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 bank sect for any country is very important because its represent a major nerve to feed a verity economic and finance activities .development any state measure by development banking sets and its represent important factor to investors attract . and because important of this subject ,teen accounting rule is a specialized for it .its related by Disclosures in the Financial Statements Of Banks and The Similar Institutions, its accredit by auditing and accounting standard consul in republic of Iraq.in date 10/28/1998. &
... Show Morein this paper copper oxide (cuO thin films were prepared by the method of vacum thermal evaporation a pressure.
Background: The repair of bone defects remains a major clinical orthopaedic challenge. Bone is a highly vascularised tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. Angiogenesis thus plays a pivotal role in skeletal development and bone fracture repair. The role of angiogenic and osteogenic factors in the adaptive response and interaction of osteoblasts and endothelial cells during the multi step process of bone development and repair will be highlighted in this study. This study aimed to identify the role of local exogenous vascular endothelial growth factor in bone healing and to analyze the expression of VEGF by immunohistochemistry in created bone defect af
... Show MoreInvestments in shares represent an essential component of companies’ assets and a source of profit making resources. These investments are linked to the areas of trading and speculation, which is reflected on their market value, which makes accounting for and evaluating these investments require their own accounting standards, and thus several international standards were issued regarding this as well as a statement of their impact on growth Sustainable, as the research problem is to show the impact of measuring investments in shares according to international accounting and financial reporting standards on the sustainable growth of economic units, the research sample and its reflection on audit procedures. In accordance with i
... Show MoreResumen
El Ultraísmo es un movimiento literario que comenzó en España a finales de 1918 y continuó hasta el año 1922. Este movimiento, que representó la contribución de España al Vanguardismo literario, que en la primera parte del siglo XX surgió en toda Europa, se desarrolló no tanto a través de los libros, cuanta a través de las revistas literarias de la época.
La creacionista es, sin duda, la escuela que dio a Ultra mayores aportes. Por esta razón, en las literaturas de Vanguardia se funden, y a veces también se confunden, con frecuencia, Ultraísmo y Creacionismo. Los dos movimientos eran como una revo
... Show MoreThis study aims to identify the anxiety pregnant women have of dying, in the light of some Demographic variables in Bethlehem (age, residence, and the mother's job). The descriptive method was used in this study. To achieve the study purposes, the researchers developed a questionnaire as a tool of study, which consisted of (19) paragraphs ,after been verified of its validity & stability.
The researchers distributed questionnaires, and then analyzed them. Results illustrated that the levels of anxiety pregnant women in Bethlehem had of dying was average, with a mean total score of (3.11), and with a standard deviation that had the total score of (0.476). Results also illustrated statistical differences in the pregn
... Show MoreThe paper deals with the language of Russian folklore. Folklore is a unique sphere of existence of the language, the most vivid expression of the national mentality. The folklore word embodied the perception and evaluation of the surrounding world. “What did the word in general mean for the life of the people? The word was equated ... with life itself. The word generated and explained life, it was ... the keeper of memory and the guarantee of the infinity of the future. The folklore text is studied by literary critics, ethnographers, historians, culturologists, and art historians. In the twentieth century, a new science emerged - linguo-folkloristics, the goals and objectives of which were formulated by A.T. Khrolenko only in the seven
... Show MoreThe research utilizes data produced by the Local Urban Management Directorate in Najaf and the imagery data from the Landsat 9 satellite, after being processed by the GIS tool. The research follows a descriptive and analytical approach; we integrated the Markov chain analysis and the cellular automation approach to predict transformations in city structure as a result of changes in land utilization. The research also aims to identify approaches to detect post-classification transformations in order to determine changes in land utilization. To predict the future land utilization in the city of Kufa, and to evaluate data accuracy, we used the Kappa Indicator to determine the potential applicability of the probability matrix that resulted from
... Show MorePlatelet‐rich fibrin (PRF) has been widely used in regenerative dentistry due to many growth factors produced. Periostin, a matricellular protein, is a reliable marker for tissue regeneration. Periostin is part of the cellular matrix and regulates bone homeostasis. This study aims to explore the efficacy of PRF in improvement of the clinical periodontal parameters as an adjunct to the scaling and root planing and to evaluate periostin level in gingival crevicular fluid (GCF) at baseline, 1‐ and 3‐month recall visits. Fourteen periodontitis patients who met the inclusion criteria were recruited in this study. Two contralateral periodontal pockets with 4–6 mm in depth in each patient were sel