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: BACKGROUND: Arthroscopic knee surgeries are performed in very large numbers worldwide, and in spite of relatively low complication rate, but the total number is significant. Some of these complications are due to tourniquet use and can be serious. OBJECTIVE: Is to asses if automated pump (with or without) dilute epinephrine saline irrigation can replace the tourniquet use in soft tissue arthroscopic knee surgeries. PATIENTS AND METHODS: 36 patients (9 females 25 % and 27 males 75 %) were included in this prospective experimental nonrandomized study, and were necessitated soft tissue arthroscopic knee surgeries. Patients were divided into two groups, in group A (patients) tourniquet and automated pump were used. In group B (18 pati
... Show MoreWidespread use of antihypertensive agents in clinical practice necessitates the knowledge of their pleiotropic effects. At the present time there are no sufficient evidences of positive effect of these medications on bone coming from randomized controlled trials; knowledge of additional effects of those drugs on the bone metabolism will allow doctors to choose optimal treatment of hypertension, taking into account the state of bone tissue. At the same time it will also allow to prevent osteoporosis in patients having osteoporosis risk factors or initial signs of bone loss.
Ten elderly hypertensive women age > 60 years old (64.2±3.6) treated with captopril for a 5-6 years ago while they attending Al Yarmouk Teaching Hospital i
... Show MoreThere are many causes for epistaxis but it is mainly idiopathic in type. In Management of epistaxis there are different modality either medical or cautery(chemical or galvanic) recently laser is used in management of epistaxis. The type of laser used in current study was 810 nm diode laser. The aim of the study is to evaluate its efficiency in control of active and non active idiopathic epistaxis; The design of the study is interventional therapeutic trial. The study was performed from December 2011 to December 2012 in Al Yarmouk teaching hospital at otorhinolaryngology department. In current study the diode laser is used in different power with same exposure time in all application; The power density is measured and choose the best one
... Show MoreThe article considers the language of the mass media as a synthesis of the language means of all other styles of language. It is alleged that the newspaper and journalistic language actively uses foreign words and elements of words, replenishing the vocabulary of the language. It is noted that the lexical-semantic system of language is sensitive to socio-economic, political, cultural and scientific-technical changes. Attention is focused on the fact that one of the reasons that affect the change in the lexical composition of the language are the mass media. Thus, the language of the media is characterized by the use of a variety of neutral vocabulary, which, in conjunction with other words in atypical combinations for it, can acquire additi
... Show MoreTHE ACTUAL SOCIETY MODEL
Our society model has been showing signs of exhaustion since the end of the XX century. The recent appearance of the Covid-19 virus is another consequence of humanity's distance from Nature and the environment it inhabits. Also, climate change, environmental deterioration, loss of biodiversity, overexploitation of natural resources, and social inequality are some of the consequences derived from this separation between society and Nature. We must change our operating habits. Inevitably from a society based on the market, hyper consumption, fossil energy and individual enrichment at all costs, we will have to change to another
... Show MoreA new way to Systems concentrates have been clarified and that allows a concentration high and analysis to automatically wavelengths of the spectrum of this system analyst of the spectrum and the center is built on Holucram Nafez gives less absorbency with efficient diffraction high when the wavelength (900 nm), which will be useful for Khallaya solar
The study aims at figuring out the intended meaning of intonation in some English conversational utterances together with identifying pitch variations that are determined by various syntactic constructions that impart the same illocutionary force of utterances. However, intonation is needed to delimit the communicative forces of utterances by virtue of its structure which the speakers intend to convey .This paper consists of four sections .Section one deals with phonology and its types .Section two discusses intonation in relation to style , forms and functions. Section three sheds some light on pragmatics. Section four deals in details with the intended meaning of intonation in some English conversational utterances. This paper comes up wi
... Show MoreIn life in general and in the press, especially the success of a particular message depends heavily shipments carried by, and images idyllic suggestive, how many meanings that reaching an audience, and is the magazines and one of those media that target a broad audience, trying to please Him and the acquisition of his attention through a form of aesthetic granted pleasure and satisfaction from this point of view, read image ad as Date pure incident of everyday life, and here was placed this research about the aesthetic image advertising in the covers of women's magazines, which has been briefing them through the Four Seasons included in the search, was the first chapter Batarh systematic talked about problem Find the placing on the form
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