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
Despite the fact of the importance and effectiveness of supporting the pricing policy for agriculture sector in Iraq, but this policy has stopped in supporting those agriculture production needs, and it was confined to support the final product only, and supporting the strategic corps exclusively after the U.S. Invasion in 2003, but after 2008 the state has returned to support some of this policy activities through providing financial loans through the agricultural initiative campaign, with trillions of iraqi dinars without any use, also providing support to some of the agricultural production needs such as fertilizers , tractors and agricultural combines, in addition supporting the pricing policy for the
... Show MoreThe Character is one of the elements of Storytelling, as it is the center of the plot, making it the basis on which the talk is about. The talk is the portrayal of the character while they’re acting; the novelist presents the character by interacting with the events, and the extent of the negative and positive appearing impact on the character. It should be noted that everyone has two personalities or more, each one appearing in a different position or situation. For instance, a man can be a father, a lover, an employee, a son or anyone else .. in another position, he might be a master, and in another a looser begging for the mercy of his humiliator, and sometimes he can show weakness to the one he loves, or show strength to his enemie
... Show MoreDue to a party's violation of his obligations or responsibilities indicated in the contract, many engineering projects confront extensive contractual disputes, which in turn need arbitration or other forms of dispute resolution, which negatively impact the project's outcome. Each contract has its terms for dispute resolution. Therefore, this paper aims to study the provisions for dispute resolution according to Iraqi (SBDW) and the JCT (SBC/Q2016) and also to show the extent of the difference between the two contracts in the application of these provisions. The methodology includes a detailed study of the dispute settlement provisions for both contracts with a comparative analysis to identify the differences in the appli
... Show MoreThe term ‘photometry’ refers to the accurate determination of the apparent brightness of an astronomical object. Until roughly 1980, nearly all astronomical photometry was done by means of analog measurements of photographic plates, or by analog or digital (photon-counting) techniques with photomultipliers. These photometers produced brightness readings which were typically displayed on dials, plotted on strip charts or printed on strips of paper, and it was often quite practical to analyse these raw data with pencil, paper and a slide rule or table of logarithms. However, during the late 1970s electronic area detectors for astronomy became more advanced: first, for a brief period, television-type cameras were employed, but these were s
... Show MoreThe objective of this research was to investigate the effect of replacing fat(shortening) with different percentages of tahena on the quality properties (physiochemical and sensory ) of shortened cake.The percentages of moisture,protein ,fat and ash of cake increased significantly(p<0.05) as the replacement was increased .The highest increase percentages were 10,48,5,and 90 %,respectivly, at 100% replacement .Carbohydrate,however,decreased by 10%at 100% replacement .these findings may indicate improvement of cake nutritional value.Standing height,as an indicator of cake volume, also increased significantly by 4% at the 50% replacement then it decreased by 4% 100% replacement level. Basic formula (control) has signific
... Show MoreIn this paper, the fuzzy logic and the trapezoidal fuzzy intuitionistic number were presented, as well as some properties of the trapezoidal fuzzy intuitionistic number and semi- parametric logistic regression model when using the trapezoidal fuzzy intuitionistic number. The output variable represents the dependent variable sometimes cannot be determined in only two cases (response, non-response)or (success, failure) and more than two responses, especially in medical studies; therefore so, use a semi parametric logistic regression model with the output variable (dependent variable) representing a trapezoidal fuzzy intuitionistic number.
the model was estimated on simulati
... Show MoreThis study aimed to IQ test standardization of Marten Lother Johan which used with childreen of the tow stage at primary schools who aged (7) years old in Baghdad (Resafaa and Kharh).
The importance of this study are :
1-The importance of childhood and its role to develop the personality.
2-The importance of this age as the child will exposure to different kind of official teaching .
3-The capability for early detection of special category for early intervention in order to provide the necessary care .
4-Using the current test could consider as a predictive tool to screen the intelligent children .
In order to achieve the study aim, the researcher had followed the
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