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.
The impact of mental training overlap on the development of some closed and open skills in five-aside football for middle school students, Ayad Ali Hussein, Haidar Abedalameer Habe
Background: Rehabilitation of the carious tooth to establish tooth structure integrity required cavity design that show a benign stress distribution. The aim of this study was to investigate the influence of the cavity position on the stress values in the reamining tooth structure restored with amalgam or resin composite. Materials and methods: Seven 2-D models of maxillary first premolar include class I cavity design was prepared, one sound tooth (A) 3 composite (B1, B2, and B3) and 3 amalgam (C1, C2, and C3). In design (BI and C1) the cavity position is in the mid distance between bacc-lingual cusp tip, design (B2 and C2) and (B3 and C3) shifted toward the buccal cusp and the lingual cusp for 0.5 mm respectively. One hundred N vertical
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The objective of this research is to analyze the relationship between the strategic planning for human resources and career path, and I have tested Search the Ministry of Health and some health centers headquarters in the Karkh district, that is applied in sample Consist of (45) Deputy Director, Head of Depts, Departmental Manager, and health center Manager.
Find interested in studying the two subjects are important and vital, at the level of organizations at the present time, namely the strategic planning of human resources and career path. To achieve the objectives of the research was designed Qusestionnair (31) items to collect Primary data. and collected t
... Show MoreAlmost human societies are not void of poverty, as the latter accompanied the emergence of humanity, and it, thus, represents an eternal problem. To advance an individual's reality and raise the level of the poor social classes, social security networks have been established. Such networks operate in society following social systems and laws to provide food, and material support. Besides, such networks help to rehabilitate the individual academically and vocationally. They empower vulnerable groups through the establishment of courses and workshop, provide (conditional) subsidies related to the health and educational aspects in order to achieve the sustainable development goals of (2030), and apply developmental roles of social safety ne
... Show MoreBackground: This study compared in vitro the marginal adaptation of three different, low shrink, direct posterior composites Filtekâ„¢ P60 (packable composite), Filtekâ„¢ P90 (Silorane-based composite) and Sonic fillâ„¢ (nanohybrid composite) at three different composite/enamel interface regions (occlusal, proximal and gingival regions) of a standardized Class II MO cavity after thermal changes and mechanical load cycling by scanning electron microscopy. Materials and methods:Thirty six sound human maxillary first premolars of approximately comparable sizes were divided into three main groups of (12 teeth) in each according to the type of restorative material that was used: group (A) the teeth were restored with Filtekâ„¢ P6
... Show MoreThrough this article, we studied the peristaltic motion of “Hyperbolic Tangent” fluid in the geometry of curvature channel by using the analysis of large wavelength and less of Reynolds number. The matter has controlled mathematically by the partial differential equations of continuity, motion, heat transfer. In the study, we used the impact of radial magnetic force. The obtained coupled non-linear equations of above equations have solved by an approximation technical. Locked formula solutions of the stream function, axial velocity, heat function has evaluated. The influence of curvature is analysed and took it into account. The impact of sundry variables on the inflow features ha
Background: To evaluate the effect of antierosive agents (10% Nano-Hydroxyapatite (NHA), 10% Casein Phophopeptide-Amorphous Calcium Phosphate (CPP-ACP), and combination of 10% NHA and 10% CPP-ACP) on loss of minerals from enamel surface of permanent teeth treated with antierosive agents when exposed to an acidic beverage and investigate the morphological changes of treated enamel surface after demineralization with cola based beverage under Scanning Electron Microscope (SEM). Materials and Methods: Sixty maxillary first premolars were randomly divided into four groups, 15 teeth for each group. Group I treated with 10% NHA, Group II treated with 10% CPP-ACP, Group III treated with 10% NHA and 10% CPP-ACP, and Group IV did not treat with any
... Show MoreThe Muslim woman actively participated in narrating, preserving, controlling and maintaining the hadith, along with her brother, the man who later became an inexhaustible representative of the effort to preserve, control, and narrate the Sunnah. Undoubtedly, the mothers of the believers, may God be pleased with them, had a great advantage in communicating Islam and spreading the Sunnah of the Prophet Especially among women, all of them heard from him, may God’s prayers and peace be upon him, and lived with him in the details of his life on the disparity between them in memorizing and narrating and publishing them. It narrated (378) recently, and it is considered the second narrator after the mother of the believers Aisha, may God be pl
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Abstract
The resources-based introduction in the study of business organizations is increasingly dealing in the study of the human capacities and the best ways to develop them and changing the resources of the organization to be essential and competent to face the business challenges. Today’s organizations need crucial practices to face those challenges and the influences of those practices which take into consideration the importance of developing the entrepreneurship inside the organization. Those practices are called “High Performance Work Systems” which is denoted by “HPWS” and defined as the practices of human resources management which help in acquiring func
... Show MoreThis research aimed to evaluate the level of readiness to teach science in the light of the information, media, and technology skills among undergraduate students at the Faculty of Edu-cation, King Khalid University. To achieve this goal, a descriptive and analytical approach was used. A list of readiness to teach science was prepared in the light of Information, media, and technology skills, and in the light of this list, a cognitive test, observation sheet, and attitude scale were prepared to assess readiness to teach science in its three aspects, cognitive, behavioral, and emotional. The sample of the research consisted of (42) students enrolled in field training courses at the sixth, seventh and eighth levels. Research tools were app
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