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.
Praise be to God, Lord of the Worlds, and prayers and peace be upon our Master Muhammad and upon all his family and companions:
And then: What most concerns rational people and reformers in the modern era is the moral deviation and delinquency that dominates childhood, due to family disintegration and the lack of discipline of most societies according to the religious and moral motives called for by the heavenly messages, especially Islam, which is the final message and guarantees the reform of people in life. Every time and place.
Islam has drawn attention to this issue (childhood) and made it the focus of its consideration, considering that the child is the nucleus of society and the preparation for the future, so it ordered that
Energy is one of the components of the national security of countries and is of particular importance to the industrialized countries, including Germany. Energy policy includes many areas and has an impact on various sectors such as the environment, climate, agriculture and others. During the past few years, Germany has witnessed many transformations, the most important of which is the energy transition towards renewable energy, and it was strengthened in the strategy that was It was developed in 2010, which aims to achieve a long-term energy transformation, and sales of the German energy technology sector have evolved from 2010 to 2020, and this issue is related on the other hand to the concept of energy security and because of its strateg
... Show MorePrecarity means the lack of social and economic networks; a considerable exposure to danger and harm. Minority groups are precariat for they lack rights and full citizenship. Precarity is related, states Judith Butler, with the individual’s performativity, and his ability to perform his gender role. Toni Morrison continually goes to past to retell the history of African Americans. The issues of race, gender and national identity are recurrent in her work. Reading her book Home (2012) evokes the idea of precarity and performativity since the two main characters, Frank and Cee are precarious characters that fail to perform their gender role properly, and eventually are exposed to hazard and harm. This research displays how African American
... Show MoreIn mammals, the kidneys originate in an embryo from the mesoderm through three excretory organs, namely: Pronephros, Mesonephros, and Metanephros. After the formation of Metanephros is completed, the kidneys begin to form nephrogenesis through mesenchymal cells located at the tip of the ureteric bud, that contribute in the formation of glomerulus and Renal tubules. The stages of glomerulus formation in the embryo of albino mice at the age of 14 to 19 days of gestation were studied. It was obtained after the sacrifice of the expectant mother and the kidneys were excised from the embryos and fixed using Aqueous Bouin's solution, Microscopic slices with a thick
... Show MoreThe research deals with the global ceramic achievement within the international forums in the past decades. As follows، showing and presenting the aesthetic and intellectual values leading to common constants that establish international artistic studies that achieve the purpose of circulation and marketing of artworks. Contemporary global plastic art has witnessed a number of technical and social transformations and changes at the technical and pragmatic levels under the pressure of the changing and accelerating tide towards technical، cognitive، social and cultural concepts.
The second chapter came to the first topic: deliberative and commoditization، and the second topic: the deliberativeness of contemporary global ceramics.
Crimes are prohibited by law and God Almighty has forbidden them with punishment or punishment.
The punishment is the prescribed punishments that the law has determined in its place and stipulated in the Book of God or the Sunnah of His Prophet, may God bless him and grant him peace.
Ta’zir: These are the punishments that are left to the ruler to assess according to what he sees as preventing corruption on earth and preventing evil. Extrapolation has proven that all the provisions of Islamic Sharia include the interests of the people, and they are based on five matters: what is in it is preserving the religion, what is in it is preserving the soul, and what is in it is preserving the soul. It involves preserving the mind, preserv
level of effectiveness of Glutathione - S - Transferees (GST), Glutathione peroxides (GPX),Malondialdehyde (MDA) the product of lipid peroxidation and some trace elements ( zinc,seleinum,iron ,copper ) had been measured in sera of (50) women with breast disease.which had been divided to : Control group (25),The first group (A) benign breast tumors (25),the second group (B) breast cancer (25). The results showed a clear moral high level of Glutathione - S - Transferees (GST), Glutathione peroxidase (GPX) , and Malondialdehyde (MDA) level in breast cancer group while a slight increase were observed in the levels of these enzymes and(MDA) in benign breast group. A significant reduction was evident in the levels of selenium and zinc
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The study aims to examine the relationships between cognitive absorption and E-Learning readiness in the preparatory stage. The study sample consisted of (190) students who were chosen randomly. The Researcher has developed the cognitive absorption and E-Learning readiness scales. A correlational descriptive approach was adopted. The research revealed that there is a positive statistical relationship between cognitive absorption and eLearning readiness.