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 objective of this research is to analyze the relationship between the strategic planning for human resources and career path, and I have tested Search the Ministry of Health and some health centers headquarters in the Karkh district, that is applied in sample Consist of (45) Deputy Director, Head of Depts, Departmental Manager, and health center Manager.
Find interested in studying the two subjects are important and vital, at the level of organizations at the present time, namely the strategic planning of human resources and career path. To achieve the objectives of the research was designed Qusestionnair (31) items to collect Primary data. and collected t
... Show MoreThe research depth and dimensions of the problem of environmental pollution resulting from the combustion of fuel used in electric power generators, especially in the summer and you are the national electric power supplied by almost non-existent state where this problem is a local phenomenon that has serious dimensions to human health, as well as the possibility of using a the tax system tools of b (environmental taxes) to reduce these pollutants, so the search is aimed at the types of gases emitted from burning fuel electric generators operating in the province of Baghdad and then measure the amount of environmental pollution as well as compared to the amount of some of these gases, which is more risk to humans with permitted by the Wor
... Show MoreNew chlropheniramine maleate (CPM) selective electrochemical membranes were prepared by using chlropheniramine maleate -molecularly imprinted polymers. MIP was prepared by bulk polymerization using 2-hydroxyethyl methacrylate (2-HEMA) as monomer, ethylene glycol dimethacrylate (EGDMA) as a cross-linker and a benzoyl peroxide (BPO) as an initiator at 600C. Three CPM-MIP electrodes were constructed by using tri-tolyl Phosphate (ToCP), tris (2- ethyl hexyl) Phosphate (TEHP) and tributyl Phosphate (TBP) as plasticizers in PVC matrix.Electrode parameters including slopes, working concentrations ph. The interference effect in the presence of (Na+, Mg+2, Al+3, Glycine, Alanine, Arginine and Phenylalanine) was studied using the separated a
... Show MoreThe aim of the current research is to reveal the effect of using brain-based learning theory strategies on the achievement of Art Education students in the subject of Teaching Methods. The experimental design with two equal experimental and control groups was used. The experimental design with two independent and equal groups was used, and the total of the research sample was (60) male and female students, (30) male and female students represented the experimental group, and (30) male and female students represented the control group. The researcher prepared the research tool represented by the cognitive achievement test consisting of (20) questions, and it was characterized by honesty and reliability, and the experiment lasted (6) weeks
... Show MoreThe sunrise, sunset, and day length times for Baghdad (Latitude =33.34º N, Longitude =44.43º E) were calculated with high accuracy on a daily basis during 2019. The results showed that the earliest time of sunrise in Baghdad was at 4h: 53m from 5 Jun. to 20 Jun while the latest was at 7h: 07m from 5 Jan. to 11 Jan. The earliest time of sunset in Baghdad was at16 h: 55m from 30 Nov. to 10 Dec. whereas the latest was at 19h: 16m from 25 Jun. to 5 Jul. The minimum period of day length in Baghdad was 9h: 57m) in 17 Dec. whereas the maximum period was 14h: 22m) in 20 Jun. Day length was calculated and compared among regions of different latitudes(0, 15, 30, 45 and 60 north).
Al-Dalmaj marsh and the near surrounding area is a very promising area for energy resources, tourism, agricultural and industrial activities. Over the past century, the Al-Dalmaje marsh and near surroundings area endrous from a number of changes. The current study highlights the spatial and temporal changes detection in land cover for Al-Dalmaj marsh and near surroundings area using different analyses methods the supervised maximum likelihood classification method, the Normalized Difference Vegetation Index (NDVI), Geographic Information Systems(GIS), and Remote Sensing (RS). Techniques spectral indices were used in this study to determine the change of wetlands and drylands area and of other land classes, th
... Show MoreStable isotopes 18O/16O and 13C/12C in the carbonate rocks of the Mishrif Formation are examined here to define the depositional characters in the basin includes paleo temperatures and paleo depth. The Mishrif formation (Cenomanian – Early Turonian) has extensive distribution in Iraq and Middle East. Mishrif Formation composed of organic detrital limestone. Four boreholes in four oilfields, Noor – well (11), Amarah – well (14), Buzurgan – well (24), Halfaya – well (8), in south east of Iraq have been studied. The studied samples have negative δ18O isotope values studied well, with Average (-4.11‰), (-4.47‰), (-4.48‰), (-4.18‰) in the studied wells res
... Show MoreIn recent years, non-oil primary balance indicator has been given considerable financial important in rentier state. It highly depends on this indicator to afford a clear and proper picture of public finance situation in term of appropriate and sustainability in these countries, due to it excludes the effect of oil- rental from compound of financial accounts which provide sufficient information to economic policy makers of how economy is able to create potential added value and then changes by eliminating one sided shades of economy. In Iraq, since, 2004, the deficit in value of this indicator has increased, due to almost complete dependence on the revenues of the oil to finance the budget and the obvious decline of the non-oil s
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