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.
Iraq has the distinction of being a great potential of non-renewable natural resources,
especially crude oil and natural gas. Since the discovery of crude oil at the beginning of the
twentieth century in Iraq. Although the different of investment types, it contributed to the oil
sector in the provision of financial resources to the state treasury , since that date until the
present time.
Search has been marked by division ((The foreign investment in the oil sector in Iraq after
2003)) into three sections. The first section included a brief history of the development of
Iraq's oil potential in terms of oil reserves, and oil fields, and the quantities of production and
export. The second section reviewed the investm
The construction sector is considered an important and influential pivot in the national economy of any country. Nations are working to develop this sector, receiving modern and developed techniques. So, this sector can be a carrier or a receiver of modern technologies. The cost of technology transfer between the international companies that sponsor this sector is a matter of great importance, especially since different factors affect the need for this advanced technology. The cost of technology transfer in construction is related to multiple factors presented by Knowledge, equipment, plant, hardware and software. The lack of distinguishing and evaluating the direct and indirect costs in the construction sector during
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One of the most important features of American foreign activity during the second half of the 19th century was the encouragement of sending Protestant missionary missions to all countries around the world. The mission of these missions was facilitated by the weakened state of the Ottoman Empire, the increasing influence of European countries, and their interference in its internal affairs. Despite the Ottoman efforts to counter the activities of these missions, the American missionary missions adopted a well-planned strategy that suited the conditions of the region, aimed at achieving their goals through direct and indirect methods, including intervention in the field of education. These missions gave great importance to educational aspects
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summary of the research
The heart is the pine-shaped flesh on the left side of the chest. The moral gentleness in this flesh is called the home of perception, reason and understanding, as well as the place of desires and passions, so it turns between one desire and another between good and evil. As for its parts, it consists of four main parts called chambers, two rooms on the right As for the two chambers below, it is called the ventricle, the heart works regularly and accurately to pump blood and distribute it to all parts of the body and vital organs. And the Holy Quran divided the types of heart into two main types of healthy hearts, which are types (healthy, hidden, living....)
And the second type is sick hea
... Show MoreThis study investigated the prevalence of quinolones resistance proteins encoding genes (qnr genes) and co-resistance for fluoroquinolones and β-lactams among clinical isolates of Klebsiella pneumoniae. Out of 150 clinical samples, 50 isolates of K. pneumoniae were identified according to morphological and biochemical properties. These isolates were collected from different clinical samples, including 15 (30%) urine, 12 (24%) blood, 9 (18%) sputum, 9 (18%) wound, and 5 (10%) burn. The minimum inhibitory concentrations (MICs) assay revealed that 15 (30%) of isolates were resistant to ciprofloxacin (≥4µg/ml), 11 (22%) of isolates were resistant to levofloxacin (≥8 µg/ml), 21 (42%) of isolates were re
... Show MoreLandsat-5 Thematic Mapper (TM) has been imaging the Earth since March 1984 and Landsat-7 Enhanced Thematic Mapper Plus (ETM+) was added to the series of Landsat instruments in April 1999. In this paper the two sensors are used to monitoring the agriculture condition and detection the changing in the area of plant covers, the stability and calibration of the ETM+ has been monitored extensively since launch although it is not monitored for many years, TM now has a similar system in place to monitor stability and calibration. By referring to statistical values for the classification process, the results indicated that the state of vegetation in 1990 was in the proportion of 42.8%, while this percentage rose to 52.5% for the same study area in
... Show MoreHemogloin (Hb) and serum ferritin levels are used to assess anemia in pregnancy. Some studies referred to the influence of maternal age, body mass index (BMI) and parity on Hb and serum ferritin levels. The study aimed to examine the possible association of maternal Hb and serum ferritin with maternal age, parity, and BMI in a sample of pregnant women in Baghdad.
Ninety healthy pregnant women, grouped in three equal groups according to the pregnancy trimester, and thirty apparently healthy non-pregnant women from Baghdad were enrolled in this observational study. Blood and serum samples were obtained for the estimation of Hb and serum ferritin levels.
The pooled data of participants showed a n
... Show MoreThe therapeutic value of the phenolic component and pure thymol was well known; this study comprised the extraction of crude phenol from two plants (Thymus vulgaris and Artemisia annua) which contain thymol with pure thymol and evaluate their effect on hematological and histological by using three different concentrations of each plant extract and pure thymol to tested them on lab mice. All the mice were allowed free access to water and feed for 21 days in laboratory conditions; orally, pure water was administered to the control mice (group I), while groups II, III, and IV were given orally with T. vulgaris, A. annua, combination of last two crude phenol plant extract 50:50 and pure thymol respectively. The levels of CHO, TRI, and HDL were
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