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.
This study aimed to evaluate the preparedness and adherence of community pharmacists to the International Pharmaceutical Federation (FIP) Health Advisory COVID-19 guidelines for pharmacists (July 2020) during COVID-19 pandemic. This was a cross-sectional study based on electronic survey using google form, which was distributed from November 19, 2020 to January 1, 2021 using social media platforms. The survey measured 21 pharmacy preventive measures (PM). A multivariate regression analysis was used to identify factors influencing pharmacy implementing of PM. Hand disinfection after serving patients represented the main adopted measure (89.3%). Surprisingly, only 35.4% of participants implemented the proper ways of hand disinfection during fa
... Show MoreExpansive soil is one of the most serious problems that face engineers during the execution of any infrastructure projects. Soil stabilization using chemical admixture is one of the most traditional and widespread methods of soil improvement. Nevertheless, soil improvement on site is one of the most economical solutions for many engineering applications. Using construction and demolishing waste in soil stabilization is still under research., The aim of this study is to identify the effect of using concrete demolishing waste (CDW) in soil stabilization. Serious tests were conducted to investigate the changes in the geotechnical properties of the natural soil stabilized with CDW. From the results, it is concluded that the
... Show MoreThis research seeks to explore the impact of notifications on enhancing user engagement with websites, primarily through user subscriptions and their interaction with notifications on these websites. The significance of this study lies in its implications for crafting compelling headlines that capture users' attention, streamline their access to journalistic content, and align with the objectives and editorial policies of news websites. It sheds light on the factors influencing users' preferences for specific notifications and their engagement with content based on their individual interests, motivations, and the satisfaction derived from such interactions.
The researcher has reached several key findings, inc
Abstract
The aim of the research is to demonstrate the role of uncertainty in adopting the general requirements for the strategic environmental assessment of service departments in Babil Governorate and the Environment Department. By focusing on a range of environmental problems, despite the efforts exerted to deal with the environme
... Show MoreDrawing upon the recent theoretical framework of Burkean concept of identification (ID), the current study aims at probing the interaction of content and form in two letters penned by Iran’s Supreme Leader and addressed to the Youth on Jan. and Nov. 2015. To this end, the study seeks (i) to determine a role ID takes in the conveyance of intended assumptions to the targeted readers; and (ii) to observe if the writer’s objectives, i.e. to identify himself with the readers and to realize his politically-religiously-infused creeds, result in success or failure; moreover, (iii) it seeks to determine how he achieved his end to attenuate the impacts of blazing inferno of Islamophobia and anti-Islam sentiments in his addressees. The who
... Show MorePurpose: The research aims to build an integrated knowledge framework for the basic research topic. The spirituality of the workplace is through access to the most important scientific proposals on these topics. In management thought framing, the knowledge within them in a serious attempt is to provide the appropriate answers about the intellectual dilemma of research by diagnosing the nature of the relationship with the influential elements and its historical development . Methodology: The study is relied on the analytical survey method. The research sample targeted (88) managers in the center of the Iraqi Ministry of Health exclusively from the researched senior leaders (general manager, assistant general manager, and head of department),
... Show MoreThis research aims to identify the impact of the selective model in acquiring the concepts of Kurdish grammar among female students in the eighth grade, and to achieve the goal of research, the researcher selected the experimental design with partial control and dimensional testing; the sample includes basic schools in the Chim district of Chamal/ Sulaymaniyah and randomly selected the basic school (Maha Bad) to be the field of application of the experiment and the random drawing method was chosen: two out of three sections and the number of students of the two sections is (75) students; section (C) represents the experimental group that studied the rules according to the selective model and its number is (37) students, while secti
... Show MoreThis Study Sought to Determine The Relationship and Impact Between The Tax Core Capabilities and Tax Settlement The Study Took Place in The Tax Administration, and Based The Problem Was to Two Hypotheses As Solutions Initial Mocked Content to Explain The Relationship Between The Phenomena, and to Test The Validity of Assumptions And Due To The Fact That The General Authority for Taxes is The Body for The Advancement of The Collection Tax In Iraq Random Sample Was Selected to Represent The Population of The Study, Since The Sample Included 22 Individuals Representing 70% of The Total Community to Study, Represented by The Director General, Agents and Directors of Departments and Branch Managers Managers Working in The General Authority fo
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