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.
Human beings have an innate and natural aim to achieve their self-interests and to show their ability to overcome challenges in a better way, therefore the move towards self determination is expressed by intrinsic motivation. The desire of absorbing in this task is to enjoy the task in it self and benefitting from it such a motivation is the desire rooted in human nature to judge and choose in which individual is conscious in his self, abilities and adequacy that help him in control the different situations of life passed by him. His choices and actions are voluntary and non-restricted to intervention or external control because control is inner and subjective, while his behavior is self-regulated with the feeling of
... Show MoreThis paper presents the synthesis and study of some new mixed-liagnd complexes containing tow amino acids[Alanine(Ala) and phenylalanine (phe)] with some metals . The results products were found to be solid crystalline complexes which have been characterized by using (FT-IR,UV-Vis) spectra , melting point, elemental analysis (C.H.N) , molar conductivity and solubilty The proposed structure of the complexes using program , chem office 3D(2000) . The general formula have been given for the prepared complexes : [M(A-H)(phe-H)] M(II): Hg , Mn ,Co , Ni , Cu ) , Zn , Cd(II) . Ala = Alanine acid = C3H7NO2 Phe = phenylalanine = C9H11NO2
The social contract represents a set of laws and determinants agreed upon by a group of individuals in order to organize society for the better.This agreement guarantees them to live in peace according to the pre-agreed laws, and on the basis of that, it represents the key to resolving the crisis relations between the state and society, and this is what prompted Iraqi society to move towards the formulation of a new social contract through popular protest movements in 2019.To overcome the old social contract that shook the trust between the state and society as a result of its negative outputs at various political, economic and social levels, and many problems emerged that hindered the process of building the social contra
... Show MorePoverty is defined as a low standard of living in the sense that a poor person can not afford a minimum standard of living. The phenomenon of poverty is one of the most serious problems that must be dealt with seriously. This phenomenon has persisted in Iraq for decades because of the harsh economic conditions and unstable security conditions due to the crises it has faced since 2013. This study requires much study and analysis. And rural areas as a special case. In this study, the researcher examined the poverty line as a criterion in estimating the poverty indicators, which include (poverty percentage H, poverty gap PG, poverty intensity PS), based on the continuous social and economic survey data for households in 2014. The ma
... Show MoreThe problem of housing in Iraq is a long-rooted and rooted problem, and it needs a great effort to find out its causes and thus give essential points that contribute to alleviating and addressing it, and it is worth noting that research into the housing problem and the housing sector in Iraq is not done in isolation from other sectors and studies. As well as the economic policies pursued and the social and political conditions. It is known that the Iraqi economy is a unilateral (rentier) economy, that is, it depends almost entirely on exporting oil and obtaining revenues, and that the economic decision and economic policies followed in Iraq are greatly affected by several factors, including the economic, social and political fact
... Show MoreBackground: The bond strength of root canal sealers to dentin and gutta-percha seems to be an important property for maintaining the stability of root canal filling, which potentially influences both leakage and root strength. The objective of this, in vitro, study was to evaluate the shear bond strength of three different endodontic sealers (Gutta-Flow, AH Plus, Apexit Plus) to dentin, in the presence and absence of the smear layer and gutta percha. Material and Methods: After slicing off the occlusal 2mm of 60 extracted human maxillary premolar teeth, the exposed dentin served as the tested surfaces; the teeth were fixed with cold cure acrylic, and were divided into two groups according to the smear layer presence, group A without smear
... Show MoreBackground: All diseases concerning bone destruction such as osteoporosis and periodontal diseases share common pattern in which the osteoclast cells are absolutely responsible for bone resorption that occurred when osteoclast activity exceeds osteoblast activity. Osteoprotegrin (OPG) considered as novel soluble decoy receptor known as “bone protector†since it prevents extreme bone resorption through inhibition of differentiation and activity of osteoclast by competing for binding site. It binds to receptor activator of nuclear factor kappa-B ligand (RANKL) and prevent its interaction with receptor activator of nuclear factor kappa-B (RANK), thus inhibits osteoclast formation. TNF-α is a pro-inflammatory cytokines having
... Show MoreThis study is planned to find relationship between interleukin-33 (IL-33) with its receptor interleukin-1 receptor 4 (IL-1R4), and assurance IL-33/IL-1R4 proportion as biomarker to atherosclerosisin rheumatoid arthritis (RA) Iraqi female’s patients with and without dyslipidemia. This study was attempted at Baghdad Teaching Hospital included 60 female’s patients with RA that were isolated into: 30 patients with dyslipidemia(G2), 30 patients without dyslipidemia(G3) and 30 individuals as control group (G1). Patients were experiencing treatment by methortexiene medication, analyzed by rheumatoid factor (RF) and erythrocyte sedimentation rate (ESR) tests. All patients and control groups age ranged from (30-55) years. The results show an inc
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