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.
Aromaticity reversals between the electronic ground (S0) and low-lying singlet (S1, S2) and triplet (T1, T2, T3) states of naphthalene and anthracene are investigated by calculating the respective off-nucleus isotropic magnetic shielding distributions using complete-active-space self-consistent field (CASSCF) wavefunctions involving gauge-including atomic orbitals (GIAOs). The shielding distributions around the aromatic S0, antiaromatic S1 (1Lb), and aromatic S2 (1La) states in naphthalene are found to resemble the outcomes of fusing together the respective S0, S1, and S2 shielding distributions of two benzene rings. In anthracene, 1La is lower in energy than 1Lb, and as a result, the S1 state becomes aromatic, and the S2 state becomes anti
... Show MorePatch in transdermal drug delivery(TDDS) used to overcome the hypodermic drawback, but these patch also have absorption limitation for hydrophilic and macromolecule like peptide and DNA. So that micronized projection have the ability for skin penetration developed named as microneedle. Microneedle drug delivery system is a novel drug delivery to overcome the limitation of TDDS like skin barrier restriction for large molecule. Microneedle patch can penetrate through skin subcutaneous into epidermis, avoiding nerve fiber and blood vessel contact. There are many type of microneedle patch like solid, polymer, hallow, hydrogel forming microneedle and dissolving microneedle with different method of microfabrication
There is a real problem when adding micro elements to the soil as a result of fixation, sedimentation, washing or toxicity, and thus economic loss. The plant needs micro elements in very small quantities that do not burn the leaves or cause poisoning to plants, including iron, zinc and boron, as they are essential elements for growth and completing the plant's life cycle, and increase the plant's resistance to diseases and insects, activate enzymes, and form the chlorophyll molecule, in addition to their role in oxidation and reduction processes and vital processes. The use of fertilizers with their modern technology has made the process of activating seeds or foliar nutrition a matter of interest to researchers as a complementary process t
... Show MoreHow I was eager to research the ruling on three of the most dangerous types to Islam and Muslims (the heretic, the sorcerer, the innovator, and related terms).
Because it is the most dangerous deadly disease that destroys the hearts of Muslims, and may even expel a Muslim from the circle of Islam, and how many Muslims have done or committed such a thing without knowing it. Indeed, how many Muslims have left Islam and whose wife has abandoned him without realizing it, and among them are those who have committed it without knowing it. As well as related words associated with heresy.( )
Because people debated such matters between extremists and lenient ones, most of whom were extremists, and they did not reach a conclusion. So I decid
The definition of the role of any institution in society is achieved through its objectives, The same is true for the military and how to deal with security threats in the humanitarian field ,Terrorism, which has almost replaced the traditional pattern of war, has waged a street war and intimidated individuals, families and society ,On the other hand, he found someone to meet him from a popular crowd of volunteers to defend their homeland from different sects, sects and religions, Thus, our study will be exposed to the role of popular mobilization in human security from a sociological point of view in Samarra, a field study of 100 male and female respondents.
Deception is defined as a linguistic and non-linguistic behavior that is used in interaction in order to make the addressees believe what is believed to be false or lack evidence. McCornack (1992) classifies deception into four manipulative strategies (i.e., fabrication, distortion, equivocation and concealment), other scholars argue that deception encompasses the strategies of “fabrication (outright lying), equivocation (being vague and ambiguous), or concealment (with holding relevant information) Thus, the present study investigates the deception strategies and motives that are used by Johnny Depp and Amber Heard during their defamation trials. Qualitative and quantitative methods are employed when analyzing the data in question. Th
... Show MoreAim: The purpose of this study was to analyze the patterns of facial fractures in children and to compare them between preschool- and school-aged children. Materials and methods: This retrospective observational study included 57 children with facial fractures. The variables analyzed were the age of the patients—divided into a preschool-aged group (0–5 years) and a school-aged group (6–12 years)—gender, cause of trauma, the facial bones involved, the pattern of fracture, the modality of treatment used, the time between injury and treatment, and the postoperative complications. Results: The incidence of facial fractures in children ≤12 years was 30.2%. The patients consisted of 40 (70.2%) males and 17 (29.8%) females, and most pati
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