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 population studies are one of the difficult tasks facing the world in all periods. most of the researchers and who have relationship to population policies and development plans, may have succumbed to the idea that the population problem is based and confined mainly in the rate of increase in population, or the so – called population explosion, and not the content because of its pressure on resources and there is no problem of population if the resources are available and therefore no need for the development and implementation of population policies in any way . While the population policies here should take a range of general and comprehensive in every respect to population and demographic phenomena distribution, not only
... Show MoreThe political situation experienced by Iraq before the events of 2003 that led to the collapse of infrastructure. rebuilding costs were estimated after 2003 by187(million USD) according to the estimates of the basic needs as stated in Five-Year Plan 2010-2014. The difficult in financing projects and the continuous demands for maintenance and operating cost, and working by contemporary styles in different countries, the strategic option is to adopt the government entering the private sector as a partner in the development process. Since public _private partnership (PPP's) is at a germinating stage of development in Iraq, it has been studied the critical success factors(CSF's) in the experiences of countries that have implemented the style
... Show MoreThe results showed the spread of disease blight leaves caused by injury fungus Alternaria in different areas of cultivation in the city of Baghdad where he was recording the highest rate and the severity of the disease of 100% and 80%, respectively, in the Abu Ghraib area and the least of 20% and 12% respectively in the Amiriya district results showed test pathogenicity of the fungus pathogen emergence of symptoms of the disease superficial discoloration Authority of black paper when wound areas and yellowing of leaves about race as centrist and leaky latest country clear ????? on Central race after 48 hours ....
Background: Drawing blood to measure total serum bilirubin is painful & time consuming. Transcutaneous bilirubinometer working by multiwavelength spectral reflectance from the skin surface on forehead or upper sternum is a quick & painless technique. Objectives: to compare the effectiveness of transcutaneous (over the upper sternum and forehead) and serum bilirubin measurement of neonate with jaundice. Subjects and Methods: This is a cross sectional prospective study. It enrolled 175 jaundiced neonates & excluded those exposed to phototherapy. It was conducted at Child Central Teaching Hospi |
The problematic of the current research marked (style between alienation and westernization in contemporary painting) is demonstrated by the fact that the stylistic forms in art are full of the influx of subjective and emotional impressions, as well as administrative and borrowing techniques, as well as their contextual meaning, whether cultural, social and political, which gives them an alien dimension at one time or another. The aim of the research is: Define the style between alienation and alienwesternization in contemporary painting. The research included six axes dealing with the first axis: an introduction to the concept of alienation, and the second axis dealing with the style in romanticism. The third dealt with: the method in i
... Show MoreLow salinity (LS) water flooding is a promising EOR method which has been examined by many experimental studies and field pilots for a variety of reservoirs and oils. This paper investigates applying LS flooding to a heavy oil. Increasing the LS water temperature improves heavy oil recovery by achieving higher sweep efficiency and improving oil mobility by lowering its viscosity. Steam flooding projects have reported many problems such as steam gravity override, but override can be lessened if the steam is is alternated with hot LS water. In this study, a series of reservoir sandstone cores were obtained from Bartlesville Sandstone (in Eastern Kansas) and aged with heavy crude oil (from the same reservoir) at 95°C for 45 days. Five reservo
... Show MoreTo decrease the impact on the environment of building waste, the recycled aggregate may be used in various sustainable engineering applications, such as roller compacted concrete pavement (RCCP). This research examined how using recycled aggregate as a partial replacement for natural aggregate as coarse or fine affected the mechanical properties of roller-compacted concrete pavement. The recycled aggregate was crushed and sieved to coarse and fine aggregate before being used in the roller-compacted concrete pavement. Compressive strength, splitting tensile strength, and flexural strength were all evaluated after the samples were prepared at 28 and 90 days of curing. According to the study's findings, the partial replacem
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