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 cartographic representation of geographical phenomenon considers the essential base in geographical analysis since as it supports the vertical house which is apartment houses consist of apartments which represent civil phenomenon , the aim of this study is to project the rule of cartographic representation methods in geographical analysis and make comparison in economic and social aspects for two approaches , the vertical and construction building methods.
The expand of city horizontally represent a problem in itself because it leads to loss of civil lands and overpass the agricultural lands as a result ,the ratio of habitation of land usage is so large in comparison with another usages of lands of the cities ; therefore ; many co
This research deals with the technical configuration of the beautiful visions among Bany Ahmar poets reflected through the incarnation of beautiful artistic images that manifests itself clearly in the combination of two contradictories simultaneously.
The main conclusion is, the Andalusian poets try to use those fictional visions in search of aesthetic pleasure and values, through forming an image from water and fire as two prominent contradicted elements to express the impact of the heat of wine which soon vanishes when it is mixed with water. By this, they show the beautiful side of nature that suggests joy and splendor.
The histological structure of integument in Mastacembelus mastacembelus have been investigated from skin fragments cut from nine regions at body surface. The results revealed that the integument of the fish investigated comprises three principal layers- the epidermis, the dermis (corium) and the subcutis-All the three principal layers may further be divided into secondary layers according to the function performed by their cells. The epidermis may further divided into three layers- the outermost epithelial coverage, the middle layer and the basal layer (stratum germinatiuum)-The dermis consists of a relatively thin upper layer of loose vascular connective tissue called the stratum laxum and a thick lower compact layer- the stratum compactu
... Show MoreForm naming system Simiaúaa can not be studied in isolation from the dimensionality of social and psychological , no doubt that names carry data psyche during social interaction , deflagration volunteered her body signifier in formats that meet the margin emotional part of the signified , Vtngams forms functions in coordinated trading to function as semantic double , it operates on coding , as well as carry emotional charge .
The science of semiotics cares Pettmvsal indications and forms of circulation, and is made form the semantic patterns , and pattern of production , and methods of functioning . Stop quite a few specialists and critics and researchers at Dalia ignorant poet and knight known ( Duraid bin embolism Jashmi ) ; it rep
Voice studies are one of the sensory studies of their first association with auditory taste, which broadcasts its connection to the most sensory point contained in the physical corners, and in order to satisfy our conscience from these fundamental voices, we searched for in modern contexts, high proportions related to the words of Muhammadiyah, so we are looking for (events In the hadiths of the Prophet (peace be upon him), to settle our journey when the true adhkaar received from the Prophet, peace be upon him, and to control us start a journey through which we repeat between the cities of audio repetitions, sometimes we find ourselves have stood at the entrance of what corresponds to the sounds between the title of the Hadith and its t
... Show MoreBefore the unit environmental problems serious the issues of the environment and conservation of contemporary issues important in the developed and developing worlds, it was natural that leads increasing global awareness to alert a group of intellectuals, scientists and politicians to the seriousness of this problem and the call to take steps deeper and more comprehensive with respect to the environment humanitarian based on the study of the various elements of this environment and a greater understanding of the relationships among them, and on this basis, steps have been taken to target the environment and to identify problems and make efforts to achieve the goals I: stop the deterioration of the environment and the second impro
... Show MoreThe tagged research problem (the outputs of the written text in conceptual art) dealt with a comparative analytical study in the concept of conceptual art trends (land art - body art - art - language).
The study consisted of four chapters. The first chapter dealt with the theoretical framework, which was represented in presenting (the research problem), which raised the following question: What is the role of the written text in the transformations of the conceptual arts?
The first chapter included (the importance of research) and (research objectives) seeking to conduct comparative research in the written text within the trends of conceptual art as a moving phenomenon in art, and to reveal the variable written text in the
... Show MoreSilymarin is derived from the milk thistle plant, and possesses numerous pharmacological actions, including hepatoprotective, anti-inflammatory, antioxidant, and anticancer properties. The aim of the study was to the determination of influence different concentrations of Silymarin on the rumen performance in 30 local lambs (divided into three groups of 10 lambs each). In the first and second groups, 420 and 210 mg kg-1 of silymarin were administered for 8 weeks, and the third group was the control, which received normal saline solution. The parameters evaluated included the level of volatile fatty acids (VFAs), ammonia and pH in the rumen. Furthermore, the in vitro digestibility of ash, protein, fat and dry matter was investigated.
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