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.
The research aims to: Preparing rehabilitative exercises with accompanying tools to rehabilitate those with shoulder dislocation. Knowing the effect of rehabilitative exercises and accompanying aids in improving the muscular strength and motor range of those with dislocations in the shoulder joint. The two researchers used the experimental design with the same experimental group with the pre and post tests, so the researcher chose a sample appropriate to the nature of his research problem, its goals and its hypotheses, as a sample of the injured was chosen to remove the shoulder joint, who completed the treatment, who were not practicing sports, and those who went to the Physiotherapy Center at Al-Was
... Show MoreThe research problem is to determine the nature of the historical relationship between the profession of social work and volunteer work. Consequently, the research aims to investigate the nature of this relationship from a socio-historical perspective. Three axes have been used to analyze this relationship: the role of voluntary work in the development of the social work as a profession, the efforts made by social work to reach professionism and to distinguish it from voluntary work, and the relationship between social work and voluntary work. The research is qualitative analytical research and adopts the Mixed Methods Research (MMR). It identifies some literature for the analysis and implementation of a scoping process. It represents a
... Show MoreAbstract The percent study aimed to determination the association between infant feeding practices and Insulin-Dependent Diabetes Mellitus (IDDM). The study was conducted at (he National Center of Diabetes in Baghdad City the Capital of Iraq throughout the period of January 2001 to January 2002. The sample was comprised of (200) mother of Insulin-Dependent Diabetes Mellitus (IDDM) of children under age of 12 years old. Data was collected through the use of a questionnaire that constructed by researcher and which were developed for the purpose of the present study. Reliability of the instruments was dete
Presents here in the results of comparison between the theoretical equation stated by Huang and Menq and laboratory model tests used to study the bearing capacity of square footing on geogrid-reinforced loose sand by performing model tests. The effects of several parameters were studied in order to study the general behavior of improving the soil by using the geogrid. These parameters include depth of first layer of reinforcement, vertical spacing of reinforcement layers, number of reinforcement layers and types of reinforcement layers The results show that the theoretical equation can be used to estimate the bearing capacity of loose sand.
Resumen Introducción Debido a su exigente entorno académico, el dolor lumbar crónico (DLC) es un trastorno musculoesquelético común entre los estudiantes de medicina, lo cual es particularmente preocupante. El tabaquismo es un factor de riesgo conocido por causar diversos problemas de salud y se ha asociado con el DLC, pero la relación específica entre el tabaquismo y el DLC aún no ha sido bien explorada. Objetivo Este estudio tiene como objetivo investigar la asociación entre el tabaquismo y el DLC en estudiantes de medicina en Irak. Diseño Se empleó un diseño descriptivo transversal que involucró entrevistas cara a cara con 200 estudiantes de medicina de 18 años o más. Los datos sobre características demográficas, comport
... Show MoreIn this paper, The transfer function model in the time series was estimated using different methods, including parametric Represented by the method of the Conditional Likelihood Function, as well as the use of abilities nonparametric are in two methods local linear regression and cubic smoothing spline method, This research aims to compare those capabilities with the nonlinear transfer function model by using the style of simulation and the study of two models as output variable and one model as input variable in addition t
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