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 basic aim of this research is to study the interactional effect of investing information technology on the relationship between value added intellectual capital and financial performance as literature review suggested on the theoretical level, including previous studies, with the deduction of its trends strongly predicted by research hypotheses and their content associated with the investment in intellectual capital after information technology tools being employed in this direction to improve the financial performance of the studied companies at the levels of both industrial and service sectors, a non-random sample was chosen included (40) forty Iraqi Joint-Stoc
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The study aims to identify the level of health services provided in private suites to government hospitals from the perspective of the recipi
... Show MoreThe importance of the research lies in preparing an experimental curriculum according to a scientific method that will contribute to the development of the special strength(endurance the strength of arms) in order to contribute to the attempt to develop the basic skills of the national team players with the goal ball for the blind As for the research problem, it lies in the weakness of the strength endurance of the national team players with the goal ball for the blind, as the research problem is clearly evident in the last minutes of the match, as well as the former studies in the field of goal ball game for the blind at the country level The research aims to prepare special exercises for endurance of strength as well as t
... Show MoreHypothyroidism is a condition in which thyroid hormones levels decreased in the blood. These hormones are necessary for energy production and body viability. In many occasions this condition is accompanied or followed by different metabolic disorders. The current study is conducted in the "Specialized center for endocrinology and diabetes" and carried on 70 hypothyroid patients and 60 randomly chosen individuals with normal thyroid function .Both groups were submitted to laboratory tests to evaluate thyroid function (T3,T4.TSH). The study involved evaluation of the relationship between hypothyroidism and insulin resistance (IR) . Health problem related to many diseases , became common lately. Insulin resistance diagnosed through
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