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 curriculum is considered one of the most important corners for the educational process, it participates in achieving the educational equilibrium between its elements.
The curriculum of (History of the Art) in the college of Art Education / dept. of plastic art education and ceramic as the other curriculums and due to the subject of history of the art develop the knowledge, taste and experiment for art studier also this subject has a direct relation with practical educational activities like colors and growth the knowledge of the student in field of contents and symbols and evidences of meaning in old , medium and contemporary arts, due to the fact that this curriculum has been applied since long time more than four years, and
... Show MoreOld New York was Wharton's term to describe this wealthy and elite class at the top of
the developing city's social hierarchy, a society which was utterly intent on maintaining its
own rigid stability. Even though, the roles of women in American society changed drastically
from 1820’s to 1860’s due to the civil war and such a progression was due in part to the
revolutionary thoughts. Women started taking their right to speak up openly and frankly and
become more like men. The role of many women had changed from being homemaker to
being able to provide for the family by either getting a job or start to be allowed to have a
voice. They had important roles not only in helping the family, but in sharing to rebuild th
This paper studies the effect of contact areas on the transient response of mechanical structures. Precisely, it investigates replacing the ordinary beam of a structure by two beams of half the thickness, which are joined by bolts. The response of these beams is controlled by adjusting the tightening of the connecting bolts and hence changing the magnitude of the induced frictional force between the two beams which affect the beams damping capacity. A cantilever of two beams joined together by bolts has been investigated numerically and experimentally. The numerical analysis was performed using ANSYS-Workbench version 17.2. A good agreement between the numerical and experimental results has been obtained. In general, results s
... Show MoreThe study aimed to get acquainted with kindergarten teachers in the development of
emotional intelligence in children, To achieve this a study too, which consisted of 40 items,
within four areas was condncted: (managing emotions, emotional knowledge, empathy, social
networking) The study tool was applied to the sample amounting (200) teachers of the
kindergarten teachers in the province of Jerash and after analyzing the results statistically
using arithmetic averages standard deviations and variance analysis quartet the following
results were reached :
- presence of statistically significant differences at the level of (α =0,05) is attributable to the
impact of the educational level in the areas of empathy and so
Most studies combine that it is important to determine the extent of the public's trust TV for two reasons. First of knowing the impact of satellite TV audience ranges and the second determining public outlets for Information Find regard to the extent of the public's confidence in knowing the contents of the satellite during the occupation of Mosul crisis by organizing the Islamic state in Iraq and the Levant And the researcher developed a questionnaire to find out the public's confidence statement satellite contents provided by the questions related to exposandscale.
The researcher audience chose the city of Baghdad to the suitabil
... Show MoreThe category of those who agree with the phrase: The Environment and Life Program warns me of the environmental damages resulting from the issue of using black oil in electrical generators in residential neighborhoods came first, with a high rate of 81.4%. With the environment, the public always turns to the public broadcasting service and its programs to provide knowledge so that it can avoid it. Thus, the respondents' attitude towards this issue was positive.
The following dilutions -710X46, -610X46, -510X46 of Bacillus thuringiensis were used for bioassay against the different larval instar of the potato tuber moth Phthorimaea operculella by the spraying method, the results showed that there was no significant influence in the percentage of egg hatching in comparison with the control. The sensitivity of larval stages was reduced with the increasing the age and exposure period. The study also showed that the larvae infected with B.t. stopped feeding, movement and a general paralysis causing the death of larva after (24-48) hours , and the larva color was changed from the natural waxy colour to brown finally to the black after death.