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.
Education is the most powerful and important weapon in fighting poverty and unemployment because it provides students with new skills that appropriate the new market requirements and fair distribution of natural resources. It also transfers knowledge, skills, and ethics over generations. Education aims to create effective leaders who go under training and rehabilitation process, create a new human and instill faith, generate the creativity and innovation, and keep abreast with scientific process, updating curriculum, and finally, applying the technical education
The loss of dental hard tissue as a result of odontoclastic activity is known as root resorption. It is unwanted and pathological in permanent teeth. Root resorption may happen within the root canal called internal root resorption or on the outer surface of the root called external root resorption. Regardless of where it occurs, root resorption is irreparable, can cause pain for the patient, necessitates treatment, and in some circumstances, resulting in the early loss of the affected tooth. It might be challenging to precisely diagnose and treat root resorption. There is limited information within literatures on root resorption therefore this review aims to understand the radiological and clinical characteristics of r
... Show Moreحضيت القيادة باهتمام كبير من قبل الباحثين ودورها الإيجابي في التأثير على الموظفين ونجاح المنظمات، في الآونة الأخير بدأت الدراسات تركز على الجانب المظلم للقيادة وتأثيرها على التابعين وبيئة العمل، وقد تم تحديد القيادة السامة بأنها أخطر الأساليب القيادية التي تتسبب بتكاليف مادية ومعنوية على المنظمات بمختلف جوانبها، ان القيادة السامة تأثر على دوافع المرؤوسين وقدرتهم على انجاز المهام، ورغبتهم في الاستمرار في
... Show MoreTriump is a happy end and a positive outcome of any good deed on the part of a human
being, or of any competition or contest in any field. A human being’s life abounds with gain
and loss. If one succeeds one will be happy psychologieally, physieally, etc. if one the other
hard one loses, one wil be in a state. Between loss and gain there are many a step.
However humans work hard to be a great success and a read winner.The life of the world constitutes a huge race-track where people try hard to head towards
the hereafter. Therefore, we find people who succed and gain the Garden, and people whose
habitation is the fire, The Glorious Qur’an has shown us in many a surah the way to success
when Allah mentions ‘great
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ABSTRACT Studying the positive and negative effects resulted from the industrial projects and laying down the comprehensive planning bases to the urban development projects which insure retaining the social, economic and environmental development, taking in to consternation the time factor within the planning process which is considered the most important factor that determine the extent of the efficient selection to the site and not interpenetrate in the industrial activities and efficiency and calculating its future expansions away from the residential areas. It is more favorable to plan the industrial areas of apparent pollution outside the bounds of the basic plan to limit the negative effects on the environment and providing
... Show MoreMarriage as a social case began Almighty God created Adam, peace be upon him then created from the rib Eve to be the first couple of human beings on the face of the earth and the formation of the first social family in the land, human and picked up this social reality through the generations, but in different shapes and purposes, but the mating process is one. So I got the divine religions and organized that life, especially in Islam, as explained every aspect of the life of the role and practice of marriage and had a large share in this organization and I got many Quranic verses and the Hadith.
With different civilizations, many of the marriage ceremony appeared in ancient societies take several forms of marriage.
But marriage and
Background: This study aimed to determine the gender of a sample of Iraqi adults utilizing the mesio-distal width of maxillary canines, inter-canine width and standard maxillary canine index, and to determine the percentage of dimorphism as an aid in forensic odontology. Materials and methods: The sample included 200 sets of study models belong to 200 subjects (100 males and 100 females) with an age ranged between 17-23 years. The mesio-distal crown dimension was measured manually, from the contact points for the maxillary canines (both sides), in addition to the inter-canine width using digital vernier. Descriptive statistics were obtained for the measurements for both genders; independent samples t-test was performed to evaluate the gende
... Show MoreThis research deals with the formalities of the mortgage contract according to American law, We have given an overview of the provisions of this law related to the subject, We have also taken into consideration the role of American jurisprudence and the judiciary in finding legal solutions to the aforementioned formality, We have discussed the formality of mortgage in American law in two sections, In the first section we showed the formalism in immovable mortgage, and the second section specified to studying the formalism in movable mortgage.