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 study discussed three areas in strategic thinking, namely, (patterns elements, outcomes) , this study aimed to measure extent to which strategic leaders have the type or types of patterns of strategic thinking, and measure the extent of their use of the elements of strategic thinking, and measurement of strategic thinking outcomes for managers at various levels , And to know the relationship between the modes of strategic thinking, elements and outcomes in organizations. the study included five banks and four hospitals and four colleges and universities, has been a research sample consisted of 168 individuals, distributed in positions (Director General , Director of Directorate , Director of
... Show MoreThe electrode in the microbial fuel cell has a significant effect on cell performance. The treatment of the electrode is a crucial step to make the electrode surface more habitable for bacteria growth, thus, increases the power production as well as waste treatment. In the current study, two graphite electrodes were treated by a microwave. The first electrode was treated with 100W microwave energy, while the second one was treated with 600W microwave energy. There is a significant enhancement in the surface of the graphite anode after the pretreatment process. The results show an increase in the power density from 10 mW/m2 to 15 mW/m2 with 100w treatment and to 13.47 mW/m2 with 600w treatment. An organic
... Show MoreThe Reversed Phase High Performance Liquid Chromatography (RP-HPLC) has been used for the separation of Poly aromatic hydrocarbons(PAHs) by using column Reprosil 100 C 18 which was found to be a suitable one for this purpose. The result showed that using mobile phase of (Acetonitrile-water) Reversed Phase HPLC , flow rate of (1.2 ml/min) , column temperature (30CËš) and wave length of (254nm), give a complete separation with a good resolution . The total separation time was less than 20 min. The result of the study showed that the vegetables of Baghdad city were polluted by poly aromatic hydrocarbons(PAHs) in different places where samples taken because of drainage of the heavy water ,industrial trash and trash of oil colanders. -
... Show MoreThe current research dealt with a vital subject contributing In success Iraqi Industrial Companies general and Iraqi Cement state company A market knowledge, It is one of the most important industrial companies that Which serve to fill the local market need Of cement without resorting to import, The problem of research was limited understanding of the importance of the role played market knowledge of the tendencies and desires of competitors, This in turn affects the company's ability to achieve competitive advantages,The research aims to know the extent of adoption Iraqi Cement state company Concept market knowledge And employment achieving Competitive advantage By removing them (Cost, and quality, and del
... Show MoreThe aim of this study to conduct the effects of fimbrial and lipopolysacchride (LPS) immunization is on the pathohistological changes in rabbits, Fifteen rabbits of both sexes (Weight 1500-2000 gm) divided into three groups (5 animals of each group). The first group was immunized by 1ml (200µg /animal) of fimbrial subcutaneously the second group gave 1 ml ( 200 µg /animal) LPS while the third group was left as negative control group that injected 1 ml phosphate buffer control subcutaneously. First and second groups recived the same dose after two weeks give as booster dose. All animals challenged after 5 weeks of immunization by5X107CFU/ml Proteus vulgaris intra peritoneally .After 7 days from challenge all the animals, sacrificed for hi
... Show MoreThe aim of the present study is to investigate whether or not xanthine oxidase (XO)–derived reactive oxygen species (ROS) may play a role in the pathogenesis of alloxan (ALX)–induced diabetes in rats using the specific XO inhibitor and hydroxyl radical scavenger, allopurinol
The involvement of oxidative stress in ALX – diabetes was assessed by the measurement of plasma and various tissues lipid peroxides levels ( using thiobarbituric acid ( TBA ) reactive substances ). Furthermore, the ability of allopurinol to influence these and other biochemical parameters, including plasma and urine ketones levels were also investigated in diabetic rats.
Rats were divided into four groups: control, untreated diabe
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