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 resources-based introduction in the study of business organizations is increasingly dealing in the study of the human capacities and the best ways to develop them and changing the resources of the organization to be essential and competent to face the business challenges. Today’s organizations need crucial practices to face those challenges and the influences of those practices which take into consideration the importance of developing the entrepreneurship inside the organization. Those practices are called “High Performance Work Systems” which is denoted by “HPWS” and defined as the practices of human resources management which help in acquiring func
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Dealing economic units at the present time with an industrial environment characterized by competitiveness and the pace of change and its strength as a result of this changing environment shall be on those who made it to adopt strategies that allow them to confront these variables and work in order to meet the market requirements of quality and price appropriate products to suit and the demand for those products and conditions to maintain
its competitive position and its development.
As a result, it became the subject of competitiveness in recent years and enjoys widespread attention at the global level. And in order to keep up
... Show MoreThe aim of the study is to diagnose the real level of technology usage in teaching and learning EFL at university from teachers and students’ viewpoints, and see if it is possible to achieve something of the researchers’ dream - accessing top universities. Two questionnaires have been used to measure the range of technology usage in Colleges of Education for Women, Baghdad and Iraqi Universities, and College of Basic Education. The results have shown that the reality of using technology is still away from the dream. The results have been ascribed to two reasons: The first is the little knowledge of using technology in teaching, and the second is that technology is not included in the curriculum.
The study aims at fathoming Robert Browning’ and Robert Lowell’s intentions of choosing the dramatic monologue as a means of exploring human psyche. Significantly, the themes of insanity and murder are not ideal from an esthetic perspective, but for Browning and Lowell it provides the key to probe into human character and fundamental motives. This study examines Browning’ and Lowell’s dramatic monologues that address crime and the psyche of abnormal men. Browning’ and Lowell’s poetry in this regard unravels complicated human motivations and delineates morbid psychologies. Their monologues probe deep down into the mind-sets of their characters and dissect their souls to the readers. The main character of each of Browning
... Show MoreThe study of the concepts of "democracy" and "human rights" and their impact on development, has taken a prominent place in the context of general political and cultural concerns, or in specialized studies even though researchers and scholars do not agree on defining the concepts: Democracy, Human Rights, Development or deriving a global definition hindering them, and that because of the importance of this topic, which proceeds from a number of considerations standing in the forefront, of which:
First: What the world witnesses today in the first decade of this century of consecration of the unipolar theory, trying to give its concepts and perceptions through the law ((excessive force)) to the power of international
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... Show MoreThe article includes the concept of aesthetics through what has been dealt with in the literature by philosophers and researchers who have addressed this concept in an attempt to derive indicators of aesthetics. The article adopted a descriptive and analytical methodology by reviewing recent literature on the concept of aesthetics and its relation to urban planning and design issues. Many subjective and objective aesthetics indicators have been identified, some of which are classified under real aesthetics, and some under fake aesthetics. The indicators were applied to the Kufa Mosque complex and Sahla Mosque complex as a comparative case study. It was found that the indicators of real aesthetics have a higher weight in determining
... Show MoreThe Muslim woman actively participated in narrating, preserving, controlling and maintaining the hadith, along with her brother, the man who later became an inexhaustible representative of the effort to preserve, control, and narrate the Sunnah. Undoubtedly, the mothers of the believers, may God be pleased with them, had a great advantage in communicating Islam and spreading the Sunnah of the Prophet Especially among women, all of them heard from him, may God’s prayers and peace be upon him, and lived with him in the details of his life on the disparity between them in memorizing and narrating and publishing them. It narrated (378) recently, and it is considered the second narrator after the mother of the believers Aisha, may God be pl
... Show MoreSpecimens of the sesarmid crab Nanonsesarma sarii (Naderloo and Türkay 2009) were collected from the intertidal zone of Khor Al-Zubair, Basrah, Iraq 2012 far from the Arabian Gulf coasts. Morphological features of this species are highlighted and a figure is provided.