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.
Background: Diabetes mellitus is a common health problem of the world. Iron may be a part of the cause of the disease and its Complications
Objectives: This study was designed to determine the relationship between the levels of iron indices and diabetes mellitus type 2. Type 2
Type of the study: Cross –sectional study.
Methods: diabetes mellitus is clinical condition characterized by hyperglycemia due to the absolute or relative deficiency of insulin. It is also followed by pathological abnormalities like impaired insulin secretion, peripheral insulin resistance, and excessive hepatic glucose production. Although type 2 diabetes mellitus i
... Show MoreAbstract
Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient. Identification and classification of drug related problems and discussing them with the health care providers. Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical
... Show MoreBack ground: Oral isotretinoin is recommended
for sever nodulocystic acne in the doses 0.5-
2mg/kg/day which is usually associated with higher
incidence of adverse effects. To reduce the
incidence of side-effects and to make it more costeffective,
the lower dose regimen of isotretinoin has
been used.
Aim: To compare the efficacy and tolerability of
oral isotretinoin 10mg and 20mg/day in acne
vulgaris.
Methods: one hundred and twenty patients with
acne vulgaris were randomized into two treatment
regimens each consisting of 60 patients. The first
was treated with 10mg/day and the second group
with 20mg/day for 24 weeks. Fifty five patients
from the first group and 47 patients from the second
The geopolities considering as build from the basies builds of the polities
geography, participating in appointing the military geography, and submit to it
geo-polities purveyed, playing important role to appointing the builds relations
between the high strategy and the military strategy, while the foreign polities of
the state, which considering as a tool for the state outside it environment and
borders playing the role of the performance and the functional works to the
peaceful or hostile reaction according to the geopolities purveyed which
participating in amassing the recourse for the economical, political, social,
military and technology strategies and activating it to achieving the state interests
and obj
The 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 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 MoreKE Sharquie, AA Noaimi, AM Oweid, JSSDDS, 2009 - Cited by 2
Abstract: The aim of this study is to assess the effectiveness of 940 nm diode laser in comparison to Endoactivator in elimination of smear layer in terms of radicular dentin permeability and ultra-structural changes of root canal walls by SEM evaluation. Twenty-eight single-rooted extracted lower premolars were instrumented up to size X4 (protaper Next, Dentsaply) and divided into two experimental groups according to the irrigation system, G1; activated by EndoActivator and G2; activated by Diode laser 940 nm, CW mode, 1.7 W. Afterward, the roots were made externally impermeable, filled with 2%methylene blue dye, divided horizontally into three segments representing the apical, middle, and coronal thirds then examined under stereo- micr
... Show MoreTHE ROLE OF ELECTRONIC-PAYMENT SERVICE PROVIDERS IN THE DEVELOPMENT OF E-BANKING IN IRAQ - AN APPLIED RESEARCH IN CENTRAL BANK OF IRAQ