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
Rayleigh distribution is one of the important distributions used for analysis life time data, and has applications in reliability study and physical interpretations. This paper introduces four different methods to estimate the scale parameter, and also estimate reliability function; these methods are Maximum Likelihood, and Bayes and Modified Bayes, and Minimax estimator under squared error loss function, for the scale and reliability function of the generalized Rayleigh distribution are obtained. The comparison is done through simulation procedure, t
... Show MoreThe effect of mental and physical health on the feelings of subject welfare is known as health-related quality of life. The chronic obstructive pulmonary disease is a common respiratory diseases. Assessment of health-related quality of life is considered important in such chronic disease. The objective of the current study was to measure health-related quality of life in a sample of chronic obstructive pulmonary patients in AL- Diwanyia city/Iraq. This study was carried out on 150 already diagnosed COPD patients who attended to the Center of Respiratory Diseases/AL-Diwaniyah Teaching Hospital during September 2019 to January 2020. The Arabic version of St George’s Respiratory Questionnaire was used to asses
... Show MoreObjective(s): To determine the impact of psychological distress in women upon coping with breast cancer.
Methodology: A descriptive design is carried throughout the present study. Convenient sample of (60) woman with breast cancer is recruited from the community. Two instruments, psychological distress scale and coping scale are developed for the study. Internal consistency reliability and content validity are obtained for the study instruments. Data are collect through the application of the study instruments. Data are analyzed through the use of descriptive statistical data analysis approach and inferential statistical data analysis approach.
Results: The study findings depict that women with breast cancer have experien
... Show MoreThe objective of the research is to evaluate the risk management practices of the variables (risk management structure, risk management methods, key components of risk management) and their relation to the principled behavior of managers behavior(innovation, proactive, risk acceptance) By adopting the questionnaire as a main tool in collecting data from managers in the National and raq insurance companies of (50) officials Department manager, department administrator, unit administrator, and analyzed their answers using the SPSS In calculating arithmetic mean, standard deviation, percentage weight and simple correlation coefficient. The most prominent conclusions were:1.There is a positive trend in the sample in both companies and a high
... Show MoreSummary of the research : Our research tagged (Arabic language in the media between warning and development) attempts to follow the most prominent phenomena that accompanied the evolution of the use of Arabic language in the media with the development of these means and spread technically globally, and how divided researchers and linguists and intellectuals Arabs into two teams, each demanding what contradicts the other, in the matter The use of the Arabic language in the media, and the arguments of each team in the need to deal with the media as one of the pillars of the nation culturally, historically and civilized, in order to enhance its position and maintain unity, continued the research highlighted the positions of hard-lin
... Show MoreAbstraction showed a case of distinction between art schools, in which reality was reduced using overlapping artistic elements and techniques to reach the artist's self-realization when abstracting the reality, and searching for implicit implications for the content of the artistic painting.
Building a system of relations and formulations between abstracting the reality of the physical forms and employing the symbols and codes to convey a message to the recipient who interacts with what he watches through the processes of explanation, interpretation, and linking the particles and reveal the pure aesthetics for the artwork.
Thus the current research deals with the following chapters and sections: the methodological framewo
... Show MoreMercury, arsenic, cadmium and lead, were measured in sediment samples of river and marine environmental of Basra governorate in southern of Iraq. Sixteen sites of sediment were selected and distributed along Shatt Al-Arab River and the Iraqi marine environment. The samples were distributed among one station on Euphrates River before its confluence with Tigris River and Shatt Al-Arab formation, seven stations along Shatt Al-Arab River and eight stations were selected from the Iraqi marine region. All samples were collected from surface sediment in low tide time. ICP technique was used for the determination of mercury and arsenic for all samples, while cadmium and lead were measured for the same samples by using Atomic Absorption Spectrosc
... Show MoreWas expanded display high reflectivity of the spectral remote infrared (m j 14-8) adoption order Alcolmtin ????????? thickness optical northeastern quarter wavelength and compared with results of previous studies based Aldrashalhalah on Ndharah matrix distinctive amended and fall of light close to the vertical arrangement multilayer materials buffer and in thin films homogeneous and uniform properties deposited on germanium basis results showed that the best choice for governments and their kills to expand bandwidth high reflectivity is much easier for the infrared than the area visible in addition to the order of these stacks is the cornerstone of the filters other visual...