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 study included examination of three types of different origin and orange juice at the rate of recurring per sample, the results showed that the highest rates of acid (pH) in the A and juice were (4). And salts of calcium is 120 ppm in juice C and 86 ppm of magnesium in the juice B, for heavy metals the highest rate of lead .18 recorded ppm in juice B, 1.32 ppm of copper in juice A, 5 ppm of iron in the juice B, 1.3 ppm of zinc in the juice B, 0.05 ppm of aluminum in each of the sappy B and A, 0.02 ppm of cobalt in the juice B, 0.3 ppm of nickel in the juice B, 170.6 ppm sodium in C juice, but for the acids, organic that the highest rates were 3.2 part Millions of acid in the juice owner a, 260 ppm of the acid in the juice the ascorbi
... Show MoreBackground: Neonatal hyperbilirubinemia is a common disease in neonates especially in early days of birth that requires a good and successful treatment for reducing the severity and its complications that can produce important and irreversible effects.
Objectives: To evaluate the effectiveness of conventional phototherapy, intensive phototherapy and exchange transfusion on outcomes of neonatal jaundice at Fatima Al-Zahra Hospital for maternity and child care in Baghdad.
Patients & Methods: A retrospective study was carried out using medical records of neonates with diagnosis of unconjugated jaundice, admitted in the septic neonatal care unit of Fatima Al-Zahra hospital over 6 months period b
... Show MoreDiversity the terms and practice the organizational filed with different concepts and environment, which Iraqi environment part from them. Some organizational in Iraqi environment leave its basic oriented to agreement with the leader desire, their fore this research focus tow basic variable (organizational citizenship behavior & transparence), we supposition which is dependent to explanation the response variable (strategic leadership). The results justification in part and not justification in another part. For example the organizational citizenship behavior effect on some parte of the strategic leadership. The transparence have faraway to fly from the relation with organizational citizenship behavior and strategic leadershi
... Show MoreThe researcher attempts to diagnose the level of the effect of strategic thinking skills (intuition, meditation, creativity) of the managers in the Ministry of Health in Iraq and some of its institutions in the formulation of human resources management: (selection, training, incentivence , performance appraisal (Recognizing the importance of the subjects studied, and because of the importance of the expected results of th
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The purpose of the subject of Total quality management is an important management style in organizations including hospitals through the achievement of this method of success in the administration to include this approach describes the provision of health services and make adjustment and suggestions that help to improve the quality of health care on an ongoing basis . Hence the idea of the study to shed light on the reality of the application of principles of Total quality management and to highlight the quality of health services provided in al-kindi hospital / Baghdad health department rusafa and the staff at the hospital were included to find out the appl
... Show MoreAbstractOBJECTIVES: To evaluate the long-term remission efficacy and safety of isotretinoin in the treatment of Behcet's disease (BD). PATIENTS and METHODS: This single-blind, controlled therapeutic study was conducted in the Department of Dermatology and Venereology at Baghdad Teaching Hospital from February 2011 to January 2012. Thirty patients with BD were included in this work. Each patient received isotretinoin 20 mg orally once daily for 3 months. They were assessed at week 2 and then monthly depending on the Clinical Manifestation Index (CMI) and to record any side effects. At week 12, isotretinoin was stopped and patients were given placebo therapy in a form of glucose capsules for another 3 months. RESULTS: Thirty patients were tre
... Show MoreEMS in accordance with ISO 14001: 2015 is considered an entry point to reduce environmental impacts, especially the effects resulting from the oil industry, which is the main source of environmental pollution and waste of natural resources, since the second revision of the standard took place in September 2015. The problem of the research was manifested in the weakness in understanding the correct guidelines that must be followed in order to obtain and maintain the standard. The purpose of this research was to give a general picture of what is behind ISO14001:2015 and how it is possible to create a comprehensive base for understanding its application by seeking the gap between the actually achieved reality, standards requirements
... Show MoreInform the people of the Enlightenment including what was said in detail
In photography
For Mohammed Hashim bin Ahmed footy famous Balva Hashim (Tel: 1349 e)
Active compounds were extracted from Anethum gravoelens to produce safety vegetable treat for diabetic, the results showed that alcoholic extract of Anethum gravoelens contain Alkaloid, glycosides, phenols, resins, saponins, coumarins, flavonoide, terpenes, steroids and volatile oils. after that it was studied the effect of alcoholic extract at dose 50, 100 mg/kg of body weight in reduced glucose level in serum of diabetic rats induced by alloxan, after the end of experiment for period 30 days the rats fasting 12 hours to measure the level of glucose in serum, the result showed asignificant decrease in serum glucose level of rats treated with extract in comparison with positive group (alloxan), So biochemical tests showed significant dec
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