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 presenting a number of scenarios for the investment of the marshes. The problem of research problem was that there is no in-depth analysis of the marshes environment. The traditional methods of the environmental analysis are insufficient. The research community is represented by the decision makers in Maysan Governorate. The research led to proposing of three scenarios with statement the requirements for the success of each one. The most important conclusions are that the three proposed scenarios for marshes investment depend on the availability of the required volunteers for each scenario. The higher the availability of the requirements, the more optimistic the scenario becomes. If t
... Show MoreABSTRACT:
Interest rates are one of the important aspects that affect the banking business directly, which is characterized by unstable dynamic dynamics, which must be viewed on a daily and continuous basis through the macroeconomic view, which directly affects the bank’s income realized from loans as interest received or interest paid on its deposits as an expense. Hence the earnings per share. The relationship between interest rates and between net income and earnings per share was measured and a correlation was found between them, and then the effect between them was measured using regression equations and they were applied and th
... Show MoreBackground : Shoulder pain is a common problem that can pose difficult diagnostic and therapeutic challenges for the family physician It is the third most common musculoskeletal complaint in the general population, and account for 5% of all general practitioners musculoskeletal consults Objective: To determine the diagnostic performance of ultrasonography compared with the physical examination for detection of rotator cuff tears in painful shoulder syndrome. Method: Prospective study was done on seventy patients (48 male, 22 female), age ranged between 30-70 years (mean age 50 years), From February 2007 to July 2011, were subjected to comparative study in Al-Kindy teaching hospital with rotator cuff tears, including physical and ultrasonogr
... Show MoreThe research aims to enrich the subject of marketing deception, which is still in the concept stage at the level of the research sample and to allow future researchers to contribute to addressing the concept of marketing deception and linking it with other variables. The research problem is that is there a correlation between marketing deception and organizational reputation in Baghdad assets. What is the reflection of marketing deception on the organizational reputation in the assets of Baghdad? The research is concerned with shedding light on the reputation of the organization in terms of frequency of purchase, place of purchase, brand loyalty, and knowing the impact of marketing deception on these fact
... Show MoreWisdom is the separation and distinction between aim in the word and work and the lack thereof in accordance with the knowledge surrounding the arts of science, which reached a thorough understanding of things and put them in the quorum. In this research, I have tried to discern the characteristics of the wisdom of Imam Hassan al-Askari (peace be upon him) and to explain his methods and actions which are indicative of the various facets of wisdom required by the nature of the actions and behavior that he has to deal with. Or future mother.
The second topic was devoted to the style of Imam (p) and his wisdom in the situations that necessitated the diversity of methods of dealing such as the method of concealment and the method of refer
Quality control charts are limited to controlling one characteristic of a production process, and it needs a large amount of data to determine control limits to control the process. Another limitation of the traditional control chart is that it doesn’t deal with the vague data environment. The fuzzy control charts work with the uncertainty that exists in the data. Also, the fuzzy control charts investigate the random variations found between the samples. In modern industries, productivity is often of different designs and a small volume that depends on the market need for demand (short-run production) implemented in the same type of machines to the production units. In such cases, it is difficult to determine the contr
... Show MoreReducing global warming potential (GWP) of refrigerants is needed to the decrease of ozone-depleting of refrigeration systems leakages. Refrigerant R1234yf is now used to substitute R134a inside mobile air conditioning systems. Thermodynamic properties of R1234yf are similar to R134a. Also, it has a very low GWP of 4, compared to 1430 for R134a, making it a proper choice for future automobile refrigerants. The purpose of this research is to represent the main operating and performance differences between R1234yf and R134a. Experimental analysis was carried out on the automotive air conditioning system (AACS) with 3 kW nominal capacity, to test and compare the performance of R134a with R1234yf. Experiments were accomplish
... Show MoreThe primary goal of root canal treatment (RCT) is to expel the presence of any necrotic or vital tissue, microbes and their byproducts from the canal space before press forward with the following steps of the RCT procedures. Although this is difficult to attain, various strives had been practiced by employing chemical and mechanical methods to eliminate as much microorganisms as possible and make the canal space valid for the obturation materials to be received. The aim of this review is to demonstrate some of what new remedies that could be used as root canal disinfectant by summarizing the recent studies regarding the efficacy of different natural products against the most persistence microbiota that could be responsible for most
... Show MoreImmunosuppressive cytokines are the main components of the tumor microenvironment and perform a vital function in controlling the immune response to malignant neoplasms.The objective: to study the influence of interleukin-4 (IL-4) and transforming growth factor-β3 (TGF-β3) on the development of breast tumors in women.Materials and methods. The concentration of cytokines IL-4 and TGF-β3 in blood serum was determined in 40 women with benign breast tumors, 40 women with malignant breast tumors, and 40 healthy patients without breast pathology, who were included in the control group.Breast cancer (BC) patients were divided into two groups; the first group included patients with the II stage of BC, who were considered to have a low le
... Show More