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.
A 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 MoreThe primary aim of this paper, is to introduce the rough probability from topological view. We used the Gm-topological spaces which result from the digraph on the stochastic approximation spaces to upper and lower distribution functions, the upper and lower mathematical expectations, the upper and lower variances, the upper and lower standard deviation and the upper and lower r th moment. Different levels for those concepts are introduced, also we introduced some results based upon those concepts.
Pregnancy at an early age of life is a major challenge. The consequences of this problem have an impact on the quality of life of the young mother and her family, and determines an important risk for her offspring. The son of a teenage mother has, in general, greater risks than that of a mother of more than 20 years. The aim of this study is to determine the prevalence and outcome of teenage pregnancy. A descriptive data base study was conducted at Al-Elwia Maternity Teaching hospital in the period from January 1, 2019 to the end of June 2019 within the age between 12 and 19 years old. The mean age of the mother was 17.4 ±1.5 years. The mean age of the father was 23.9 ± 5.7 years with (69.5%) with Vaginal delivery and most of the
... Show MoreThe current research aims to know the method and strategy of rainstorming for students to open the door towards innovation and creativity in the field of teaching the subject of geography and the importance of brainstorming method and the studies that touched on it. The study also dealt with the steps of teaching the method of brainstorming and the most important (traditional and modern), and the difficulties of using the method of brainstorming in the teaching process, as well as explained the guidance to improve teaching using the method of brainstorming in the teaching p
... Show MoreThis piece of research deals with assimilation as one of the phonological processes in the language. It is a trial to give more attention to this important process in English language with deep explanation to its counterpart in Arabic. in addition, this study sheds light on the points of similarities and differences concerning this process in the two languages. Assimilation in English means two sounds are involved, and one becomes more like the other.
The assimilating phoneme picks up one or more of the features of another nearby phoneme. The English phoneme /n/ has t
... Show MoreGraphic design art depends on changeable cognitive systems which their relation and items relying on the accumulation of humane knowledge and thong and the humane look to the venality and his explanation to the relation between him and the venality , then the graphic design art becomes an important item of this accumulation knowledge besides , it is on kind of knowledge kinds . The technological advancement in communication lauds to increasing in communication media and design methods , where the computer and its application in graphic design promotes the design process because of it's capalebities which lead to in creasing in production process , minimizing the cost and time and achieving creative and aesthetic aspect because of it's fe
... Show MoreSingapore has invested its human resources for the development of the country since earlier times, so it has directed attention to the education sector. Education and development complement each other, as investment in education has contributed over several years to the development of Singapore economy and has made it one of the strongest economies in Asia and the world. Despite the obstacles that faced educational policies in Singapore, the presence of a wise leadership capable of overcoming difficulties and solving them, and providing the appropriate atmosphere for the development of education has contributed significantly to making it one of the most advanced educational systems in the world, and making this system the main pillar for
... Show MoreThe current research dealt with the symbolic significance and its effectiveness in the design of the industrial product, the aesthetic communicative discourse that embodies the imagination and human conscience. Whether according to what has been termed custom or what has been approved by traditions long ago, symbolism may be the main actor in linking the identifying components of the product. In addition, symbolism provides the user with the key to accessing a direct awareness of the product’s shape and function, as an identification of the product by stimulating the symbolic form of the consumer’s imagination and inviting him to To meditate in order to realize the implicit meaning behind these forms and thus achieve the symbolism of
... Show MoreThat the diplomatic work and its importance in foreign policy planning assumes the following points: 1. Choosing the tool in the sense of choosing the most correct tool that reflects the reality of the situation on the one hand and the disposal of strong energy to reach the implementation of the political decision. The declaration of war and entering into a resolution that uses force merely to face insulting ambassadors does not mean Power of the State concerned. But an imbalance in its foreign policy. 2. The coordination of the tools, that the foreign policy scheme must be such a role, and on the external style, diplomatic work, military action and propaganda must complement each other, to the extent that each of them is the first attac
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