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 research aims to form a clear theoretical philosophy and perceptions about strategic Entrepreneurship through the relationship between high Involvement management practices, the basis in creating that leadership and high-performance work systems as a support tool in achieving them according to the proposals (Hitt et al, 2011), in an attempt to generalize theoretical philosophy and put forward how to apply it within The Iraqi environment, and on this basis the problem of the current research was launched to bridge the knowledge gap between the previous proposals and the possibility of their application, aiming to identify the practices of high Involvement management and the possibility of high-performance work systems and thei
... Show MoreOne of the issues that occupied the doctrinal mind and differed the attention of scientists is the question of (the quality of the composition of God), so each team of scientists went the doctrine that led him to his evidence.
I wanted through this research to stand on the truth of the matter according to what I reached after looking at the views of the people and their evidence and direct the dispute between scientists.
It was presented with an introduction that was an introduction to the issue, where it began with the introduction of the definition of attributes, and then began to define the composition and view the views of scientists and evidence, and then concluded it with a conclusion mentioning what I have reached.
Background: The discriminative power of the classical WHO parameters in relation to male fertility is quite low, because they only address few aspects of sperm quality and function. This has led investigators to focus their attention on the male gamete and in particular its genome.Objective: To explore which of the sperm DNA damage parameters measured by comet assay are more reliable, and their relations with the standard semen parameters.Methods: Study was done on 40 infertile men selected from couples attending the Institute of Embryo Reasearch and Infertility Treatment at Al-Kadhimiya City/ Baghdad in the period between February 2009 and May 2009, with a history of infertility of ≥1 years; and 15 healthy volunteers of proven fertili
... Show MoreThe research aims to identify the level of balance in the architectural thought influenced by the rational type human consciousness, the materialistic based on the Empirical type, moral based on human experience as source of knowledge.
This was reflected in architecture in the specialized thought that the mind is the source of knowledge which explains the phenomena of life. The rational approach based on objectivity and methodology in (Form Production), the other approach is based on subjectivity in form production (Form Inspiration).
The research problem is that there is imbalance in the relationship between the rational side and the human experience in architecture, which led into imbalance between theo
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Background: Polymethylmethacrylate (PMMA) is the most ‎commonly used mâ€aterial in denture construction. This material is ‎far from ideal in fulfilling the‎ mechanical requirements, like low impact and transverse strength and poor thermal conductivity are present in this material. The purpose of this study was to study the effect of addition a composite which include 1%wt silanized silicone dioxide nano fillers (SiO2) and 1wt% oxygen plasma treated polypropylene fiber (PP) on some properties of heat cured acrylic resin denture base material (PMMA). Materials and methods: One hundâ€red (100) prepared specimens were divided into five groups according to the tests, each group consisted of 20 specimens and t
Background: The appointment system is a common practice in primary health care clinics in developed countries. The patients and health care providers in the primary health care setting perceived the appointment system as an indicator of good quality service.
Objective: The aim of this study was to survey patients’ and health care providers’ attitudes towards the introduction of an appointment system and their satisfaction with the existing ‘walk-in’ system in the primary health care setting.
Subjects and Methods: A questionnaire survey was conducted included a convenient sample of 234 patients as well as 76 health care providers from two primary health care center
... Show MoreBackground: Ulcerative colitis disease is a chronic inflammatory condition that affects the gastrointestinal tract. In regulation of this inflammatory process, Interleukin-6, C-reactive proteins and albumin have a major role. Overproduction of IL-6 by immunocompetent cells contributes to activate the liver to produce CRP, transudation of plasma albumin and development of the inflammatory condition. Elevated levels of IL-6 in saliva could be expected, because the saliva-producing cells are part of the digestive system. The purpose of this study was to assess salivary IL-6, CRP and albumin in ulcerative colitis patients in relation to oral findings. Materials and methods: Forty eight saliva specimens collected from three groups of subjects (s
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