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 the nineteenth century, a new type of cities appeared, known as new cities located on the edges of major cities, and these cities began to decentralization, urban studies turned to this type of cities to find out the most important reasons for the emergence of new cities and find out what those cities will become . Therefore, we will discuss in this research how the urban emergence of these cities (edge cities) occurs, so the research formulates its problem : The need to know the stages that edge cities go through, ending with their emergence, and the mechanisms that cities take within their context ( regeneration or adaptation ), Assuming that edge cities are a
... Show MoreMany cases of gravitational bullets are reported in developed and non-developed countries. However, few papers highlighted these cases in the literature. In our study, we present two cases of gravitational bullets that have an unusual coincidence in the injury characteristics through their ages, and gender, the site of the inlet.
The majority of statisticians, if not most of them, are primarily concerned with the theoretical aspects of their field of work rather than their application to the practical aspects. Its importance as well as its direct impact on the development of various sciences. Although the theoretical aspect is the first and decisive basis in determining the degree of accuracy of any research work, we always emphasize the importance of the applied aspects that are clear to everyone, as well as its direct impact on the development of different sciences. The measurements of public opinion is one of the most important aspects of the application of statistics, which has taken today, a global resonance and has become a global language that everyone can
... Show MoreObesity is disorder in a foremost nutritional health it’s developed with countries developing. Also is known as increasingin fat accumulation that lead toproblem in health, besidesmay coin one of the reasons lead toloss of life,the obesity not effect on adults just but effect onoffspringand juveniles. In some ofinhabitants the incidence of obesity is superior in female than in male; on the other hand, the variation degree of the between the genderdifferby country.Obesity is generally measured by body mass index and waist circumference, Obesity are classified according to body mass index into:Pre obesity sort 1 : (25 - 29.9) kg/m2, Obesity sort 2 : (30 - 34.9 kg/m2) and extreme obesity sort 3: (40 kg/m2) or greater. Obesity is described by
... Show MoreThe technical development has significant effects on the mediator Alcinmatugrave, and TV originated mainly based on technical, with the development and the continuation of these technologies and the enormous impact on the level of the television picture, initially dramas in recent times approaching in the aesthetic composition of the film thanks to the employment of modern digital technologies, Montag was not only one of the cinematic elements that went into television thanks to technical developments analogue and digital, and which added the possibility of large processors in the picture, high-definition digital cameras that have led to dispense often for artificial lighting intensive imaging light available, as these cameras have helpe
... Show MoreBackground: This study aims to determine whether cigarette smoking and anxiety degrees are related among nurses. Methods: A correlation design study was conducted at Baquba Teaching Hospital in Diyala Governorate, and the study period extended from September 10th, 2023, to January 28th, 2024. A nonprobability purposive sample was used to include 200 nurses working at Baquba Teaching Hospital, Iraq. Data were collected using a self-administered questionnaire from January 10th to February 7th, 2024. There were two components to the study instruments. Initially, the demographic sheet contained the individuals' sociodemographic data. The Taylor manifest anxiety scale is included in the second section. The collected data were analyzed us
... Show MoreAtherosclerotic cardiovascular disease (ACVD) is an inflammatory disease of the coronary arteries associated with atheroma formation, which can cause disability and often death. Periodontitis is ranked as the sixth most prevalent disease affecting humans affecting 740 million people worldwide. In the last few decades, researchers have focused on the effect of periodontal disease (PD) on cardiovascular disease. The aim of this review was to investigate the association between these two diseases. PD is a potential risk factor that may initiate the development, maturation, and instability of atheroma in the arteries. Two mechanisms were proposed to explain such association, either periodontal pathogens directly invade bloodstream or in
... Show MoreDiversity has become one of the required phenomena to be available within public organizations, in light of the changes taking place in the global and international environment and in various fields. Therefore, it was imperative to study the impact of this phenomenon in various institutions, especially public ones, in most developing countries, including Iraq. The current research aims to analyze the relationship between The demographic diversity and institutional effectiveness of a sample of workers in public institutions included (500) respondents. The questionnaires were distributed to them randomly. Diversity is considered an independent variable and institutional effectiveness a dependent variable. The researcher used interview tools a
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That Iraq's dependence on the revenues of the oil product in financing its development programs and growth rates , Making the economy affected by external forces represented by fluctuations in crude oil prices in the global market, Which is directly reflected on the performance and efficiency of the Iraqi economy.
The study adopted its objectives to analyze the time series for the period (1988 - 2015) through the use of standard and statistical methods, Four standard models were estimated to reach those targets, Where the results of the stability test showed instability of most variables at their original level, But to achieve stability when taking the first differences, While the result
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