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
Characterized by the Ordinary Least Squares (OLS) on Maximum Likelihood for the greatest possible way that the exact moments are known , which means that it can be found, while the other method they are unknown, but approximations to their biases correct to 0(n-1) can be obtained by standard methods. In our research expressions for approximations to the biases of the ML estimators (the regression coefficients and scale parameter) for linear (type 1) Extreme Value Regression Model for Largest Values are presented by using the advanced approach depends on finding the first derivative, second and third.
In this study, the concentrations of uranium for four species of plants; Spinacia, Brassica Oleracea, BEASSICA Oleracea Var Capitata and Beta Vulgaris were measured in addition to the measurement of uranium concentrations in the selected soil by calculating the number of significant traces of alpha in CR-39. The 2.455 Bq/kg in Spinacia plant were the highest concentration while the lowest concentration of uranium were 1.91 Bq/kg in BEASSICA Oleracea Var Capitata plant. As for the transfer factor, the highest value 0.416 were found in Spinacia plant and the lowest value 0.323 were found in BEASSICA Oleracea Var Capitata plant. The uranium in the models studied in it did not exceed the international limit, according to the International Atomi
... Show MoreThis work aims to investigate the integrated ultra-dense wavelength division multiplexing (UDWDM) and polarization division multiplexing (PDM) schemes incorporated in the free space optic (FSO) communication system. Erbium-doped fiber amplifiers (EDFAs) are used as post and pre-amplifiers in the proposed UDWDM–PDM–FSO system to boost the transmission power for increasing the distance. Thirty-two channels are transported over the FSO link to realize the total data transmission of 160 and 320 Gbps with 0.08 and 0.1 nm channel spacing, respectively. Results are also reported with non-return to zero modulation schemes. The performance of the proposed UDWDM–PDM–FSO transmission sys
Background:-Osteoarthritis (OA) is the most common form of arthritis and the leading source of physical disability in elderly people. The Prevalence of OA is increasing and will continue to do so as the population gets older. The OA is predominantly managed in primary care centers by primary health care physicians and much can be done to alleviate symptoms from osteoarthritis by combinations of therapeutic options including pharmacological and non-pharmacological treatments.
Objectives of study :- To assess the knowledge, attitude and practice of Iraqi PHCC physicians in Baghdad, AL-Rusafa, regarding the management of osteoarthritis patient, and it's association with sociodemogra
... Show MoreSynthesis of 2-(4-Acetyl-phenyl)-4-nitro-isoindole-1, 3-dione chalcones were performed by fusion of 3-nitro phthalic anhydride with p-aminoacetophenone. Then the later was grinded with different aromatic aldehydes in the presence of sodium hydroxide to produce new chalcones derivatives A3-10 without using any solvent formation of new N- arylphthailimide chalcones were confirmed by FT-IR,1HNMR, 13CNMR spectroscopy and all final compounds were tested for their antifungal and antibacterial activity some of them showed more biological activity than the standard drugs