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
Among the things that have happened and that have emerged from the developments in society is the phenomenon of dairy banks, where institutions collect milk from donating mothers or sellers of milk and benefit from it by sterilizing and selling it.
This topic is considered one of the important topics, as Islam considers breastfeeding as a link as well as parentage, and it has the same genealogy as the spread of sanctity. Therefore, Imamate jurists addressed this topic with research despite its absence in Islamic societies.
The importance of r
... Show MoreThe research dealt with the concepts of the philosophy of values and its epistemological variables according to specific propositions represented in their scientific approaches to value theory in the field of industrial design. As the epistemological propositions of the theory of values were dealt with based on the epistemological fields that dealt with the concept and what values are, starting with the modernist propositions and postmodern, passing through the propositions of sociological and psychological thought, which was a prelude to extracting the concepts of value theory and adopting it in the field of industrial product design. The epistemological approaches to value theory in industrial product design were repr
... Show MoreOne of the prominent goals of Metrical Phonology Theory is providing stress of poetry on the syllable-, the foot-, and the phonological word- levels. Analysing poetry is one of the most prominent and controversial issues for the involved number and types of syllables, feet, and meters are stable in poetry compared to other literary texts. The prosodic seeds of the theory have been planted by Firth (1948) in English, while in Arabic يديهارفلا in the second half of the eighth century (A.D.) has done so. Investigating the metrical structure of poetry has been conducted in various languages, whereas scrutinising the metrical structure of English and Arabic poetry has received little attention. This study aims at capturing the
... Show MoreGlassy polymers like Poly Mathyel Metha Acrylate are usually classified as non-porous materials; they are almost considered as fully transparent. Thin samples of these materials reflect color changing followed by porous formation and consequently cracking when exposed to certain level of ?-irradiation. The more the dose is the higher the effect have been observed. The optical microscope and UV-VIS spectroscopy have clearly approved these consequences especially for doped polymers.
Doppler broadening technique is suggested to monitor the development of tumours. It depends on the sensitivity of positronium (Ps) annihilation parameters to the sub- microstructural changes in biological tissues. This technique uses high resolution HpGe detector to measure the lineshape parameters (S and W) in normal mice's mammary tissues and adenocarcinoma mammary tissues as a function of tumour growth. The results demonstrate that the central parameter (S) decreases and the wing parameter (W) increases as the tumour grow. It is found that the S parameter changes considerably with the distribution of voids which are affected by the tumour development. Therefore the present technique can successfully be employed to monitor the developm
... Show MoreThe present study was carried out on forty eight epididymis of sexually mature dogs to elucidate light microscope features and the presence of testosterone receptors inside epididymis in different seasons. Twenty four dogs aged 3 years were used during the periods from 1/2/2015-1/2/2016. The epididymis were carefully dissected from the testis after orchidectomy operations and fixed, dehydrated, clarified and embedded in paraffin. Sections were stained with hematoxylin and eosin and periodic acid schiff. As well as, paraffin embedded cytoimmunochemistry technique was used for detection of testosterone receptors. Muscular coats showed no significant differences during different seasons or among segments. Epithelial heigh
... Show MoreThe study was carried out at field agriculture in Baghdad–Iraq in 2015. For purpose evaluated the performance the selected implements tillage, suitable tire pressure and speed tractor under silt clay loam to measured Effective field capacity, Actual Time for plowing One Donam ( hr), Appearance Tillage ( number of clods > 10 cm), Fuel consumption measure in two unit (L/Donam and L/hr) and Machinery Unit Energy Requirement ( kw.hr / Donam). Split – split plot design under randomized complete block design with three replications using Least Significant Design 5 % was used. Three factor used in this experiment included Two types of plows included Chisel and Disk plows which represented main plot, Three Tires Inflation Pressure was second fa
... Show MoreBackground: Laparoscopic cholecystectomy
has become the standard of care for the
elective management of cholelithiasis. Little
information exists, however, regarding the
appropriateness of this procedure in the setting
of acute symptomatology.
Objective: This study was designed to
evaluate the outcome of laparoscopic
cholecystectomy in acute and severe acute
cholecystitis based on early and late biliary
complications, their incidence and
management, and conversion rates to open
surgery.
Methods: A prospective study done between
April 2007 and November 2010, in the
department of general surgery, medical city
teaching hospital, Baghdad. Includes patients
with acute cholecystitis admitted f