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 Leishmania donovani parasite causes visceral leishmaniasis (VL), an acute and fatal form of leishmaniasis. Because traditional therapy alternatives, such as glucantime and other pentavalent medicines, are toxic and have side effects, new treatments with fewer negative effects are needed. Only a handful of drugs are clinically beneficial to treatments of the disease, but considerable limitations threaten their very usage. Novel, safe, and efficient drugs, including those against antimalaria and leishmaniasis co-infections, are so essential. Artemether (ATM) is an Artemisinin derivative that has been demonstrated to be useful in the treatment of malaria and, more recently, leishmaniasis. The current research was carried out to evaluate th
... Show MoreBackground: Both bladder cancer and schistosomiasis are endemic in Egypt. The former has a unique epidemiological pattern, which has been linked to bladder infestation by Schistosoma. The last decades have witnessed a great reduction in the infection rate of schistosomiasis and a decline in the incidence and changes in the patterns of bladder cancer. Whether these changes are linked to each other or a co-incidence is a subject of investigations.
Method: Literature on epidemiological data of bladder cancer and Schistosoma in Egypt was searched for in Medline, Scopus, PubMed, and Google Scholar. Furthermore, a hand search for literature and reports released by the Egyptian government and involved agencies was perfo
... Show MoreCurrent Thesis has aimed to identify : The Psychological barriers for university students , Differences in psychological barriers depending on the variable sex (Males – Females) , Adjustment to College life for university students, Differences in Adjustment to College at university life depending on the variable sex (Males – Females), and finally, The correlation between psychological barriers and Adjustment to College life. The researcher has prepared a sample consisted of (100) male and female students who were randomly selected from university students, The researcher has adopted a measure of (2002) to measure the psychological barriers, also the researcher adjustment scale with university life.
The results showed that universi
It is recognized that organisms live and interact in groups, exposing them to various elements like disease, fear, hunting cooperation, and others. As a result, in this paper, we adopted the construction of a mathematical model that describes the interaction of the prey with the predator when there is an infectious disease, as well as the predator community's characteristic of cooperation in hunting, which generates great fear in the prey community. Furthermore, the presence of an incubation period for the disease provides a delay in disease transmission from diseased predators to healthy predators. This research aims to examine the proposed mathematical model's solution behavior to better understand these elements' impact on an eco-epidemi
... Show MoreBackground: Several risk managem-ent standards had been developed including the Project Management Institute, the National Institute of Standards and Technology, actuarial societies, and ISO standards.
Objective: The study aimed at evaluating risk management among managers of model and ordinary primary health care centers in Baghdad City and comparing the risk management among these centers.
Methods: A descriptive comparative des
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The developed financial infrastructure is one of the most important elements for achieving stable financial system in a country. The importance of developed financial infrastructure comes from its role in create economic and financial context attractive for foreign investments. Thus, this paper aims first to measure an index of financial infrastructure, and secondly, to gauge the nexus between the developed financial infrastructure and foreign investments inflow in Malaysia and Indonesia. We estimate the index of financial infrastructure by using different indicators such as (the institutional environment, access to finance, legal environment, and others).
By using the G
... Show MoreIn recent years, the attention of researchers has increased of semi-parametric regression models, because it is possible to integrate the parametric and non-parametric regression models in one and then form a regression model has the potential to deal with the cruse of dimensionality in non-parametric models that occurs through the increasing of explanatory variables. Involved in the analysis and then decreasing the accuracy of the estimation. As well as the privilege of this type of model with flexibility in the application field compared to the parametric models which comply with certain conditions such as knowledge of the distribution of errors or the parametric models may
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This study aimed to survey fungi associated with the product Indomie and Chips being the trades Iargely by a very important segment of society who are the children, beside consumed by adults, but less so, as the survey results to accompany some fungui samples sterile showed proportions presence included various fungi like. Aspergillus flavus, Aspergillus niger, Penicillium Spp., Fusarium graminearum, F.moniliforme, Alternaria alternate and Rhizopus Spp., and other fungi sterile are not diagnosed. The results showed large dominion fungi A. niger by presence sterile samples of both producers, followed by infection in Fusarium Spp., Penicillium Spp., and A. alternata by infection percentage 55, 20 and 17% respectively for the pr
The flexibility of interaction between the movement of macroeconomic variables that affect and are affected by the balance of payments, especially the movement of the current account, implies a perception of the maturity of economic development and what the theory assumes from the launch of a wide range of economic movement that varies in the degree of its influence according to the level of economic development and the vitality of the internal/external overlap relations through the assumed response to the movement of the macroeconomic variables. On this basis, it is possible to estimate the soundness and rationality of the economic decision taken that takes into account the required reciprocal repercussions between the current a
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