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 concept of privatization is built on the basis of the transfer of assets and services of the public sector to the private sector this concept has appeared in the eighties of the last century whene the high oil prices took place and recession solution swept the world Which called for the freedom of the market and left the room for the private sector to take the initiatine in economic activity. Both the IMF have adopted this thesis in their programs of the structural adjustment in light of external and internal factors helped to Create the conditions to accept thesis that under the pretext of achieving a number of economic goals.
In Iraq in spite of
... Show MoreKhadija Al-Hadithi was known for her love of the Arabic language. She was a distinguished and serious phenomenon in Arabic science and culture. She was born in Basra Governorate, one of the ancient and important cities in the history of Arabic grammar and one of the centers of the intellectual and scientific movement. The Basra Grammar School emerged there and made numerous achievements in the field of Arabic linguistics that remain an important source for students of the specialty.
The 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 MoreThe research article deals with the process of building or rebuilding the state in Iraq after 2003 in its various dimensions, in light of the vision and foundational procedures that were developed and supervised by the United States in cooperation with the new leaders of Iraq based on the mechanism of sectarianethnic representation, and diagnosing the imbalances that arose out of that vision and the accompanying procedures, which led to the emergence of new variables in the political process, especially in the post-ISIS* phase, which produced important challenges to the political system and the Iraqi state. The political dynamics and balances emerging after ISIS* represented at the same time opportunities and risks in the process of
... Show MoreThe problem of poverty and deprivation constitute a humanitarian tragedy and its continuation may threaten the political achievements reached by the State. Iraq, in particular, and although he is one of the very rich countries due to availability of huge economic wealth, poverty indicators are still high. In addition, the main factor in the decline in the standard of living due to the weakness of the government's performance in the delivery of public services of water, electricity and sanitation. Thus, the guide for human development has been addressed which express the achievements that the state can be achieved both on a physical level or on the human level, so in order to put appropriate strategies and policies aimed at elimin
... Show MorePhysicians are infrequently selected to serve in the yearlong role of Jefferson Science Fellow (JSF) as senior science advisor for the US Department of State or the United States Agency for International Development. The authors discuss the role of a JSF in promoting “science diplomacy” from the perspective of one alumnus, who sites examples of ongoing, long-term collaborative projects including one focusing on medical education reform in Iraq that would not have been possible without the JSF program. More than 3 decades of political and social unrest, terrorism, the internal displacement of millions of Iraqi citizens, the arrival of Syrian refugees, international sanctions, and the effect of fluctuating oil prices that fund education i
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