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 achievement of agricultural development provide food security and to form a basis for economic growth and comprehensive social, requires a number of actions to overcome the obstacles and problems facing the development of this economic sector, to make it able to achieve food security and operation of the workforce, and reduce dependence on the outside in the provision of food peripherals, and so it is only available through the highest degree of efficiency and economic mobilization of resources, so most of the developed and developing countries alike seek to achieve sustainable agricultural development tobacco meet the food requirements and good jobs for c
... Show MoreThe policy issue in all countries of the world is concerned with government and research because it has the ability to reveal many of the problems facing the state and its organizational and scientific capabilities in the development of solutions and appropriate treatments that go beyond random and improvisational reactions, As a result of this interest, many studies have attempted to conceptualize and academicism it. The concept of public policy has been linked to various aspects of social life such as social, economic, educational, agricultural or other aspects. Public policy, regardless of its meaning or its relation to aspects of life, refers to the systematic thinking that directs the behavior and actions of the state, organization
... Show MoreBACKGROUND: Anemia during pregnancy is still a challenge throughout the world, and it may cause severe health consequences in the maternal and fetal sides. AIM: This study aims to find out the prevalence of maternal anemia and potential adverse outcomes in Iraq. METHODS: In Medical City Tertiary Center in Baghdad, singleton pregnant ladies came for delivery were involved over 6 months’ period. Based on hemoglobin (Hb) readings; they were divided into no anemia group (Hb>11 g/l) and anemia group which were further subdivided into mild, moderate, and severe (Hb =10–10.9, =7.1–9.9, and <7 g/l, respectively). Full history and examination were performed by attending obstetrician and pediatrician for the upcoming b
... Show MoreBACKGROUND: Anemia during pregnancy is still a challenge throughout the world, and it may cause severe health consequences in the maternal and fetal sides. AIM: This study aims to find out the prevalence of maternal anemia and potential adverse outcomes in Iraq. METHODS: In Medical City Tertiary Center in Baghdad, singleton pregnant ladies came for delivery were involved over 6 months’ period. Based on hemoglobin (Hb) readings; they were divided into no anemia group (Hb>11 g/l) and anemia group which were further subdivided into mild, moderate, and severe (Hb =10–10.9, =7.1–9.9, and <7 g/l, respectively). Full history and examination were performed by attending obstetrician and pediatrician for the upcoming babies. RE
... Show MoreHarriet Jacobs was a writer and a reformer. As a female writer in the nineteenth century, Jacobs wrote her narrative as a means of resisting the system of slavery. She wrote her book Incidents in the Life of a Slave Girl: Written by Herself, (1842) to reflect upon the exploitation of the black people and the need to change the hierarchal attitude that governs white/black relations. She was engaged in many abolitionist events and her anti-slavery approach appeared clearly in her writings. She shares Du Bios ideas about freedom and emancipation and the need for a political and cultural change. Thus, Du Bois’s theory provides a framework for her autobiographical novel where she portrays Linda Brent, the main character, a strong wille
... Show MoreHarriet Jacobs was a writer and a reformer. As a female writer in the nineteenth century, Jacobs wrote her narrative as a means of resisting the system of slavery. She wrote her book Incidents in the Life of a Slave Girl: Written by Herself, (1842) to reflect upon the exploitation of the black people and the need to change the hierarchal attitude that governs white/black relations. She was engaged in many abolitionist events and her anti-slavery approach appeared clearly in her writings. She shares Du Bios ideas about freedom and emancipation and the need for a political and cultural change. Thus, Du Bois’s theory provides a framework for her autobiographical novel where she portrays Linda Brent, the main character, a strong w
... Show MoreMottos Of Opposition Movements In iraq during the umayyad period and their religious and political indications - al shia and al khawarij
In order to take measures in controlling soil erosion it is required to estimate soil loss over area of interest. Soil loss due to soil erosion can be estimated using predictive models such as Universal Soil Loss Equation (USLE). The accuracy of these models depends on parameters that are used in equations. One of the most important parameters in equations used in both of models is (C) factor that represents effects of vegetation and other land covers. Estimating land cover by interpretation of remote sensing imagery involves Normalized Difference Vegetation Index (NDVI), an indicator that shows vegetation cover. The aim of this study is estimate (C) factor values for Part of Baghdad city using NDVI derived from satellite Image of Landsat-7
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The effect of short range correlations on the inelastic longitudinal
Coulomb form factors for different states of J 4 , T 1with
excitation energies 3.553,7.114, 8.960 and 10.310 MeV in 18O is
analyzed. This effect (which depends on the correlation parameter )
is inserted into the ground state charge density distribution through
the Jastrow type correlation function. The single particle harmonic
oscillator wave function is used with an oscillator size parameter b.
The parameters and b are considered as free parameters, adjusted
for each excited state separately so as to reproduce the experimental
root mean square charge radius of 18O. The model space of 18O does
not contribute to the tra