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.
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Abstract
The research aims to diagnose the reality of applying the eighth requirement (operation) of the business continuity management system according to the international standard (ISO 22301: 2019), in the General Tax Authority, which is related to planning, implementing and controlling specific processes and procedures to address risks and opportunities, and the research adopted the checklist of the standard ( ISO 22301: 2019), in obtaining information, to measure the extent of application and documentation, the percentages and the weighted arithmetic mean were relied upon, and the research reached a set of result
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The aim of this research is to identify the effectiveness of thinking skills in developing the life skills of the students of the first Academic year, particularly the differences in life skills according to the variable of study specialization (human-scientific). To achieve the research objectives, the life skills scale was constructed on the classification of (WHO). The psychometric properties of the scale were examined. The validity of the scale, which is the final form of (60) items, was valid for measuring the life skills. The scale was then applied to the research sample of (112) students of the first year of the University of Bisha. The SPSS program processed
... Show MoreObesity is a risk factor associated with age-related disorders that accelerate aging, and it increases the risk of metabolic diseases. Therefore, this study was conducted to investigate the association of leukocyte telomere length (LTL) with the presence of higher body weight in middle-aged females and males. The study subjects comprised 160 (80 control and 80 higher body mass index BMI groups) with ranging ages of 30-50 years included and stratified for BMI. The physio-biochemical analysis was measured using enzymatic determination. Mean telomere length was determined by using the southern blotting technique. The association analysis revealed a significant variance (P < 0.01) in biochemical parameters between higher BMI grou
... Show MoreBackground: Parvovirus B19 is a human pathogenic virus associated with a wide range of clinical conditions. During pregnancy congenital infection with parvovirus B19 can be associated with poor outcome, including miscarriage, fetal anemia and non-immune hydrops.
Objective: The study aimed to determine the prevalenceof Parvovirus B19 DNA in pregnant women attending the Military hospital in Khartoum, demonstrating the association between the virus and poor pregnancy outcomes.
Subjects and methods: This study was a cross sectional study, testing pregnant Sudanese women whole blood samples (n= 97) for the presence of Parvovirus B1
... Show MoreThe study aims to make an in-depth analysis and the financial account components in the Iraqi balance of payments because it reflects the economic center of the country towards outside world, it also helps in making decision about monetary and financial policies, finance and foreign Trade the importance of FDI for Iraq lies as an important sources as wells provides advanced technology and job chances, It also avoids the country negative effects of borrowing processes from abroad . for analyzing direct and indirect foreign investment on the balance of payments and financial account in a period between (2003 to 2015), a community and research sample have been selected, presented in CBI/ Balance of payments. Department,
... Show MoreArab-Islamic architecture has undergone a change at multiple levels affected by modern technology, so the research sought to address the role of contemporary technologies on a fundamental and fundamental component of architecture, which is the architectural space, what is known as the essence of architecture and its ultimate destination, with a focus on the architectural space in the architecture of the contemporary Arab Islamic mosque, because the mosque’s architecture is so important in Islamic law and the belief of the Muslim person himself, where the mosque is the functional style produced by the Islamic faith and embodied in it, whereas, knowing the levels of influence of contemporary technologies in the architectural spac
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