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.
Background: The final stage of endodontic therapy is complete obturation of the root canal system to provide as perfect as possible at the cementodentinal junction of the apical foramen. The purpose of this in vitro study was to evaluate the sealing ability of injection molded thermoplasticized gutta percha and lateral condensation techniques with and without the use of sealers. Materials and Methods: Forty freshly extracted adult human maxillary central incisors with complete formed apices were utilized in this study. The teeth were randomly divided into four groups for evaluation of the apical seal. Group (1) lateral condensation gutta percha technique without sealer, (2) lateral condensation gutta percha technique with sealer, (3) Inject
... Show MoreThe study objectives were to 1) explore the real-world experience of hospital pharmacists with the differences in effectiveness safety, and interchangeability between biosimilar medicines and their reference biological counterparts, 2) reveal pharmacist recommendations to enhance the safety of biopharmaceutical medicines in public hospitals.
The study has a mixed-method design where the core component was qualitative (interviews) and the supplemental component was quantitative (adverse drug reaction, ADR, reports). This qualitative component included semi-structured (mostly face-to-face) interviews involving hospital pharmacists from different hospitals with experience with biological or biosimilar medicines. The interviews were c
... Show MoreThis Study aimed To know The relation between Types of blood and health problems which human Suffered from , and the effect of food intake on health.
Samples of study contained 269 person aged between 30 – 70 years which choiced randomly for sex , we are take all in formation about samples of study by form paper contian sex , age, type of blood , weight (kg) , height (cm) , smoking or.not , sporting or not, problems in digestive tract , sensitivity for foods , heart problems , ratio of cholesterol in blood , Sinusitis , Asthma , diabetic meliuts , arritable bowel syndrome , diaherra , problems in kidney and urination , hypertension , anemia , alternation in liver function , arthritis with form record in daily food intake and its ade
Historical scripts and Academic studies have bestrewed almost all the events of the movement of march 1941 . Yet the need was present to shine more light on important sides . These important sides were neglected due to some reasons among which came the absence of the historical material which can make a new historical detection. Then there were historical topics concerning our research which comes within context of sanitarily conditions , rarely seizes the attention of the researchers for many reasons some of them were not subjective.
The spread of Malaria among the British force was one of the sanitarily conditions that were related to the movement of march since their arrival to Basra city and its continuous spread after the second
When the guard honey bees, Apis mellifera L., form a clump at the hive entrance or on the flight board, the oriental hornet, Vespa orientails L., either creeps toward the clump or hovers over it in order to take a bee. Once the hornet creeps, only few bees facing the hornet become alert, rock their heads and antennae, open their wings, and take a posture of defense. The rest of the clump stays listless without any signal of concern. However, the clump stays dense and the defending bees do not detach themselves neither from the rest of the clump nor from each other. For this reason, it is very difficult for the hornet to grab a bee unless the latter makes a “mistake” by detaching herself from other adjacent bees. If the hornet grabs s
... Show MoreIraq enjoys many factors and ingredients that made it “affect and be affected at the same time” by the American-Iranian conflict from the “strategic geographical position” adjacent to Iran as an important point and that Iraq has been part of this conflict since the last period which witnessed the outbreak of the first Gulf War (1980-1988) because of border problems and a dispute over Shatt al-Arab, and what followed after that, specifically from 2003 when the United States of America and its allies occupied Iraq’s lands and made a political change by the destruction of its security and military institutions. It increased the importance of Iraq in being a subject of competition between the competing parties in exploiting the
... Show MoreThis research aims to analyze the intellectual and civilizational regression that afflicted Iraqi and Arab society due to political and religious tyranny and internal conflicts, which was reflected in the deterioration of human rights values and the absence of equality and justice in dealing with the other religiously, which affected the reluctance of members of religious groups to interact with their national societies and then migrate to Outside, which contributed to a double loss, in terms of the loss of these societies by productive and effective national competencies, and in terms of distorting the image of Islam. The research stressed that the first treatments of this phenomenon are the consolidation of the values of citize
... Show MoreThe disposal of textile effluents to the surface water bodies represents the critical issue especially these effluents can have negative impacts on such bodies due to the presence of dyes in their composition. Biological remediation methods like constructed wetlands are more cost-effective and environmental friendly technique in comparison with traditional methods. The ability of vertical subsurface flow constructed wetlands units for treating of simulated wastewater polluted with Congo red dye has been studied in this work. The units were packed with waterworks sludge bed that either be unplanted or planted with Phragmites australis and Typha domingensis. The efficacy of present units was evaluated by monitoring of DO, Temperature, COD
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The current research aims to determine the relationship of the impact of the components of the financing structure, especially financing through debts, as well as the earnings per share in the value of the shares of companies listed in the Iraq Stock Exchange. The research sample and identifying the strength of the combined effect of the ratio of financing through debt and earnings per share in maximizing The market value of the firm and the real value, as well as the variation between these relationships according to model of the real value of the companies and the market value of the research sample companies. The research community is represented by the Iraq Stock Exchange, while a conditional deliberate sample
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