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 development issue is considered as one of the most important matters of concern to governments, intellectuals and specialists in the contemporary world, especially in developing countries that are trying hard to move out of the afflicting underdevelopment domain to a brighter future and achieve the aspirations of those countries through organized planning which take advantage of available resources, whether material or humanitarian, in the best way possible.
The development process are taking place at multiple levels ranging from national to regional to local where the community is stimulated and excited for the cooperation, participation and preparation to perform planned change in the methods of thinking, acting and production.<
Despite the history of Baghdad city extends into a long history, most of the contemporary buildings of Baghdad have been shaped in the era of modernity. Furthermore, most of the buildings of modernity in Baghdad are types of modernity buildings in Iraq as a whole, and due to all the joints of change and development are taking place in Iraq starts from Baghdad. Accordingly, all selected buildings, which would be presented as case studies of modernity will be exclusively in Baghdad. Although the importance of this significant modernist product, which represents the identity of Baghdad, which should be preserved by the renewal and preservation policies, the problem of research was emerged as follow: new fin
... Show MoreRelationship between thyroid dysfunction and periodontal disease has been mediated through an immune response. Cytokines are implicated in the initiation, consequences of immune response and a crucial role in the pathogenesis of thyroid disease, directly target thyroid follicular cells; and in the development and progression of periodontitis. This study aimed to detect cytokines levels which known to be associated with periodontitis in serum and saliva, to test the hypothesis that hypothyroidism influences the levels of biomarkers of periodontitis. Samples were collected from sixty patients with hypothyroid age ranged (20-64) years, thirty of patients were without periodontitis (group I) and 30 with periodontal disease (II); moreover, 30 su
... Show MoreIf the State attaches great importance to its foreign relations and intends to strengthen them in order to ensure the achievement of the highest national goals and interests. External relations between countries are one of the most prominent features of foreign policy, which depends on a combination of internal and external factors, the modern relations between Tunisia and Tunisia, which goes back to the pre-independence of Tunisia, when Iraq was a supporter of Tunisia's independence from France in the 1940s, Although these relations did not cause any disturbance by the two countries, but they remained weak relations did not develop in all areas except the sports and cultural field, which we will determine the reasons and the pos
... Show MoreBackground: Curve of Spee (CS) is an anteroposterior anatomical curve established by the occlusal alignment of the teeth viewed in the sagittal plane. This occlusal curvature has clinical importance in orthodontics and other fields of dentistry. This study aimed to evaluate the relationship between the CS and dentofacial morphology of different skeletal patterns in both genders. Materials and Methods: Eighty six Iraqi Arab subjects (44females,42 males ) their age ranged from 17 -30 years, classified into: Skeletal I with normal occlusion(15 females and 15 males), skeletal II with CI II div 1 malocclusion (15 females and 15 males) and skeletal III with CI III malocclusion (14 females and 12 males). Forty one variables measured us
... Show MoreBackground: Biologic mechanisms of the form-function interaction are one of important component of orthodontic diagnosis. The purpose of this study is to search for the statistical associations between natural postural and craniofacial morphologic variables of the head. Materials and methods: The sample comprised natural head posture (NHP) cephalograms of 90 subjects, aged 18 to 25 years. Interpretation of the facial structure was made by using both intracranial and the extra-cranial reference lines in AutoCAD computer program. Results The measures of anteroposterior maxillary position, SNA showed a low negative correlations with the anterior cranial base angulation to true vertical (SN.Ver) and with the cranio-cervical position of the head
... Show MoreQuality of e-service is one of the critical factors that decide the success or failure of organizations. It may increase competitive advantages as well as enhance the relationships with the customers. Achieving high e-service quality and user satisfaction are challenging since they depend fundamentally on user perception and expectation which can be tricky at times. To date, there is no agreement as to what service quality is, and how it should be measured, whether it is a function of statistical measures of quality including physical defects or managerial judgment, or it is a function of customer perception about the services. This paper deep-dived the quality of e-services offered b
This study aims to measure the basic foundations of organizational health in the General Company for Food Products and to indicate the extent of its presence or not within the company under investigation.
This research was completed using a descriptive and analytical approach using a sample of 97 employees from the General Company for Petroleum Products. Calculating the arithmetic mean, standard deviation, coefficient of variation, and confirmatory factor analysis are all part of the data processing process.