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.
Abstract
The cultural contrast is considered of the essential subjects in the field of administration of international businesses which have great and effective role for representation in one social system for the individuals have various belongings, and the nursing performance is considered an essential basic for health care, thus a discussion for two variables have done to formulate the intellectual frame for this research which are( the cultural contrast and the nursing performance). depended a questionnaire as a research tool by(90) he/ she nurses of the Iraqis and the arrivals( the
... Show MorePraise be to God, and may blessings and peace be upon the Messenger of God, his family and companions, and from his family and after ...
It is the right of every nation to be proud of its heritage, science and civilization among the nations, taking pride in the efforts of its construction and the keenness of its scholars and dedication to serve their nation and their history, and from the great sciences that boast and honor our great nation and distinguish it over others the science of attribution and the preservation of the novel over generations and ages. The novel is preserved from the plagiarism of the nullified, the excess of the deceitful and the liars, and the science of isnad from religion as the scholars said, and without the
The aim of the research is to clarify the role of service quality through its dimensions represented by (tangibility, reliability, safety, response, empathy) in tax compliance with taxpayers, i.e. performance of the duties and obligations of the taxpayer through its dimensions (registration, accounting, payment of the amount of tax), and to know For this role, a sample was taken from the taxpayers of the branches of the General Authority for Taxes spread in the governorate of Baghdad and its affiliated districts, which amount to (15) tax branches, as (215) questionnaires were distributed to know the impressions and reactions of the taxpayers regarding the level of service quality through the aforementioned dimensions. Using the statistic
... Show MoreDrama "The Condamned of Altona" shows many different aspects of the 20th century. It contrasts strong, self-assured characters with weak, unsure ones to address absurdism and existentialism. Also, this piece shows the misery of the decade by showing Frantz, one of the play's heroes, taking his own life. Through suicide, disillusionment, and worry, the play depicts the upheaval of the 20th century, which was marred by numerous crises. The play's depiction of the jail and its inmates exemplifies the regret that accompanied the two world wars . Not only does guilt serve as a metaphor for the wrongs done by the Germans, but it also serves as a metaphor for the French inactivity during the occupation. And also the writers who did not devote thei
... Show MoreMeans the current research study in the direction iconic structures plates Ottoman calligraphers , as they took turn in this area and because it excelled in the form of a strong incentive and motivation to seek calligraphers in this direction so as to simulate the skill of the artist and parallel to the side of his creativity as well.And iconography , RECEIVED of objective vision and aesthetic and semantic in the output of compositions written according to the specific significance and this has a clear impact on the propensity to develop technical and aesthetic and expressive in the output of the structure of synthetic iconography is limited by rules or building in the form of public panel linear . And that all forms , whether animal , h
... Show More<p>There is an Increasing demand for the education in the field of E-learning specially the higher education, and to keep contiuity between the user and the course director in any place and time. This research presents a proposed and simulation multimedia network design for distance learning utilizing ATM technique. The propsed framework determines the principle of ATM technology and shows how multimedia can be integrated within E- learning conteext. The first part of this research presents a theoretical design for the Electricity Department, university of technology. The purpose is to illustrate the usage of the ATM and Multimedia in distance learning process. In addition, this research composes two entities: Software entity
... Show MoreThis article discusses the most beloved and creative dialect of the Arabs - the Iraqi dialect, despite its complexity, but it has a lot of beautiful foreign vocabulary. We followed a descriptive and historical approach, also tracked phonetic changes in this dialect, and then gave phonological explanations for these phenomena, trying to connect most of the phenomena with their historical roots in the standard Arabic "al-Fussha" and in ancient Arabic dialects. Most modern linguists have realized the need to study these dialects, since many of the modern dialect characteristics are only extensions of some ancient Arabic dialects, and do not refer them to the classical language. The study of modern Arabic dialects may be faced with a nu
... Show MoreAbstract : The concept of moderation is one of the important concepts that have been discussed in political thought in general and in Islamic political thought in particular. It concerns the status of moderation and balance and the need of Islamic societies to apply them in contemporary times. The Islamic societies faced challenges facing Islamic advancement. And the right, which is the middle between the excessive and the excessive -and the exaggeration and cost-, and between negligence and default, moderation and integritybetween both two sides are: excessive and negligent". In addition, the concept of moderation and its intellectual roots have been sought in the Holy Quran and the noble prophetic, and the search for its charac
... Show MoreThis research attempted to take advantage of modern techniques in the study of the superstructural phonetic features of spoken text in language using phonetic programs to achieve more accurate and objective results, far from being limited to self-perception and personal judgment, which varies from person to person.
It should be noted that these phonological features (Nabr, waqf, toning) are performance controls that determine the fate of the meaning of the word or sentence, but in the modern era has received little attention and attention, and that little attention to some of them came to study issues related to the composition or style Therefore, we recommend that more attention should be given to the study of