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.
This study was conducted to examine the anatomical aspects of
Abstract
Documentary credits are considered successful means to reduce imports, especially unnecessary imports that lead to the outflow of foreign currency from the country. However, due to the backwardness of the banking methods, the reintroduction of documentary credits after 2003 did not effectively contribute to reducing import rates. This has had a negative impact on the Iraqi economy and made it vulnerable to external markets. Documentary credits are also considered the best way to ensure payment in international trade, providing independent credit support and sufficient security for exporters and importers against commerci
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... Show MoreSamples (4th) reviewed are deposited and stored in the Iraqi Natural History Museum (INHM), and there are 4th of them. Sciurus anomalous (Güldenstädt, 1785) species are preserved and mummified. It is a Caucasian squirrel (S. anomalus) that was medium in size, with a grayish-to-chestnut color, a golden gray back, and a golden tail. It is found in the forests of East and Southeast Asia. The variety possessed for the study was previously registered in the vertebrate literature by several authors and was stored by scientific methods in the museum. As a result of the multiplication and growth of these species, and to know the environmental changes that occurred in them, they were compared with models and samples found throughout Iraq
... Show MoreThe 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
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