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.
Singapore 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
... Show MoreThe current research dealt with the study of space compatibility and its role in enhancing the functional aspect of the design of the interior spaces of isolation hospitals by finding a system or format that is compatible with the nature of the changes occurring in the structure and function of the space system, as well as contributing to enhancing compatibility between the functional aspect and the interior space. Therefore, the designer must The interior is the study of the functional and spatial aspects as they are the basic aspects for achieving suitability, and through the interaction between the person and the place, the utilitarian performance characteristics are generated that the interior designer is interested in and tries to d
... Show MoreItraconazole (ITZ) is an antifungal drug (BCSII) used for the treatment of local and systemic fungal infections. Furthermore, ITZ used as an antifungal prophylaxis for immunocompromised patients.
The objective of the study is to overcome the two problems of low and pH dependent solubility of ITZ by its preparation as floating microparticles.
Firstly, pH-dependent floating microparticles were prepared using oil in water solvent evaporation method, from which the best one (F7) selected as a best pH-dependent formula with composition of ITZ (200mg),EC (800mg), HPMC 15cps (200mg) and safflower oil (2ml) .Then, F7 was compared with the selected Relatively pH-independent ITZ floating microparticles formula wit
... Show MoreEcolinguistics is a twofold field in which ecology and language are its two major concerns. That is, this field is concerned with the way through which our thoughts, ideologies and the like influence the environment. The present study aims at analyzing (6) constructive and destructive environmental advertisements to find out how the techniques of erasure and salience operate in these types of advertisements. It studies the linguistic expressions that achieve these techniques in the constructive and destructive advertisements. The qualitative and quantitative methods are exploited in the current study. Analyzing (6) constructive and destructive environmental advertisements in accordance with Stibbe’s (2015) model of salience and erasure
... Show MoreThe present study aimed to asspssment the nutrition a program to sample of student from internal departments of Baghdad University (AL-Jadiriya Complex) and the University of AL-MustanSiriya four grades and aged (19-24) year study included 150 male and female students by (75) male and (75) of female register height, weight nd body mass index were study habits and food pattern of the same sample (150) and by aspecial form and take the personal information interviews and record information on food intake during 24 hour .noted adifference practie in the weights and longths of male and female (sample).
BMI rates were within the normal weight as the value of BMI for males aged (19- 21)and (22-24) and (22.21) and (23,37),respectively and th