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.
Coronavirus 2019 (COVID-19) pandemic led to a massive global socio-economic tragedy that has impacted the ecosystem. This paper aims to contextualize urban and rural environmental situations during the COVID-19 pandemic in the Middle East and North Africa (MENA) Region.
An online survey was conducted, 6770 participants were included in the final analysis, and 64% were females. The majority of the participants were urban citizens (74%). Over 50% of the urban residents significantly (
Research includes evaluation of projects implemented and which entered into trial operation period in accordance with the evaluation criteria and of (cost, quality and time) to determine the size deviations gap for the sample of projects during the years of assessment (2011-2012-2013-2014) of each of the three evaluation criteria, and then followed by a calculation the size of the overall gap to the problem based on the research problem to determine deviations from the specific implementation of each project by answering several questions to answer turns out the reasons for these deviations occur.
The importance of research Focus on the evaluation of received projects from contractors executing the projec
... Show Moreيعد العلاج الحركي من الوسائل العلاجية التأهيلية من الوسائل المهمة الامنة لأنها تؤمن على حياة الانسان بكافة شؤونه وتعد التمرينات التأهيلية اسلوبا فعالاً وطبيعياً لا تعرض المريض الى مضاعفات على وظائف الجسم الاخرى لأنها خالية من اي دواء كيمياوي ضار ، كما استخدمت تقنيات حديثة في العلاج الطبيعي بشكل واسع معد حسب اسس علمية منها تمرينات (Core) التي تساعد في تخفيف الالام بالانزلاق الغضروفي للفقرة الرابعة والخا
... Show MoreThe image of television dominates the cognitive and artistic motivations. It is the formulation of ideas and visions along with its documentary ability. It is the main element in television work as it is a story that is narrated in pictures. Therefore, attention to image building is a major point of gravity in the work structure as a whole. On the image is the element carrying all aesthetic and expressive values of news and information directly to the hints that work to stimulate and stir the imagination of the recipient to evoke mental images added to the visual images to deepen the meanings.
All visual arts carry elements and components that follow in a particular pattern to give special meanings and specific connotations. However,
Increasingly, public organizations in the federal state are required to work together, as well as to work with others to achieve their objectives. In Iraq there are two levels of organizations, including federal and local, and these organizations have been forced to work for many years in an environment in which the responsibility for service delivery is shared between policy makers and service providers, and between local governments and the federal government. It is sometimes difficult to manage the relationship between these organizations (federal and local) and do not always provide the best possible outcome of this relationship. This paper reviews how to manage the relationship between local administrations and
... Show MoreMedulloblastomas and ependymomas are the most common malignant brain tumors in children. However genetic abnormalities associated with their development and prognosis remain unclear. Recently two gene fusions, KIAA1549–BRAF and SRGAP3–RAF1 have been detected in a number of brain tumours. We report here our development and validation of RT-RQPCR assays to detect various isoforms of these two fusion genes in formalin fixed paraffin embedded (FFPE) tissues of medulloblastoma and ependymoma. We examined these fusion genes in 44 paediatric brain tumours, 33 medulloblastomas and 11 ependymomas. We detected both fusion transcripts in 8/33, 5/33 SRGAP3 ex10/RAF1 ex10, and 3/33 KIAA1549 ex16/BRAF ex9, meduloblastomas but none in the 11 ep
... Show MoreDetermination of the level of adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6)in hypo-and hyperthyroid patients from Educational Baghdad Hospital in Baghdad City was investigated. Fifty patients with hypothyroidism and Fifty patients with hyperthyroidism were selected. A control group of thirty euthyroid persons was included. Blood was collected by vein puncture and serum was separated and stored at –20C. Adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6) were estimated using ELISA method. The findings show a significant (p<0.05) increase in obestatin level in hypothyroid patients, while there is no significant difference in hyperthyroid patientsas compared with the euthyroid subjects.
... Show MoreBackground Type two diabetes (T2DM) is characterized by insufficient insulin production and secretion. Additionally, the body develops insulin resistance which affects 90–95% of diabetics. Complex cytokines, receptors, genetic pathways, and the immune system are involved in T2DM. Interleukin-18 (IL-18) is one of the inflammatory cytokines associated with Type 2 diabetes. Environmental and genetic variables, including genetic polymorphisms, can increase T2DM risk and its consequences. Single nucleotide gene polymorphisms (SNPs) are important risk factors for diabetes that can be used to find the disease early and treat it better. Objective This study aimed to determine the levels of IL-18 in the serum of Iraqi patients with Type 2 diabetes
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