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 research aims to identify the role of community participation in achieving organizational distinction in the Dhulia's municipality, which is one of the formations of the Ministry of Construction, Housing, Municipalities and Public Works in Salah al-Din Governorate, which is one of the service organizations that have a fundamental role in providing service to the community, which has faced many administrative challenges and many problems caused by the rapid and continuous changes in the environment, therefore modern management concepts must be adopted, such as community participation and the knowledge of its role To achieve its goals, which helps it in facing changes as well as achieving organizational excelle
... Show MoreThe Almighty Allah has addressed His followers by advising them to follow the example of the prophet (PBUH). Allah says: (INDEED IN THE MESSENGER OF ALLAH YOU HAVE A GOOD EXAMPLE TO FOLLOW). So, He was a true and everlasting example for the people to follow and imitate in all aspects of life. Knowledge and learning, especially Qura'nic knowledge, are among the priorities.
The present study is concerned with how to follow the Prophet example (PBUH) in the field of Qur'an reciting. It aims at showing His instructions on Qur'an reciting, and how He was followed by His Companions. The present study falls into an introduction and four sections. Section One deals with the commands given by Allah to follow His prophet. Second Two
... Show MoreBackground: The rapid evolution of Artificial Intelligence (AI) has significantly influenced Education, demonstrating substantial potential to transform traditional teaching and learning methods. AI reshapes teacher-student interactions and the relationship with knowledge. Objective: To analyze the potential benefits, ethical challenges, and limitations of AI in Education based on recent scientific literature, emphasizing the balance between technology and human interaction. Methods: A documentary research approach with a descriptive focus was employed, following the PRISMA protocol for systematic reviews. The search strategy involved analyzing evidence from 18 scientific articles published within the last six years. Results:AI o
... Show MoreResults: it was found that labelled cells participated in the formation of myotubes, which formed mature muscle fibers, and possibly new satellite cells. The results of this experiment may eventually revolutionized therapeutic procedures for some form of muscle diseases
This study was carried out to investigate the preparation of thermosetting polymeric blend consisting of three adhesive types, namely: epoxy, polyvinyl formal (PVF) and unsaturated polyester. Both of epoxy and PVF were used as a matrix-binder at fixed weight. Whilst unsaturated polyester was used at different weights and added to the matrix so as to produce prepared epoxy-PVF-unsaturated polyester blend. Several experiments were performed at different operating conditions, mixing speed and time at room temperature to identify the most favorable operating conditions. The optimum mixing speed and mixing time for the prepared blend were 500rpm and 5 minutes respectively.
Solid wastes-synthetic sack fib
... Show MoreAbstract:
Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear
... Show MoreAutoría: Nuha Mohsin Dhahi. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 5, 2022. Artículo de Revista en Dialnet.