الفهرس 
Asymmetric hydrogenationOnly 14 pages are availabe for public view
 |  | from | 138 |  |  |
| | | from | 138 | | |
Abstract
Warfarin is an anticoagulant involved in preventing thrombosis and thromboembolism, which is prescribed for patients with chronic atrial fibrillation, pulmonary embolism, deep vein thrombosis, recurrent stroke, and prosthetic heart valves. In clinical practice, warfarin anticoagulant activity should be monitored for the international normalized ratio (INRs) to ensure an appropriate, safe, and efficient dose; incorrect dosage administration may cause a high risk of potentially devastating bleeding and failure of preventing thrombosis. Several factors have been reported to influence the variability in warfarin dose, including age, body size, vitamin K intake, interacting medications, and genetic variants. A large number of evidences demonstrated that genotype-guided dosing of warfarin is a widely recognized example of pharmacogenetics, and clinical utility of genetics-guided warfarin initiation could provide safe and optimal anticoagulation therapy. Given that, this study was designed to identify the potential importance of EPHX1 polymorphism in patients with coumarin based oral anticoagulant resistance and its clinical significance. This cross-sectional study was conducted in hematological unit of internal medicine department at Faculty of medicine, Tanta University, during the period from March 2018 to March 2019. Thirty patients with oral anticoagulant resistance (>10mg/ day) (group 1) were enrolled in this study besides 10 patients with optimum response to oral anticoagulant. Patients who had blood transfusion for 6-9 weeks, bone marrow or liver transplant and less than18 years old were excluded from the study.