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.
In diabetes, impaired wound healing and other tissue abnormalities are considered major concerns. Many factorsaffect the time and quality of wound healing. One of the purposes of medical sciences is wound healing in a short time withreduced side effects. The herbal products are more precious in both prophylaxis as well as curative in delayed diabetic woundhealing activity when compared to synthetic drugs.A wide range of evidence has shown that capers plant possesses differentbiological effects, including antioxidant, anticancer and antibacterial effects. Phytochemical analysis shows thatC. spinosahashigh quantities of bioactive constituents, including polyphenolic compounds, which are responsible for its health-promotingeffects. The healing
... Show MoreAbstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. O
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Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through eviden
... Show MoreIn recent years, the search for economic and environmentally friendly alternatives has become a global necessity to achieve sustainability and preserve raw materials. From this concept, natural bitumen (NB) derived from sulphur springs is now one of the most promising alternative energy resources for many applications, especially in asphalt pavement construction. Its low price and abundance characterise NB since sulphur springs produce thousands of tonnes of NB annually and are used in very limited fields. Two main objectives were adopted for this work. The first objective is to examine the virgin NB properties from five sulphur springs and compare them with petroleum asphalt. The second objective is to enhance NB properties by appl
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The present paper attempts to find out the role of developmental loans in promoting strategic crops especially the basis stemming from the problem of non - defining economic feasibility study and the negative or positive revenues of developmental loans, directed to Iraqi Agricultural sector in general and Basic strategic crops in particular which resulted in the difficulty of planning and future prediction to grant loans agriculturally directed in terms of quality and quantity and the arbitrary of distributing these loans .the strategic crops have been selected as sample of population where the sample of Basic strategic crops include wheat and barley .The paper has come to several of conclusions mainly are as follows :- the increase in n
... Show MoreThe objective of this research to analyze the effectiveness of monetary policy in achieving economic stability and growth for the period 2004-2011 ،This period of time saw a fundamental shift in monetary policy after the issuing new law the Central Bank of the full independence of the monetary authority ،This is Prompt the monetary authority to bring about a change in the philosophy and objectives and the tools used to achieve the desired goals ،Which give them the ability to control the size of the money supply and to achieve price stability Indeed، Monetary policy has been able to achieve the golden triangle of economic stability ،Consisted of staff، exchange rate stability and low and stable general level of prices
... Show MoreVocational education has great importance to comprehensive national development as it provides intermediate cadres able of operating the factories and laboratories in the farms and fields beside the work in the fields of health, service, administration and commercial. Due to the importance of this type of education in society, it is necessary to do a qualitative reform of vocational education in order to make the educational staffs get the necessary basic expertise to adapt the requirements of the labor market and try to rearrange and organize the workforce through put long-term economic and social policy through certain planning open to the workforce. The workforces structure according to gradual expansion in all the national ec
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Analyzing the size of the interrelationships between the main economic sectors in the Iraqi economy is an important necessity to know the impact of each sector on other economic sectors on the basis of the interrelationships and reciprocity between them, and what these relationships have achieved in terms of enhancing development and increasing the gross domestic product. To achieve the objectives of the study, we relied on mathematical (quantitative) analysis using user-product tables. Issued by the Ministry of Planning / Central Bureau of Statistics and Research (Directorate of National Accounts) for the economic sectors that make up the Iraqi economy. The study conc
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