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.
Abstract:-
The phenomenon of financial and administrative corruption is not the result today, but not tied to time or designated place, he is the scourge is rampant in all countries of the world, without exception, those developed and developing, a phenomenon that crossed national boundaries and become withstand a global character, and corruption is limited to communities of particular economic systems without the other, but suffered Throughout history most societies to varying degrees, Iraq is one of the countries that suffered and continues to suffer from corruption, which has become, B grumble in most of the Iraqi state institutions, especially after the occupation in 2003 as administrative corruption in Iraq arrived i
... Show MoreBackground: Orofacial cleft is the most common craniofacial birth defect and the fourth most common congenital malformation in humans that have an effect on oral health in addition to nutrient intake affected in those children. This research aims to investigate gingival condition, dental caries experience and nutritional status among children with orofacial cleft and compare them with normal children. Materials and methods: The study group included 36 children with an age ranged (4-9) years of orofacial cleft. The control group included 37 children matched the control group in age and gender. Gingival condition measured by Gingival Index (Löe and Silness, 1963), while dental caries status was measured by (D1-4MFs/d1-4mfs) index according
... Show MoreThe challenges facing today's multi-customer and this is due to the multiplicity of products and speed in launching new products so search came to reveal the reveal the of the new product classification standards through a relationship (good products, low interest products, useful products and products desired) and the customer emotionally blackmail through deportation (fear, obligation and guilt). dentified the problem of the research in several questions focused on the nature of the relationship between the variables of research, and for that outline supposedly to search it expresses the head of one hypothesis and branched out of which four hypotheses subset, but in order to ensure the validity of the ass
... Show MoreObjective: To determine the functional and radiological outcomes of lower third tibia closed fractures fixed by nail or plate osteosynthesis. Methodology: This randomized controlled trial included 20 patients presenting with closed fracture lower third tibia in Al-Kindy teaching hospital, Baghdad, Iraq. The patients were divided as every other one into two equal groups; group I had fractures fixed by 3.5 mm locked plate and group II by intramedullary locking nail. We followed all patients for 24 weeks to assess surgical complications, fracture union, alignment and functional outcome based on Knee society score (KSS). Results: The mean union time in both groups was 10.2 ± 1.48 and 9.3 ± 1.77 weeks, respectively (p = 0.003). Mean KSS in bot
... Show MoreBackground: Nasal obstruction is common in otorhinolaryngology outpatient visitors. The diagnosis of such compliant is by history, clinical examination and diagnostic procedures. Nasal endoscopy and computerized tomography scan are common diagnostic investigations. Nasal obstruction is either anterior or posterior (nasal septal deviations, hypertrophied turbinate pathological cyst, polyps, mass etc), or postnasal obstruction (hypertrophied turbinate, adenoid hypertrophy, nasopharyngeal cyst or nasopharyngeal tumors).
Aim of study: Prospective study to compare endoscopic finding and computerized tomography of nose, paranasal sinuses and postnasal space as diagnostic methods for nasal obstruction and other nose, p
... Show MoreAbstract
The changes that happened in the environment of business have great effects upon organizations with different activities specially the banks which requires the existence of an able opinion resources can adapt with the changes . Accordingly importance put upon intellectual capital which become one of the basic resources for organizations and one of success and growth elements with the availability of expertise , skills and capability of making essential changes in different process due to the presentation of innovations and creations of the to support banks activities .Therefore the intellectual capital represents the more r
... Show MoreAir pollution is considered one of the major environmental problems that contain many challenges and difficulties facing most countries of the world, including Iraq. The problem has emerged widely with the emergence of the industrial revolution in the world and the tremendous increase in the population and the increase in the number of transportation and its development in addition to excavation, maintenance and work Construction and weather fluctuations, such as dust and sandstorms, pollution resulting from oil refining, extraction, diversion and other processes that cause pollution, and the start of the world using methods that limit the volume of environmental pollution. The most prominent of these methods is the imposition of
... Show MoreThe Banking Supervision of the most important functions of the Central Bank of Iraq, which he intended to have a strong banking system and a sound and competitive, and exercised control over the banks by inspection bodies to ensure their compliance with the laws, regulations and orders and instructions and the safety of their financial positions.
The research was aimed to release the concept of banking inspection, compliance and problems and obstacles faced by the inspectors, and monitors compliance and down to make recommendations.
Has been reached on a set of theoretical and practical conclusions, including: -
1-confirmed the statistical analysis of the answers to the research sample the importance of the role o
... Show MoreAntibiotics present the greatest threat to soil and aquatic ecosystems among the different therapeutic groups of medicines (which include prescription drugs and treatments for cancer). The strongest drugs, antibiotics, have been utilized to stop the growth of microorganisms or eradicate them. Using high-performance liquid chromatography technology with fluorescence detection, the amounts of levofloxacin and tetracycline in the wastewater from three hospitals (Medical City, Al-Kindi, and Al-Yarmouk) were determined. Levofloxacin and tetracycline were chosen in this study because they are the most important water pollutants. These antibiotic residues were separated and measured using a gradient elution technique on a reverse-phase C18
... Show More