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.
The non static chain is always the problem of static analysis so that explained some of theoretical work, the properties of statistical regression analysis to lose when using strings in statistic and gives the slope of an imaginary relation under consideration. chain is not static can become static by adding variable time to the multivariate analysis the factors to remove the general trend as well as variable placebo seasons to remove the effect of seasonal .convert the data to form exponential or logarithmic , in addition to using the difference repeated d is said in this case it integrated class d. Where the research contained in the theoretical side in parts in the first part the research methodology ha
... Show MoreBackground: Polycystic ovary syndrome (PCOS) is
the most common form of chronic anovulation
associated with androgen excess; it occurs in about 5
– 10% 0f reproductive age women. Metabolic
syndrome is characterized by insulin resistance,
hypertension, obesity, abnormalities of blood clotting
and dyslipidemia.
Adult women with PCOS have an increased
prevalence of the metabolic syndrome(MBS).
Objectives: To detect the prevalence of metabolic
syndrome in women with proved PCOS, attending the
Specialized Center for Endocrinology and Diabetes, in
Baghdad.
Materials and methods : A total number of 40
women with proved PCOS were included in this study
which was conducted in the Specialized Center f
Background: Otitis media with effusion is characterized by accumulation of fluid in the middle ear in absence of acute inflammation and it is the most common cause of acquired hearing loss in children, and may negatively affect language development failure of medical treatment of middle ear effusion frequently require myringotomy and tympanostomy tube insertion.
Objectives: To determine tympanostomy tube complications of tube in children with chronic otitis media with effusion who were treated with Shah Grommet tube insertion.
Methods: The Medical records of 162 ears of 87 children (52 male and 35 female) were reviewed respectively, the patients ages wer
... Show MoreIn this paper we generalize some of the results due to Bell and Mason on a near-ring N admitting a derivation D , and we will show that the body of evidence on prime near-rings with derivations have the behavior of the ring. Our purpose in this work is to explore further this ring like behavior. Also, we show that under appropriate additional hypothesis a near-ring must be a commutative ring.
Praise be to God, who is satisfied with Islam as our religion, “He opened a clear conquest for us,” and whoever works with us through the Shari’ah works and protects us. And that our master and Mawlana Muhammad His servant and Messenger is a prophet who has been merciful and compassionate. "
And after:
The occupation of Iraq and the accompanying bone events, and the following severe obstacles, resulted in a set of problems that require legitimate stances, and satisfactory answers, remove confusion and delusion, amid the clash of opinions and contradictions of jurisprudence. Work and application.
Among the difficult problems that surfaced in light of the new political developments on the land of Iraq: (the ruling on dealing
The study aims at investigating the effectiveness of the Virtual Library Technology, in developing the achievement of the English Language Skills in the Center of Development and Continuous Education, in comparison with the individual learning via personal computer to investigate the students' attitude towards the use of both approaches. The population of the study includes the participants in the English Language course arranged in the Center. The sample includes 60 students who were randomly chosen from the whole population (participants in English Courses for the year 2009-2010). The sample is randomly chosen and divided into two experimental groups. The first group has learned through classroom technology; while the other group has l
... Show MoreAt the local level in the early 1990s first established an Islamic bank 1993 is called Iraqi Islamic bank and was established by Dr. abdullatef hmim and with capital of 200 Million Iraqi dinars .
After 2003 began the attention of Iraqis tend to create Islamic banks until now up to 30 banks in the present , He confirmed Mr. Governor of the Iraqi Central Bank recently that there is more than 40 iintroduction licence to establish an Islamic bank in Iraq , That banking activity which is compatible with Sharia law widely welcomed by savers and those in need for more development and modernization in order to gain a greater share within the Iraqi market , and allowed the Iraqi Central Bank in recent years
... Show MoreSome genetic factors are not only involved in some autoimmune diseases but also interfere with their treatment, Such as Crohn's disease (CD), Rheumatoid Arthritis (RA), ankylosing spondylitis (AS), and psoriasis (PS). Tumor Necrosis Factor (TNF) is a most important pro-inflammatory cytokine, which has been recognized as a main factor that participates in the pathogenesis and development of autoimmune disorders. Therefore, TNF could be a prospective target for treating these disorders, and many anti-TNF were developed to treat these disorders. Although the high efficacy of many anti-TNF biologic medications, the Patients' clinical responses to the autoimmune treatment showed significant heterogeneity. Two types of TNF receptor (TNFR); 1 an
... Show MoreThe objectives of this research are to determine and find out the reality of crops structure of greenhouses in association of Al-Watan in order to stand on the optimal use of economic resources available for the purpose of reaching a crop structure optimization of the farm that achieves maximize profit and gross and net farm incomes , using the method of linear programming to choose the farm optimal plan with the highest net income , as well as identifying production plans farm efficient with (income - deviation) optimal (E-A) of the Association and derived, which takes into account the margin risk wich derived from each plan using the model( MOTAD), as a model of models of linear programming alternative programming m
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