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.
شهدت العالم منذ نهايات القرن الماضي وبدايات القرن الواحد والعشرين تطورات دراماتيكية على صعيد الادبيات التنموية ، اذ تحولت التنمية من المفهوم التقليدي الذي اهتم بالنمو الاقتصادي الى رؤية جديدة هي رؤية التنمية البشرية ومن ثم الى التنمية المستدامة التي اعطت للتنمية البعد الانساني وجعلت من مشكلات واحتياجات البشر منطلق لها لتحويل الفرد والمجتمع الى مرحلة جديدة تضمن له العيش الكريم وتحقق معه
... Show MoreThe present study aims to identify the socio-psychological implications that police investigators experience regarding the variable of gender, age, place of residence, qualification, military rank, and work experience. The study included 6 individuals who were working in investigation department in Hebron district as a sample. The results demonstrated that the targeted sample had a dump attitude toward the socio-psychological implications. The psychological implications reflected 2.8739, the social side represents 3.2956.
The whole world and the Arab world, especially an important part of this international system, is undergoing a radical transformation at all levels. This mosaic of political, economic, social and military relations and alliances, whether based on the special interests of the major Powers or on the basis of mutual interests, The major transformations to social, economic, political and military conflict and these transformations still bear more surprises, at all levels, nothing remains constant, all changed, relations changed and alliances changed and loyalties fell and the principles of the M changed and the spectacular imperial economies collapsed and the will of the masses was no longer fixed.
Man was closely associated with nature in its various forms, as it represented the incubator for him in all areas of his life, so writers often made it a material for their literature and a fertile ground for their productions, so it appeared in its various forms and man’s need for it, its good and its bad in literature throughout history, and the Arabs are like Other nations, since the pre-Islamic era, nature was an important outlet and a refuge for poets in the production and creativity of literature and to this day, and when we talk about a poet from the Fatimid state, we find that nature - especially spring and its flowers - in that period took its take from literature and represented a phenomenon for many Among the
... Show MoreThe formal integration of the interior spaces in general and the commercial spaces of the watch shops in the large commercial centers in particular is the goal that the designers aim to reach in order for the interior space to become successful in terms of the design idea and its characteristics. Implementation mechanism. One of the reasons for achieving formal integration in the interior spaces of watch shops is the requirements of the design that must be available in these spaces to reach a state of formal integration between the interior and the exterior so that the space becomes fully integrated in all respects. Because of the aforementioned reasons for dealing with the research, through four chapters: The first chapter included the
... Show MoreDeep submicron technologies continue to develop according to Moore’s law allowing hundreds of processing elements and memory modules to be integrated on a single chip forming multi/many-processor systems-on-chip (MPSoCs). Network on chip (NoC) arose as an interconnection for this large number of processing modules. However, the aggressive scaling of transistors makes NoC more vulnerable to both permanent and transient faults. Permanent faults persistently affect the circuit functionality from the time of their occurrence. The router represents the heart of the NoC. Thus, this research focuses on tolerating permanent faults in the router’s input buffer component, particularly the virtual channel state fields. These fields track packets f
... Show MoreThe research aims to identify the importance of using analytical procedures in the detection of creative accounting practices. To achieve this goal, (100) questionnaires were prepared and distributed to the auditors in the Federal Financial Supervision Bureau and the authorized auditors' offices and practitioners of the auditing profession in Iraq. For the purpose of testing the research hypothesis and analyzing data, some appropriate statistical methods have been used and the use of the statistical program (SPSS) to analyze the data. The results of the research showed that the analytical procedures and tests applied by the auditor have a role in revealing and limiting creative accounting practices and methods and that auditors u
... Show MoreIn this research, non-thermal plasma system of argon gas is designed to work at normal atmospheric pressure and suitable for work in medical and biotechnological applications. This technique is applied in the treatment of the Staphylococcus epidermidis bacteria and show the role of the flow rate of Argon gas on the killing rate of bacteria, and it obtained a 100 % killing rate during the time of 5 minutes at the flow Argon gas of 5 liters/ min.
Herpes labialis is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums, or the skin around the mouth. Although there is no successful treatment available, the local use of compounds with effective anti-inflammatory and cytoprotective effects may be of value in this respect. This project was designed to evaluate clinically the local use of silymarin, a group of flavonoids with powerful antioxidant, anti-inflammatory and cytoprotective activity, in the treatment of herpes simplex ulcer. Fifty three patients with herpes labialis ulcers (HLU) were enrolled in this randomized, single blinded, placebo controlled clinical study, and they were al
... Show MoreThe process of granting loans by banks is the confidence they give to their customers, but this trust should not be a cornerstone in granting loans even if granted these loans on the basis of sound banking should involve risks that may be exposed to the bank because of the failure of the client to meet The bank's financial obligations to the bank due to the unexpected economic conditions affecting the customers, which makes them in a state of faltering, which weaken the ability of banks to provide loans, which are the most important sources of revenue and profits, so the problem of non-performing loans is one of the main problems facing most of the banks Which impede the functioning of its work and the reasons that led to the agg
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