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.
Requires economic work finding built institutional paint strategies and policies are formulated general economic and clarity in its stated objectives and the involvement of all economic institutions, political and stakeholders to discuss all the issues of economic, financial, monetary and analyzed for the purpose of renewal energies and determine the duties and responsibilities, leaving full freedom to the private sector in the formation of institutions to carry out his duties economic, and that the institutional structures to create the right climate for the implementation of its economic policies, which would facilitate the task of the private sector, and this h
... Show MoreResearch includes evaluation of projects implemented and which entered into trial operation period in accordance with the evaluation criteria and of (cost, quality and time) to determine the size deviations gap for the sample of projects during the years of assessment (2011-2012-2013-2014) of each of the three evaluation criteria, and then followed by a calculation the size of the overall gap to the problem based on the research problem to determine deviations from the specific implementation of each project by answering several questions to answer turns out the reasons for these deviations occur.
The importance of research Focus on the evaluation of received projects from contractors executing the projec
... Show Moreيعد العلاج الحركي من الوسائل العلاجية التأهيلية من الوسائل المهمة الامنة لأنها تؤمن على حياة الانسان بكافة شؤونه وتعد التمرينات التأهيلية اسلوبا فعالاً وطبيعياً لا تعرض المريض الى مضاعفات على وظائف الجسم الاخرى لأنها خالية من اي دواء كيمياوي ضار ، كما استخدمت تقنيات حديثة في العلاج الطبيعي بشكل واسع معد حسب اسس علمية منها تمرينات (Core) التي تساعد في تخفيف الالام بالانزلاق الغضروفي للفقرة الرابعة والخا
... Show MoreCoronavirus 2019 (COVID-19) pandemic led to a massive global socio-economic tragedy that has impacted the ecosystem. This paper aims to contextualize urban and rural environmental situations during the COVID-19 pandemic in the Middle East and North Africa (MENA) Region.
An online survey was conducted, 6770 participants were included in the final analysis, and 64% were females. The majority of the participants were urban citizens (74%). Over 50% of the urban residents significantly (
Medulloblastomas and ependymomas are the most common malignant brain tumors in children. However genetic abnormalities associated with their development and prognosis remain unclear. Recently two gene fusions, KIAA1549–BRAF and SRGAP3–RAF1 have been detected in a number of brain tumours. We report here our development and validation of RT-RQPCR assays to detect various isoforms of these two fusion genes in formalin fixed paraffin embedded (FFPE) tissues of medulloblastoma and ependymoma. We examined these fusion genes in 44 paediatric brain tumours, 33 medulloblastomas and 11 ependymomas. We detected both fusion transcripts in 8/33, 5/33 SRGAP3 ex10/RAF1 ex10, and 3/33 KIAA1549 ex16/BRAF ex9, meduloblastomas but none in the 11 ep
... Show MoreThe image of television dominates the cognitive and artistic motivations. It is the formulation of ideas and visions along with its documentary ability. It is the main element in television work as it is a story that is narrated in pictures. Therefore, attention to image building is a major point of gravity in the work structure as a whole. On the image is the element carrying all aesthetic and expressive values of news and information directly to the hints that work to stimulate and stir the imagination of the recipient to evoke mental images added to the visual images to deepen the meanings.
All visual arts carry elements and components that follow in a particular pattern to give special meanings and specific connotations. However,
Increasingly, public organizations in the federal state are required to work together, as well as to work with others to achieve their objectives. In Iraq there are two levels of organizations, including federal and local, and these organizations have been forced to work for many years in an environment in which the responsibility for service delivery is shared between policy makers and service providers, and between local governments and the federal government. It is sometimes difficult to manage the relationship between these organizations (federal and local) and do not always provide the best possible outcome of this relationship. This paper reviews how to manage the relationship between local administrations and
... Show MoreContamination of the operating theatre is a major cause of nosocomial infection. This report aimed to show the types of microorganisms and their percentages cultivated from operating theatres of 16 health directorates of 14 Iraqi governorates (3 health directorates in Baghdad and 1 in each other 13 governorates) that was reported to the Pollution Control Section at Ministry of Health in Iraq from first of January to the end of June 2018. The data of all health directorates have included cultivation taken from governmental and private hospitals. Duhok, Erbil, Sulaymaniyah, and Nineveh were not involved in this report due to unavailability of their data during the above period. Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureu
... Show MoreColorectal cancer (CRC) is the most common gastrointestinal malignancy and one of the top ten common cancers worldwide with approximately 2 million cases. There are multiple risk factors that could lead to CRC emergence; of which are genetic polymorphisms. Excision repair cross-complementing group 2 (ERCC2) gene encodes for ERCC2 enzyme which plays a crucial role in maintaining genomic integrity by removing DNA adducts. Several studies suggested that there could be a link between genetic polymorphisms of ERCC2 gene and the risk of CRC development. Hence the present study aims to validate the relationship between the following ERCC2 single nucleotide polymorphisms (rs13181, rs149943175, rs530662943, and rs1799790) and CRC susceptibility. A t
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