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 ethyl acetate synthesis via heterogeneous reactive distillation is studied experimentally using ethanol and acetic acid. Three types of cation exchanging resins were used as catalysts: Zerolit 225, Zerolit 226 and Ambylite 400. Experiments were carried out in two units of the same dimensions. Each unit consisted of three sections: rectifying, reactive and stripping sections of heights (60+25+20) cm respectively and 2.5cm column diameter. The first unit (column-A-) was a fractionation type and the second unit (column-B-) was packed column. The packing type was hollow glass cylinders with 10 mm height, and 4, 5 mm inner and outer diameter respectively.
The experiment
... Show MoreThe present study examines the main points of differences in the subject of greetings between the English language and the Arabic language. From the review of the related literature on greetings in both languages, it is found that Arabic greeting formulas are more elaborate than the English greetings, because of the differences in the social customs and the Arabic traditions and the Arabic culture. It is also found that Arabic greetings carry a religious meaning basing on the Islamic principle of “the same or more so”, which might lead to untranslatable loopholes when rendered in English.
This paper studies the demonstratives as deictic expressions in Standard Arabic and English by outlining their phonological, syntactic and semantic properties in the two languages. On the basis of the outcome of this outline, a contrastive study of the linguistic properties of this group of deictic expressions in the two languages is conducted next. The aim is to find out what generalizations could be made from the results of this contrastive study.
Review of multidrug sensitivity and resistance in enterococcus
All domains in this world built based on set of theories. Those theories have been responsible for interpretation of some phenomena and interlocking relationships around us. Commonly, theories are categorized by which aspect is believed. Also,can find a group of theories produced regardingto the leadership domain. This paper will be presented some of these theories like (Great Man Theory, Trait Theory, Behavioral Theories, Contingency Theories, Situational Theory, Transactional Theories, and Transformational Theories). where these theories considered the most popular and common in the field of leader and will be discussed by this work
We presented here a 25years old lady with a multiple hatdtid cysts in lung and liver and spleen in large number in each organ. Which regarded inoperable and difficult to treared.We use medical treatment with antihelimenthes drugs in new regime and follow-up over 1year clinically, laboratory investigations, U/s and CT.scan. There was good disappearance of liver and spleen cysts with very good response in lungs.
Background: Pregnancy is considered a major risk factor for development and progression of periodontal disease. There are hormonal changes in both estrogen and progesterone hormones in addition to bacterial effect and poor oral hygiene that will enhance development of periodontal disease in pregnant women. Materials and methods: Seventy subjects were enrolled in the study, the subjects with an age range (20-35) years old without any history of systemic disease. The subjects were divided into 20 non-pregnant women they represent the control group (G I), 30 pregnant women with gingivitis (GII) and 20 pregnant women with periodontitis (GIII).All periodontal parameters (plaque index, gingival index, bleeding on probing, probing pocket depth an
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