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 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 MoreRecent studies have tended to look at Mottagorat texts for seeking more of the information provided by the book for the reader, has been known by several terms Mottagorat texts, including thresholds, including the margins of the text and the parallel texts, and came this difference, according to researchers who ate the subject of research and investigation. Thus, the researchers assert that all these texts must be subjected to provide information even if propaganda of the text. Hence arose the importance of these texts in Informatics scientific material being wrapped body of the text as well as being propaganda material to evoke the recipient to read, and then to the importance of this topic, the search came on five chapters, the first c
... Show MoreThis research is concerned with the study of (the aesthetic of constructive relations in linear composition) with what distinguished Arabic calligraphy through the style and artistic method in its construction, and the specifications it carries that enabled it to pay attention to building formations to achieve in its total linear ranges aesthetic values and relationships. Through the research, the models and the exploratory study that he obtained, the researcher was able to raise the research problem in the first chapter according to the following question: What is the aesthetic of constructive relations in linear formation?
The importance of the research in achieving the aesthetics of the formations, which is a wide field according t
Media theories and studies have provided many diligences on the concept of social media and the circle of influence, including the theory of social marketing which deals with how to promote ideas espoused by the elite in a society to become a recognized social value. The emergence of social networks provided a revolutionary breakthrough, taking the media to unprecedented horizons; and giving its users great opportunities to influence and move across borders without restrictions and censorship, except in a relatively limited manner.
So, the emergence of social media has created channels of live broadcasting from its audience in a method of development that changes the essence of the known communication theories; a
... Show MoreThe 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 MorePersonification in Arab poetry is not confined to the abstract items in nature: it trespasses them to include more than that. We found after reviewing the anthologies of the poets tens of the personified items are full of human attributes - via personification- such as speaking, moving, feeling human feelings.. Personification formed a remarkable feature in the relationship between poets and war, which was clear in the Pre-Islamic poetry, because it occupied the minds of the ancient Arab mindset. The poets have envisioned war as ugly as a force that brings destruction and devastation. The paper aims at stating the position in which poets personified war with female tributes. Thus, it is impregnated, conceived, and produced birth like a w
... Show MoreDBN Rashid, IMPAT: International Journal of Research in Humanities, Arts, and Literature, 2016 - Cited by 5
This study aims to discuss the projects of poultry in Wasit province in 2013 and geographical distribution according to the type and contrast on the level of administrative units representing Districts and The reasons for this discrepancy, as well as knowledge of the factors affecting the distribution by the analysis and reasoning and description This study divided to the four themes, The first of the statement of nutritional importance and economic Poultry focused on the importance of various poultry products, The second one shows the relative position of the province of Wasit between the provinces of Iraq in poultry and production of eggs and meat farming projects, and then followed by the third one (theme) as it ensures the geographic
... 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
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
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