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.
Public relations have become vital functions in modern institutions in the complex business world. They play an important role in facilitating the process of communication between the institution and its audiences and achieve mutual understanding between the parties as public relations play this important role based on research and analysis, policy formulation and programming programs and communication with the public.
The significance of this research comes from the challenges faced by public relations in state institutions. Misunderstandings and ambiguities still plague most workers in this field, especially in defining the concept, objectives and basic functions of public rela
... Show MoreTime and space are indispensable basics in cinematic art. They contain the characters, their actions and the nature of events, as well as their expressive abilities to express many ideas and information. However, the process of collecting space and time in one term is space-time, and it is one of Einstein’s theoretical propositions, who sees that Time is an added dimension within the place, so the study here differs from the previous one, and this is what the researcher determined in the topic of his research, which was titled (The Dramatic Function of Space-Time Variables in the Narrative Film), Which included the following: The research problem, which crystallized in the following question: What is the dramatic function of the tempor
... Show MoreThe cinematic medium consists of a group of elements that overlap with each other in balance, giving it its high influential capabilities, and the character is one of the most important of these elements, as it performs a set of important functions, foremost of which is the transmission of the main ideas to the recipient, and since cinema is an art closely related to the intellectual data of the worlds outside it, it is influenced by them and then reproduces them intellectually more deeply and with a higher vitality through its intermediate elements, including the character, to re-broadcast them to society with a retrograde movement, and the character of the prisoner is one of the cinematic characters that achieved this goal, as we can infe
... Show MoreThe aim of the present study was to investigate the histological structure of the tongue in Mongoose (Herpestes javanicus) and its related to the feeding pattern. Five adult animals were used in this study . The tongues were dissected and fixed in 10% formalin, then prepared by following stages (dehydration, clearing, and embedding).The serial section(5µ) were stained with(H&E) and some special stains.The histological examination showed that the tongue consists of three tunicae (mucosa, submucosa and musclaris) and the lining epithelium of the filiform papillae is composed of keratinized stratified squamous epithelial tissue. The cylindrical papillae are covered with a highly keratinized stratified squamous epithelial tissue, whereas the k
... Show MoreEmily Bronte is born in Yorkshire on 30 July 1818. Her father, Rev. Patrick Bronte, is a man of intelligence and determination which enables him to gain an admission as a sizar to 81. John's Cambridge in 1802. He has six children where Emily is the fifth. The mother is a young beautiful girl who belong to an important family. Both Emily's parents try to teach
Their children well, support them all the time and elevate them to
"-.../
high levels. This causes an eagerness towards reading and writing, but the happiness of the children is affected by the sickness and later on by the death of their mother in 1821. After that things would
... Show MoreUltrasound is a mechanical energy which can generate altering zones of compression and rarefaction along its path in the tissues. Ultrasound imaging can provide a real time screening for blood and multiple organs to aiding the diagnostic and treatment. However, ultrasound has the potential to deposit energy in the blood and tissues causing bio effects which is depending on ultrasound characteristics that including frequency and the amount of intensity. These bio effects include either a stable cavitation presented non thermal effects or inertial cavitation of harmful effect on the tissues. The non-thermal cavitation can add features in diagnostic imaging and treatment more than the inertial cavitation. Ultrasound Contrast agents are a micro
... Show MoreTennessee Williams' The Glass Menagerie is peopled with powerless and defenseless characters. These characters are hypersensitive and in a constant search for protection. They are highly pressurized by life and its bitter reality. Adding to that they are haunted by their fear from the future. They are escapist who try their best to hide behind a protective shield. Their tireless search for security is never smothering. Their only possible defensive mechanism is to flee from their immediate hostile and aggressive surrounding. To achieve this aim, each character has improvised a method that suits him / her best. For example, one of the characters (Tom) sought refuge in alcohol and late night shows. While the other (Amanda) chose to re-live th
... Show MoreDomestic violence, or as sometimes known as family abuse, is usually related to a domestic or local setting as in cohabitation or in marriage. It can take the forms of being physical, verbal, economic or emotional. Globally, most of the domestic violence is overwhelmingly directed to females as they tend to experience and receive severe forms of violence, most likely because they do not involve their intimate, or sometimes even non-intimate partners, in the process of mental and physical self-defense.
Sometimes countries justify domestic violence directed to females, they may be leg
... Show MoreThis study was carried out to investigate the preparation of thermosetting polymeric blend consisting of three adhesive types, namely: epoxy, polyvinyl formal (PVF) and unsaturated polyester. Both of epoxy and PVF were used as a matrix-binder at fixed weight. Whilst unsaturated polyester was used at different weights and added to the matrix so as to produce prepared epoxy-PVF-unsaturated polyester blend. Several experiments were performed at different operating conditions, mixing speed and time at room temperature to identify the most favorable operating conditions. The optimum mixing speed and mixing time for the prepared blend were 500rpm and 5 minutes respectively.
Solid wastes-synthetic sack fib
... Show MoreResults: it was found that labelled cells participated in the formation of myotubes, which formed mature muscle fibers, and possibly new satellite cells. The results of this experiment may eventually revolutionized therapeutic procedures for some form of muscle diseases