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.
Brainstorming is one of the fundamental and necessary concepts for practising the auditing profession, as auditing standards encouraged the implementation of brainstorming sessions to reach reasonable assurance about the validity of the evidence and information obtained by the auditor to detect fraud, as the implementation of brainstorming sessions and the practice of professional suspicion during the audit process lead To increase the quality of auditing and thus raise the financial community's confidence in the auditing profession again after it was exposed to several crises that led to the financial community losing confidence in the auditing profession.
The research aims to explain the effect of brain
... Show MoreBrainstorming is one of the fundamental and necessary concepts for practicing the auditing profession, as auditing standards encouraged the implementation of brainstorming sessions to reach reasonable assurance about the validity of the evidence and information obtained by the auditor to detect fraud, as the implementation of brainstorming sessions and the practice of professional suspicion during the audit process lead to increase the quality of auditing and thus raise the financial community's confidence in the auditing profession again after it was exposed to several crises that led to the financial community losing confidence in the auditing profession.
The research aims to explain the effect of brain
... Show Moreكان المؤتمر الآسيوي الأفريقي الأول الذي عُقد في مدينة باندونغ الاندونيسية عام 1955 هو المؤتمر هو الأول الذي اجتمعت فيه الدول الآسيوية والأفريقية بعد الحرب العالمية الثانية. كان مؤتمر باندونغ بمثابة نقطة الانطلاق نحو تأسيس حركة عدم الانحياز، والتي كانت مصر أحد أبرز أقطابها. شهد المؤتمر تقاربا في الآراء ووجهات النظر بين جمهورية مصر العربية وجمهورية الصين الشعبية، لا سيّما وإن الحكومة المصرية كانت قد تبنت س
... Show MoreThe objective of this article is to study the impact of environmental pollution on air, water, and soil quality with a focus on the role of environmental bacteria in bioremediation of pollutants. The research also addresses the ability of some strains of bacteria to remove heavy metals and petroleum hydrocarbons and degrade toxic substances, resulting in improved environmental quality. Outcomes: Empirical studies reveal that environmental pollution leads to significant health and environmental problems, such as a rise in respiratory disease as a result of air pollution, water pollution that affects aquatic life, and soil pollution that decreases crop output. Other bacterial strains such as Pseudomonas, Bacillus, and Streptomyces have also b
... Show MoreTHE ROLE OF ELECTRONIC-PAYMENT SERVICE PROVIDERS IN THE DEVELOPMENT OF E-BANKING IN IRAQ - AN APPLIED RESEARCH IN CENTRAL BANK OF IRAQ
The present study was designed to shed light on the molecular effects caused by acute myeloid leukemia (AML). It was also aimed to investigate ASXL1 point mutations in newly AML patients as compared to healthy control. The study comprised of 43 AML Iraqi patients and their ages ranged between 16-75 years. It included 23 females and 20 males compared with 20 healthy controls. Results revealed that the extracted DNA from 30 AML patients and amplified by PCR to obtain ASXL1 gene from exon 12 showed larger bands (479). Among forty three patients, two of them displayed point mutations of deletion and substitution, while the others were normal since no mutations were detected. The total of mutations in two mutated patients was 27 mutations, the m
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Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient. Identification and classification of drug related problems and discussing them with the health care providers. Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical
... Show MoreBackground: Diabetes mellitus is a common health problem of the world. Iron may be a part of the cause of the disease and its Complications
Objectives: This study was designed to determine the relationship between the levels of iron indices and diabetes mellitus type 2. Type 2
Type of the study: Cross –sectional study.
Methods: diabetes mellitus is clinical condition characterized by hyperglycemia due to the absolute or relative deficiency of insulin. It is also followed by pathological abnormalities like impaired insulin secretion, peripheral insulin resistance, and excessive hepatic glucose production. Although type 2 diabetes mellitus i
... Show MoreObjective: to evaluate the increase in weight after biological agents and the association of weight gain with the body mass index among a sample of patients attending Baghdad Teaching Hospital Methods: A prospective study is carried out in Baghdad teaching hospital biological units and outpatient clinic of rheumatology for a period of one year starting On April 2015 and ending on March 2016. 120 patients were included in the study 40 psoriatic arthritis .40 ankylosing spondylitis and 40 rheumatoid arthritis Results : The study findings indicate that significance differences are seen regarding weight gain and b
Some parameters for advancement of Leishmania tropica infection were examined in three groups of golden hamsters, Group (1) inoculated with autoclaved killed Leishmania tropica , Group (2) inoculated with BCG vaccine alone while Group (3) Inoculated with mixed vaccine (autoclaved killed Leishmania with BCG). The follow up of experimentally infected animals with virulent isolation of Leishmania tropica was done for 90 days, the animals inoculated with mixed vaccine (autoclaved killed Leishmania with BCG) showed the minimum average in each of foot pad thickness (2.3 ± 0.05) mm after (60) days of infection, spleen enlargement (1.13±0.38) after (45) days of infection, spleen length (23.9±0.08) mm after (30) days of infection, liver weight(3.
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