover there is statistically significant correlation between the genotype s1m1 and atrophy (P = 0.006), and almost close to Intestinal metaplasia (P = 0.052). In conclusion the genotypes of H. pylori cagA and vacA in Gaza strip are similar to that in our region (Egypt, Jordan, "Israel"). There was no statistically significant relationship between the genotypes of H. pylori and the clinical diagnosis of gastroscope and this may be due to other environmental or dietary factors
Jordan: Basim 'Abdallah Najeeb Abu-Shamma
No full textA document from Amnesty International's Urgent Action Networ
Effects of Utilizing Black Glass Balls, Phase Change Material, and Fins on the Performance of the Single-Slope and Single-Basin Solar Water Distiller under Climate Conditions of Mosul City: An Experimental Study
No full textThe present investigation involves an experimental examination of incorporating rectangular fins, black glass balls as porous media, and phase change material (PCM) above the absorber surface to improve the effectiveness of the single-slope and single-basin solar water distiller system, known as MSS-FPPCM. Data was gathered in November and December 2023 in Mosul City, Iraq. The performance was evaluated with and without the addition of porous media at varying water depths. The results indicated that the highest basin water temperature, PCM temperature, productivity, and efficiency were achieved when utilizing fins, black glass balls, and PCM. The maximum temperatures recorded for water basin and PCM, productivity, and efficiency were 55°C, 55.4°C, 1.01 kg/m2, and 30.83%, respectively, at a water depth of 3cm. The results highlight the significant impact of porous media, phase change material, fins, and water depth on heat exchange, evaporation, and heat transfer rates
Descriptive Analysis of the Economic and Social Factors of Cucumber Farmers in Baghdad Governorate (Adopting and Non-Adopting Sub-Surface Irrigation Techniques)
No full textThe objective of this study was to identify the economic and social characteristics of cucumber farmers in the study area. The random sample included farmers from Abu Ghraib district and Yusufiya, Baghdad governorate, which is the most important central region in Iraq. areas for the cultivation of this crop in recent years, due to several reasons, including the deteriorating security situation in the region, which led to a severe shortage of water sub-rivers used for irrigation, high fertilizer and seed prices as there is little support by the state in the field of agricultural inputs As well as flooding the local agricultural crops market crop imported cucumber from outside the country (Abo Graib and Yusufiya), where the importer cucumber price cheaper than the local cucumber, as a result of the reasons aforementioned became the cultivation of this crop is very limited in these areas after they constitute a high relative importance relative to the rest of Iraq. As it became not economically feasible to farm the cultivation of this crop under those circumstances. In order to find serious solutions in solving these problems, the Iraqi Ministry of Agriculture recently issued a decision to ban the import of vegetable crops, which enjoys abundant production within the country, including the cucumber crop. This decision can be exploited to bring about a change in guiding farmers to focus on these crops and improve production
Rheology of sodium and calcium bentonite–water dispersions: Effect of electrolytes and aging time
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