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
Investment in the human resource has become an important part of the strategies of educational organizations so that they can be competitive, so that the access of academics in universities to the international awards as a result of their research excellence indicates the effectiveness of this human talent so the interest has emerged in the implementation of a strategy to manage these human talent in organizations in general and educational ones In particular as one of the power sources that can not be imitated. The focus of the organization on the interaction between the working people has increased attention to the human element in order to achieve the desired quality levels, which called for organi
... Show MoreThe researchers seek to shed light on the importance of accounting disclosure on social responsibility, and the research aims to provide a theoretical approach to social accounting and its disclosure, identify the concept of sustainable development, highlight the theoretical foundations of sustainable development and employ disclosure of social responsibility towards achieving the goals of sustainable development, and identify the impact of The accounting disclosure on social responsibility in achieving sustainable development goals, and the research problem can be reviewed by asking the following question (Does the accounting disclosure of the social responsibility of economic units contribute to achieving sustainable developmen
... Show Moreهدفت الدراسة الى الاهتمام واستغلال ماهو جديد من تقنيات واجهزة حديثة في تعليم السباحة الحرة عن طريق توجيه الاطفال على تطوير مداركهم واستيعابهم بالتطور التكنولوجي الذي يتناوله العالم ،قامت الباحثتان باعداد منهج تعليمي باستخدام نظارة الواقع الافتراضي وذالك بتوفير بيئة مشابهة للبيئة الحقيقية تحاكي مدارك عقول الاطفال في عالم افتراضي لتتكون صورة كاملة عن مهارات السباحة الحرة ،ومن هنا اتت المشكلة نتيجة تعل
... Show MoreIn The Name of Allah Most Gracious Most Merciful
Scholars, past and present, have paid attention to the books of Fasting and Hajj, and they have compiled literature on that, and they have written treatises and researches. The best days, and as for the pilgrimage, it is one of the great pillars of Islam, which God Almighty has distinguished by making its rituals in the best of places, which is the Sacred House of God.
Football is one of the most important team sports, practiced by men and women, young and old, across various age groups. The physical development in this sport can be attributed to athletic training and modern technology, which have contributed significantly to advancing the sports field in general. Outstanding performance in football requires precise and quick physical abilities, closely tied to the competitive nature of the game. Speed is fundamental in football, making the use of technologies such as GPS tracking devices and heart rate monitors essential in both training and matches. This study aims to develop the speed of Al-Talaba SC players in Baghdad using a scientifically-based approach to improve their performance. The impo
... Show MoreOne of the contemporary trends in education and training is the use of educational, competitive and digital games, because one of the most important goals of games is (motivation and challenge). Thus, it ensures the expected reaction from the recipient’s interaction with the game, so we seek his interaction with the content he receives. It is no secret that games distance him from boring content and introduce him to the world of motivation by integrating them with magical elements that make an attractive and desirable game. Naturally, in the case of stimuli and motives that activate the recipient within the context of the educational process procedures, the return is high and especially enjoyable. The aim of the research is to pre
... Show MoreThe developing countries, like our country Iraq suffer from deep comprehensive structural crisis, manifestations and a clear imbalance between the demand and the supply sides. The overall imbalance in the external balance. As a consequence, this caused the accumulation of foreign debts or failure in the implementation of economic development programs. The countries which are forced to resort to the International Monitoring Funds, and the World Bank for assistance and to express an opinion on policies that include restrictions controls that belong to the monetary, and fiscal side group, imposed on the economies crisis, as a condition for returning to normal which called reform programs. The organize of the events of radical changes in the
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Most of the industrial organization in the world became suffering from the problem of the pollution of the poisonous chemicals things, this urged to depend on the principle of the responsible production, because it has the positive role by dealing with these chemical things and to safe the health of the society, due to the main goal of this study is to restrict the role responsible production in accomplishing the system of the environmental management through an actual study in the northern gas company in Kirkuk province, the topic has acquired a big importance bacause there were a limited number of studies and res
... Show MoreThis research aims to numerous risks to the portfolio of the insurance company that arise from practicing the activity in general, and the risks arising from insurance contracts in particular, and what is the role of the company in the disclosure to help users (such as owners) to understand and concentration of risks in the financial reporting and identifying movable risks size to reinsurers that may affect the solvency of the portfolio and makes them at a given moment required to fulfill the obligations towards policyholders outweigh the financial capacity, which leads to stumble or bankruptcy.
So I sought this research is to identify the extent of the obligation to disclose the accounting for this risk and the extent of their i
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