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 region is defined by the spatial dimension, which consists of a set of stabilizers (towns and villages). The concept of the territory requires conditions on the nature of functional relations and the mutual influence of the regions within the region. Any territory must be based on the interdependence and interaction between the mother city and its surrounding countryside and cities, and when the interdependence is strong and the interaction is clear, it helps to define the territory. The regions are divided on different bases. There are geographically or national homogeneous regions, and there are cultural regions that want to preserve their culture in terms of language or religion. There are administrative regions to manage
... 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 MoreThis study falls within the core of the deliberative theory, as this research seeks to highlight the concept of dialogical imputation that is present in all the discourses received by the recipient, and that this is not limited to dialogues, and that is why it is called (deliberative imperative). This is in agreement with the deliberative and functional approach that sees literary discourse as a dialogical and fulfilling necessity, due to its attachment to artistic connotations and submerged meanings in the saying. The allotted obligation and its impact on determining the purposes: The specific implication represented an important axis of pragmatic research, and a major concern in the work of discourse analysis. Because of its great importa
... Show MoreBackground: Determination of sex and estimation of stature from the skeleton is vital to medicolegal investigations. Skull is composed of hard tissue and is the best preserved part of skeleton after death, hence, in many cases it is the only available part for forensic examination. Lateral cephalogram is ideal for the skull examination as it gives details of various anatomical points in a single radiograph. This study was undertaken to evaluate the accuracy of digital cephalometric system as quick, easy and reproducible supplement tool in sex determination in Iraqi samples in different age range using certain linear and angular craniofacial measurements in predicting sex. Materials and Method The sample consisted of 113of true lateral cepha
... Show MoreThe Theoretical bases of women's rights in Islamic shariate
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 MoreVoice 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 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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