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 internal administrative spaces of the interior designer formed an obsession for their development and for finding solutions and treatments to advance to enhance the state of adaptation for their employees by providing a healthy, appropriate and sound environment for work and production. . The first chapter focuses on laying theoretical foundations to show what health materials are used in the administrative spaces of the training directorates of the Ministry of Education in Baghdad. The second chapter dealt with the knowledge of health materials, their impact and effectiveness in the interior space, and the variables of their functional characteristics and their work in the interior spaces in a way that enhances the development of
... Show MoreThis study has sought to explore the Yemeni online news websites’ treatment of the tropical storm “Luban” which hit the coasts of al-Mahra governorate, and other parts of the Yemeni Eastern and Southern governorates in October 2018. The study also examined how the Yemeni news websites covered the disaster on the basis of the problematic situation model. The study’s findings revealed a form of logical balance in distributing the coverage of the disaster in its different phases. The coverage was a bit more focused on the disaster phase than the pre- and post-disaster phases. Additionally, the websites paid more attention to precautionary measures and the disaster’s humanitarian and material losses. The findings reveal that the ne
... Show MoreThis article discusses some of the metaphorical use of language units. Here we will define the basic concepts and underline the causes of this phenomenon. Through research it is proven that through the application of names of some body parts achieves the variety of metaphorical meanings.
The specialist researcher fined the relations between economic ideas with economic facts in his theory which called humanity building it is appeared clearly ( in Ibn Khalduons’ Muqaddimah) in a clothe of economic social phenomenon's as a systematical analysis in all fifty chapters of al Muqaddimah ,therefore this paper deal with Ibn Khalduon economic thoughts as important says which describe the society building in its economic subjective and examine the relationship between The dissert and the city within economic says which are cover the social analysis ,and determinate the analysis objects which clearly in this dualism model ,between the state and economic bas
... Show MoreThe inner wasteland can be observed in Samuel Beckett’s early and later plays. His characters suffer from loss of identity, emotions, and sense of time. They lead a life of failure, repetition, inaction, loneliness, doubt, suffering, and nothingness. The inner wasteland includes many aspects, such as the multi and split identity, the habitual repetitive element of life, the dark sorrowful life the characters lead, lack of communication and relations among them, their unfree, inactive condition, their foggy terrible recollections, loneliness, dryness of love, and uncertainty. The analysis and the illustration of each aspect will show how the inner wasteland is intensified in the selected later plays of Beckett.
Background: This study is to evaluate the necessity of prescribing prophylactic antibiotics for nasal packing in spontaneous epistaxis. There are few published papers of infective complications in such patients.
Methods: This prospective study analysed 149 consecutive patients admitted to AL-Kindy teaching hospital with spontaneous, epistaxis, who underwent nasal packing over 2 years period . in the first year, 78 patients received prophylactic antibiotics , In the second year 71 patients were not given prophylatic antibiotics. Exclusion criteria included antibiotics prescribed for unrelated pathology and post-operative epistaxis. Signs and symptoms of acute otitis m
... Show MoreThe study aimed to identification the effect of brainstorming in linguistically grow of garten child the sample of study is composed from (48)male and female children have been distributed for two groups,one of them is experimental and another is disciplined for every per of garten and pre education,and they have been awarded in a number of variations. For measuring the subordinate variation(linguistically grow)the researcher prepared ascale for this purpose that consist of two parts:the first part the scale of linguistically grow of garten child(4-5 years)and the second part the scale of linguistically grow of pre education child (5-6 years).Consist of every one from (20)shapes of linguistically grow shapes for garten chil
... Show MoreThis research aimed at studying the role of calculated knowledge an its efficiency in improving the performance especially most of the organizations are living within knowledge era which concentrate on new technology investment in different fields of modern live . Under the scientific trends towards the economy of calculated knowledge which depend basically on new computer program in order to utilize the knowledge to raise the level of work performance exploiting different resources in the best way that helps the organizations to achieve their objectives because the information technology and computer programs became a means of survival and indispensible instrument within the developed world which depend on prosperity . progress
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