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 proliferation of electronic games, video games and computers has caused children and teenagers to become attracted to these games and become their favorite entertainment. The widespread of these games has generated widespread debate about positive aspects and negative aspects. It is evident that there are two main trends in the impact of electronic games on the behavior of children and adolescents. The first trend is that e-games have positive effects on children and adolescents, especially in cognitive abilities and skills in learning. While the second view sees that electronic games have negative effects that appear in social isolation and lack of movement and aggression. Through the review of previous literature, the current resea
... Show MoreA summary of zooplankton research done in Peruvian marine waters is presented. We first provide a brief overview of the evolution of zooplankton studies off Peru before reviewing zooplankton biodiversity, regional distribution, seasonal and interannual fluctuation, trophodynamics, secondary production, and modeling are some of these topics. We evaluate research on various meroplankton, macroplankton, mesoplankton, and microplankton groups and provide a list of species from both published and unpublished sources. Three regional zooplankton groups have been identified: A shelf group on the continental shelf dominated by Acartia tonsa and Centropages brachiatus; A slope group on the continental shelf with siphonophores, bivalves, foramin
... Show MoreBackground: The Titanium and its alloys are suitable for dental implant and medical applications. Biocompatibility of the materials is a major factor in determining the success of the implant and has a great impact on their rate of osseointegration. The aim of this study was to evaluate the biocompatibility and cytotoxicity of Ti2AlC in comparison to CPTi & Ti6Al7Nb in rabbits. Materials and Methods: 10 male New Zealand White rabbits, weighing (2-2.5 kg), aged (10-12 months) were used in this study. Cylindrical implants were prepared from the study materials (CPTi, Ti6Al7Nb and Ti2AlC) with (8mm) height and (3mm) diameter for the evaluation of tissue response and disc specimens were prepared with (6 mm) diameter and (2 mm) thickness for ev
... Show MoreIn the South of yement, when the accupation of Aden in 1839 by the British, British politics has proceeded in accordance with interests in promoting the existence and exploitation of this important site to implement their interests. Historians believe that Britain played a major role in the conflicts that have taken place on the land of Yemen, through a series of military and political dealings between them and the Ottoman Empire prior to withdrawal of Yemen and between local authorities and power to Yemen, such interactions have led to very serious consequences for the future of Yemen and Yemen was often divided into three parts, the northern areas under the authority of Imam Yahya, and the South, under the control of Britain, Asir and
... Show MoreBackground: Periodontal diseases are initiated by microbial plaque, which accumulates in the sulcular region and induces an inflammatory response. The Receptor activator of nuclear factor-kappa B ligand / osteoprotegerin (RANKL/OPG) axis is involved in the regulation of bone metabolism in periodontitis, in which an increase in receptor activator of nuclear factor-kappa B ligand or a decrease in osteoprotegerin can tip the balance in favor of osteoclastogenesis and the resorption of alveolar bone that is the hallmark of periodontitis. This study was performed to investigate the role of salivary levels of RANKL and OPG in pathogenesis of chronic periodontitis. Subjects and Methods: Fifty five subjects with chronic periodontitis with ages rang
... Show MoreOne of the management accounting tools is responsible accounting. In this system, the organisation is divided into responsibility centres that help to connect an individual performance responsible to perform through a combined system of reports according to the implementation of the mechanism of exception tools which gives assistance in planning. The exploitation of the organisation's available resources is achieved through the application of responsible accounting. Also, the best exploitation will lead to the provision of low-cost products through the disposal of all types of waste or loss during the cost centres. By providing products at a lower cost and satisfying the wishes of the needs of customers, the result reflects the competitive
... Show MoreIn light of what constitutes the cultural factor from a great importance in the context of the incorporation of an active and participant civil society in the process of democracy- building and the achievement of political development, this article tries to look at the concept of the political culture and the civil society with the stand on the nature of existing relationship between them in its theoretical part, then the move to dissection of the civil society crisis in Algeria under the prevalent cultural values for understanding the relationship between the two variables in its empirical part, as a step towards the detection on the pivoting of democratic values in activating the political participation and attainment the democratic co
... Show MoreBackground: Pyogenic discitis most frequently occurs
after home delivery, hemorridectomy, and dilatation and
curettage. Discitis is generally due to blood borne bacterial
invasion of the disc from adjacent end-plate via
communicating vessels. Infective discitis remains an
uncommon, but potentially serious cause for back pain.
Delayed diagnosis can occur and a high index of suspicion
may occur.
Methods: The study included 30 patients suffering from
localized low back pain with limitation of movement.
Diagnosis was made by history, physical examination and
investigation mainly E.S.R and MRI.
Results: 50.3% of patient with discitis had a history of
vaginal delivery, 15% had a history of hemorridectomy
The theory of probabilistic programming may be conceived in several different ways. As a method of programming it analyses the implications of probabilistic variations in the parameter space of linear or nonlinear programming model. The generating mechanism of such probabilistic variations in the economic models may be due to incomplete information about changes in demand, production and technology, specification errors about the econometric relations presumed for different economic agents, uncertainty of various sorts and the consequences of imperfect aggregation or disaggregating of economic variables. In this Research we discuss the probabilistic programming problem when the coefficient bi is random variable
... Show MoreJamal Basha: His Administrative and Political Effort in Baghdad