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 current research aims to identify the level of partnership between school and community agencies to improve secondary school outcomes for students with intellectual disabilities and develop strategies that help enhance community partnerships between schools and agencies. The researcher used the qualitative research approach; he utilized the interviews as a tool for data collection. The sample of research included (12) participants: three female school leaders, three male-school leaders, three female-school supervisors, and three male-school supervisors in schools that have programs for students with intellectual disabilities in Riyadh. The results of the study showed that the level of partnership bet
... Show MoreSince the Internet has been more widely used and more people have access to multimedia content, copyright hacking, and piracy have risen. By the use of watermarking techniques, security, asset protection, and authentication have all been made possible. In this paper, a comparison between fragile and robust watermarking techniques has been presented to benefit them in recent studies to increase the level of security of critical media. A new technique has been suggested when adding an embedded value (129) to each pixel of the cover image and representing it as a key to thwart the attacker, increase security, rise imperceptibility, and make the system faster in detecting the tamper from unauthorized users. Using the two watermarking ty
... Show MoreThe investment government expenditure is considered the fundamental of enhancing the economic activity as it has become a mean for achieving capital accumulation in all economic sectors, The Iraqi economy is characterized of being yield unilateral depending petroleum revenues as an essential resource of financing government expenditure , as the contribution of petroleum sector in GDP is large in proportions to other economic sectors contribution.
The relationship between investing government expenditure, and non-oil GDP is about to be not existent during the
... Show MoreThe understanding exchange rate policy is fundamental in order to identify the mechanism by which works out macroeconomic, And the vital for macroeconomic analysis and empirical work to differentiate between the de facto regimes and de jure regimes, Where the proved surveys and studies issued by the international monetary fund that there is divergence between the de facto regime (Regime of exchange applied by the country actually) and between the de jure regime (Regime de jure through the documents and formal writings of officials of the central bank), And launched studies on the de facto regime (Being a the basis of evaluating monetary policy) Stabilized (peg-like)arrangements or
... Show MoreBACKGROUND: CRC is one of the most common cancers in the world. K-ras is proto-oncogene with GTPase activity that is lost when the gene is mutated. Analysis of K-ras mutational status is very important for CRC treatment, being the most important predictors of resistance to targeted therapy. OBJECTIVE: This study aims to determine the frequency and spectrum of K-ras mutation among Iraqi patients with sporadic CRC. PATIENTS, MATERIALS AND METHODS: This study enrolled 35 cases with sporadic CRC; their clinicopathological parameters were analyzed. The FFPE blocks were used for DNA extraction; PCR amplification of K-ras gene and hybridization of allele-specific oligoprobes were performed. The assay covers 29 mutations in the K-ras gene (codons 1
... Show MoreThe Influence of Some Vitamins and Biochemical Parameters on Iraqi Females’ Patients with Malignant Breast Cancer"
Objective : The present study is aimed to evaluate the effectiveness of short wave diathermy and
ultrasound therapy for the management of patients with knee osteoarthritis
Methodology : all patients who referred to the Medical Rehabilitation Unit in Baghdad Teaching
Hospital and Sadr A!-Qanat Center. The period of the study was from October 2004 to April 2005, total
number of patients was 24 (9 male and 15 female). Age range of patients was 42-70 years. Complete
clinical and radiological examinations were achieved on all patients and referred to the Medical
Rehabilitation Unit for physiotherapy. Short wave diathermy and ultrasound therapy were applied on
all patients.
Results : Demographic distribution revealed th
The research aims to study the entrepreneurial performance of the banks, according to the intelligence of competitive and strategic as the entrepreneurial performance is the one who does not stand the benefits of excellence in accomplished when just achieving the bank's objectives planned, but exceed it down to creativity in accomplishing these goals in a manner leads to making a entrepreneurial bank in the markets and the focus the eyes of competitors and the banks and other Following his example.
Was chosen the subject of research and strategic intelligence and competitive because of its impact on the strategic success of the banking sector, the fact is the entrepreneurial in the Iraqi banking mar
... Show MoreIn this paper we use the Markov Switching model to investigate the link between the level of Iraqi inflation and its uncertainty; forth period 1980-2010 we measure inflation uncertainty as the variance of unanticipated inflation. The results ensure there are a negative effect of inflation level on inflation uncertainty and all so there are a positive effect of inflation uncertainty on inflation level.  
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