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 administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce costs) to prove the hypothesis has sought research to achieve its goal of Alkadivh and Alkoppelan &nb
... Show MoreThe information revolution، the new language has become one for all the peoples of the world through handling and exchange and to participate in all key areas (economic، cultural and scientific) and Accounting episode of this revolution has turned most of the traditional systems (manual) in companies to automated systems، this transformation in the regulations summoned from the auditors that develops their traditional examination automated systems so had to provide tools for auditing help auditors to keep abreast of developments and as a result there is no evidence checksum Local Private audited automated systems came search to provide evidence helps auditors for guidance as part of COBIT، which provides audit procedures Detailed inf
... Show MoreThe research aimed to modeling a structural equation for tourist attraction factors in Asir Region. The research population is the people in the region, and a simple random sample of 332 individuals were selected. The factor analysis as a reliable statistical method in this phenomenon was used to modeling and testing the structural model of tourism, and analyzing the data by using SPSS and AMOS statistical computerized programs. The study reached a number of results, the most important of them are: the tourist attraction factors model consists of five factors which explain 69.3% of the total variance. These are: the provision of tourist services, social and historic factors, mountains, weather and natural parks. And the differenc
... Show MoreThe Role of Japan in the Reconstruction of Iraq
The Economist opinion (views) gathered on the great Importance’s of small enterprise on the production sectors at Developed or in developing countries, statistics indicate that these enterprise represent almost 90% of the total enterprises in most economies in the world.
Many of these enterprises have originated in Iraq since the beginning of last century and the question of financing these enterprises remained an issue facing the most of workers in this sector, because of the peculiarty of which are characterized by which as a lack of financial abilities and the difficulty of obtain the sources of financing in Iraq and considered the enterprise as the guarantor of fulfilling Financial obligations. Afte
... Show MoreAbstract:
Al-Marba'aniyah, which is a long cold wave, was defined by ancient
Iraqis. It represents the coldest days in Iraq. In this research paper, a new
scale was put to define it. It shows that the period between the minimum
temperature degree recoded in December and the minimum temperature
degree recorded in January is considered to be the period of Al-Marba'aniyah.
The research concluded that Al-Marba'aniyah is unsteady and it changes in
the days of its occurrence. It was also concluded that the dates of the
beginning and the end of Al-Marba'aniyah are unsteady, too. Moreover, it was
found out that each of the Siberian high, European high, and finally the
subtropical high are the responsible systems for
Background:The effects of contraception on Trichomonas vaginalis have important implications for women who suffer from infections associated with disruptions in the vaginal ecology, such as bacterial vaginitis and urinary tract infections.
Objective: To find the association of the common types of contraceptions with the Trichomonasvaginalis infection in women admitted to the Al-BatoolTeaching Hospital for Maternity and Children in Baqubah city.
Type of study: Cross-sectional study
Methods: This study consist of 75 women with contraception use and71 apparently healthy non contraception user women admitted to outpatient in Al
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