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.
E-wallet, also referred to as digital wallet, is a software application designed to replace physical wallets, with the primary purpose of facilitating online transactions when users wish to make virtual payments. Nowadays, E-wallets are not limited to mobile applications, but they have also been extended to wearable devices, such as smartwatches, enabling users to make payments via their watches. This research study focuses on three main E-wallet service providers in Malaysia, namely TouchNGo E-wallet, Boost, and Grab pay, as they are the top three E-wallets in the country. The aim of this paper is to explore the real-world implementation of E-wallets among mobile phone users in Malaysia, employing the Technology Adoption Model as the th
... Show MoreThe inflammatory response is a crucial aspect of the tissues’ responses to deleterious inflammogens. This complex response involves leukocytes cells such as macrophages, neutrophils, and lymphocytes, also known as inflammatory cells. In response to the inflammatory process, these cells release specialized substances which include vasoactive amines and peptides, eicosanoids, proinflammatory cytokines, and acute-phase proteins, which mediate the inflammatory process by preventing further tissue damage and ultimately resulting in healing and restoration of tissue function. This review discusses the role of the inflammatory cells as well as their by-products in the mediation of inflammatory process. A brief insight into the role of natural an
... Show MoreBackground: Small cardamom or green cardamom is the dried fruit of the tall perennial herbaceous plant, Elettaria cardamomum Maton belonging to the family Zingiberaceae. The major use of small cardamom on world wide is for domestic culinary purpose and in medicine. This study was conducted to test the effect of small cardamom extracts on Mutans streptococci and Candida Albicans in comparison to 0.2% chlorhexidine gluconate and de-ionized water in vivo. Materials and Methods: Mutans streptococci and Candid Albicans were isolated, purified and diagnosed according to morphological characteristic and biochemical test. In this experiments, the effect of control agents and small cardamom extracts as a mouth rinses was tested on the saliva
... Show MoreThe postmodern ideas and concepts have produced social, political and economic variables that have been affected by wars, crises, the role of globalization and the information revolution. They have created many variables in concepts and great variables in technological, artistic and cultural innovations. All these changes have contributed to changing the form of the theatrical show aesthetically and intellectually, which cast a shadow over the nature of the actor's performance who has become more demanding to change his performance and to find the mechanisms and new nature of work governing him corresponding to those variables and this prompted the researcher to adopt the subject (the performance variable of the actor's techniques in pos
... Show MoreMedia, especially press plays an important role in fighting corruption and tackling this phenomenon, which has become widespread in our society, through its effective role in raising awareness of the seriousness of spreading of corruption of all its forms in society.
All international conventions and agreements stress the necessity of the role of media and its importance in the light of corruption. All countries also commit themselves to the necessity of guaranteeing the freedom of media and the circulation of information and preparing it as a prerequisite for activating the People’s Control Mechanism and supporting measures and means to prevent and combat financial and administrative corruption more actively and effectively.
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In this study, active knife and fixed knife of single-row disc silage machine has three different clearance C1, C2 and C3 (1, 3 and 5 mm) and it is tried in three different working speed V1, V2 and V3 (1.8, 2.5 and 3.7 km / h) and PTO speed (540 min-1) and machine's fuel consumption (l/h), average power consumption (kW), field energy consumption (kW/da), product energy consumption (kW/t), field working capacity (da/h), product working capacity (t/h) and Chopping size distribution characteristics of the fragmented material were determined. It has been found that knife-counter knife clearances smaller than 3 mm (1 mm) and larger (5 mm) have a negative effect on machine performance in general. In terms of fuel and power consumptions, the m
... Show MoreIn this paper we have dealt with the word " בַּיִת" in the Book of Joshua because it makes one of those that highly employed the word בַּיִת" " in the Old Testament. The Book of Joshua comes sixth in the order of tanakh wich was written by Joshua son of Noon in Palestine during the fifteenth century B.C. and it covers a three-decade era extending from the death of Moses til the death of Joshua son of Noon.
The word " בַּיִת " in this paper refers to the place, where expressions are made by a noun modified by a noun . The modifier is"" בַּיִת , and the modified is another noun. Herein, we
... Show MoreBackground: Penetrating neck injuries are common problem in our country due to increasing violence, terrorist bombing and military operations.
These injuries are potentially life threating and need great attention and proper management.
Objective: The aim of this study is to focus on the importance of anatomical zonal classification of the neck in the management of penetrating injuries of the visceral compartment of the Neck.
Methods :70 patients with various injuries who were managed at causality unit and Otolaryngology department in Al-Kindy Teaching Hospital during aperiod from January 1st 2015 to October 31st 2015.
The study carried on those patient depending on proper clinical examination and their urgent management.