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
The research aims to clarify the role of electronic marketing and what it can achieve in promoting the products of the national industry in Iraq. Marketing channel depends on modern communication and information technology that industrial and metal companies can use in promoting and selling their products along with traditional marketing outlets. To achieve the objectives of the research, a questionnaire was used, which consists of three axes, the first includes the personal data of the sample (gender, age, educational attainment, place of residence, marital status, income level), while the second axis includes various questions about the products of the national industry. Third axis includes que
... Show MoreReinforced concrete (RC) slabs strengthened with carbon fibre reinforced polymer (CFRP) and subjected to flexural actions may experience many types of failure, including FRP debonding, FRP rupture and concrete crushing. Of these different types of failure modes, FRP debonding stands out as the most predominant type of failure because of its dependence on the relatively weak bond interface between the soffit of the RC member and the FRP sheet attached to it. Many anchorage systems have been developed to enhance the performance of strengthened systems, one of which is the hybrid anchor, which combines the effects of patch anchors and spike anchors. Hybrid anchors have shown significant enhancement when used with RC members subjected to shear
... Show MoreThis paper aims to prove an existence theorem for Voltera-type equation in a generalized G- metric space, called the -metric space, where the fixed-point theorem in - metric space is discussed and its application. First, a new contraction of Hardy-Rogess type is presented and also then fixed point theorem is established for these contractions in the setup of -metric spaces. As application, an existence result for Voltera integral equation is obtained.
Background : Polycystic ovary syndrome (PCOS) is the most common cause of infertility in reproductive-age women , it is an important harbinger of metabolic disorders. It has been reported that hyperamylasemia can be used as marker of ovarian cancer patients . The current study was conducted to evaluate amylase activity and to estimate the correlation of this enzyme with insulin and insulin resistance in PCOS patients. Methods: This study was conducted on forty five patients with PCOS in comparison to twenty five women as control. Fasting blood sample was taken from each subject and analyzed for amylase activity , FSH,LH, Insulin , proteins, and blood sugar , meanwhile insulin resistance was determined by HOMA-IR index. Results: The result
... Show MoreHealth literacy is an important method used by the authorities to strengthen the health system. The aim of this study is to assess the knowledge of some basic health principles among women of different educational states. This is a crosssectional study, performed from December 2014 until January 2016, Baghdad. All candidates were: females > 18 years, neither medical staff nor students. They were divided into two groups: educated and uneducated. The sample included 213 women, there were 112 educated and 101 uneducated women. Regarding educated group, accurate answers regarding route of transmission of typhoid fever was 73.2% in educated subjects vs. 49.5% in uneducated subjects. Main source of information for both groups was p
... Show MoreLinear programming currently occupies a prominent position in various fields and has wide applications, as its importance lies in being a means of studying the behavior of a large number of systems as well. It is also the simplest and easiest type of models that can be created to address industrial, commercial, military and other dilemmas. Through which to obtain the optimal quantitative value. In this research, we dealt with the post optimality solution, or what is known as sensitivity analysis, using the principle of shadow prices. The scientific solution to any problem is not a complete solution once the optimal solution is reached. Any change in the values of the model constants or what is known as the inputs of the model that will chan
... Show MoreOvarian cancer has a high mortality and delayed diagnosis. Several immunological alterations take place during ovarian carcinogenesis, and can be of value in the surveillance of the diseases. This research was conducted to evaluate serum immunoglobulin levels in women with ovarian cancer and to assess their role in disease process. The present study is composed of 85 women (mean age = 62.03±12.4 yrs) with clinically and pathologically confirmed ovarian cancer and 65 healthy females as a control group (mean age = 61±12.1 yrs). ELISA test was achieved for the determination of serum [IgG, IgA, IgM]. The findings of current study illustrated significant (P=0.001) increase in serum IgG, IgA, and IgM levels as compared to co
... Show MoreThe employment of cognitive radio (CR) is critical to the successful development of wireless communications. In this field, especially when using the multiple input multiple output (MIMO) antenna technology, energy consumption is critical. If the principal user (PU) is present, developers can utilize the energy detecting approach to tell. The researchers employed two distinct phases to conduct their research: the intense and accurate sensing stages. After the furious sensing step was completed, the PU user was identified as having a maximum or minimal energy channel. There are two situations in which the proposed algorithm's performance is tested: channels for fading AWGN and Rayleigh. When the proposed methods' simulation results a
... Show MorePhosphorus (P) is an element that is potatoes require in large amounts. Soil pH is a crucial factor impacting phosphorus availability in potato production. This study was conducted to evaluate the influence of P application rates on the P efficiency for tuber yield, specific gravity, and P uptake. Additionally, the relationship between soil pH and total potato tuber yield was determined. Six rates of P fertilization (0–280 kg P ha−1) were applied at twelve different sites across Northern Maine. Yield parameters were not responsive to P application rates. However, regression analysis showed that soil pH was significantly correlated with total potato tuber yield(R2 = 0.38). Sites with soil pH values < 6 had total tuber yields,
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