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 Mediating Role of Cobit 2019 in Managing the Relationship Between Qualitative Characteristics of Accounting Information and Information Asymmetry
The research aims to measure the impact of positive and negative fiscal policy shocks on monetary stability in Iraq, which represents monetary stability as an indicator of real and price stability. Fiscal policy shocks are quantitative changes in public spending and public revenue affecting the output and price cycle, and fiscal policy despite the accompanying time gaps, but it remains a policy Influential and has a significant degree of impact on economic growth and development in developing countries. The fiscal policy represents a numerical translation of the economic and social objectives planned in the state's general budget tool consistent with the GDP cycle. The economic and social goals stem from the core of the functions and the ma
... Show MoreThe possibility of predicting the mass transfer controlled CaCO3 scale removal rate has been investigated.
Experiments were carried out using chelating agents as a cleaning solution at different time and Reynolds’s number. The results of CaCO3 scale removal or (mass transfer rate) (as it is the controlling process) are compared with proposed model of prandtl’s and Taylor particularly based on the concept of analogy among momentum and mass transfer.
Correlation for the variation of Sherwood number ( or mass transfer rate ) with Reynolds’s number have been obtained .
Cutaneous leishmaniasis (CL) is a widespread, yet often overlooked, parasitic disease caused by the Leishmania protozoan, which is prevalent in numerous countries, including Iraq. This condition is marked by the appearance of skin lesions on various exposed areas of the body. In most old-world regions, sodium stibogluconate (SSG) is the classical widely used drug to treat CL. The progression of skin ulceration is controlled by different inflammatory modulators including cytokines and enzymes. In this study, the possible role of the enzyme Matrix metalloproteinase9 (MMP-9) and its inhibitor Metallopeptidase inhibitor-1 (TIMP-1) as immunological markers was evaluated in CL patients suffering from cutaneous leishmaniasis before and aft
... Show MoreBackground: Dental caries is a localized, progressive destructive, largely irreversible microbial based disease of multifactorial nature; these factors include (host, microbes and food) they influence differently on the initiation and progression of dental caries. The aims of the study: was to evaluate the effect of smoking on salivary flow rate, secretory immunoglobulin (SIgA) level and viable count of mutans streptococci (M.S) bacteria in oral cavity and their relation to dental caries experience. Material and method: The samples were collected from 80 male students ranging in ages from 18-22 years old. Where they divided in to two groups, 40 non-smokers (control group) and 40 smokers (study group). Unstimulated salivary samples were c
... Show MoreMethotrexate (MTX) is widely used chemotherapeutic agent with different side effects including germ cells toxicities. Silibinin is one of the structural isomers of silymarin, with different phytotherapeutic applications, and its possible protective effects against MTX induced germ cells damage were investigated in this work. Twenty five male mice were divided into five groups (n=5) allocated as follows: Group 1 received buffer for five days given by single intraperitoneal (IP) injection per day; Group 2 in addition to buffer for five days, animals received at day five single dose of 20mg/kg of MTX IP. Groups (3, 4, and 5) received respectively, (50, 100, or 150mg/kg body weight) of silibinin IP single daily dose for five days then at day fi
... Show MoreOsteoporosis is a systemic disease of the skeleton, characterized by low bone mass and alteration in the micro-architecture of the bone tissue that lead to an increase in brittleness with the ensuing predisposition to bone fracture. Global statistics shows that women are more exposed to this disease than men and in particular at menopause. This study was designed to evaluate the use of some bone markers: serum osteocalcin (Ost), alkaline phosphatase (ALP), as bone formation markers, also parathyroid hormone (PTH), calcium and inorganic phosphate level, for the assessment of patients with osteoporosis and to evaluate their role in monitoring of several types of therapeutic interventions (such as bisphosphonates, hormonal replacement thera
... Show MoreThe aim of this research is to estimate the parameters of the linear regression model with errors following ARFIMA model by using wavelet method depending on maximum likelihood and approaching general least square as well as ordinary least square. We use the estimators in practical application on real data, which were the monthly data of Inflation and Dollar exchange rate obtained from the (CSO) Central Statistical organization for the period from 1/2005 to 12/2015. The results proved that (WML) was the most reliable and efficient from the other estimators, also the results provide that the changing of fractional difference parameter (d) doesn’t effect on the results.