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 present theoretical study analyzes the legacy of the Chicago School of Urban Sociology and evaluates it in the light of the growth and development of Chicago City and the establishment of sociology in it. Sociology has become an academic discipline recognized in the United States of America in the late nineteenth century, particularly, after the establishment of the first department of sociology in the University of Chicago in 1892. That was during the period of the rapid industrialization and sustainable growth of the Chicago City. The Chicago School relied on Chicago City in particular, as one of the American cities that grew and expanded rapidly in the first two decades of the twentieth century. At the end of the nineteenth centur
... Show Moreيهدف هذا العمل الى بيان طبيعة العلاقة بين الادارة بالتجوال والتجديد الاستراتيجي ، ومدى تأثير المتغير المستقل في المتغير التابع. تضمنت فقرات الاستبانة بوصفه الأداة الرئيسة لجمع البيانات ثلاث جوانب اساسية، تضمن الاول البيانات الشخصية للمستجيبين، فيما تضمن الجانب الثاني الفقرات الخاصة بمتغير الادارة بالتجوال من خلال خمسة ابعاد، فيما اشتمل الجانب الثالث على فقرات التجديد الاستراتيجي عبر تناول اربعة ابعاد. ي
... Show MoreThis work aims to show the nature of the relationship between management by walking around (the independent variable) and strategic renewal (the dependent variable), as well as it shows the effect of the independent variable on the dependent variable. Questionnaire items were considered the main tool for data collection by three basic aspects. The first involved the personal data of the respondents, while the second included items related to management by walking in five dimensions, and the third is strategic renewal items by addressing four dimensions. The tourism sector, while the community has six Excellent grade hotels was taken into account in this wor
... Show MoreThe development taking place on the sports field at the general level and in the game of football at the private level, being the most popular game in the world, has reached very advanced stages. The use of modern aids and technology has contributed greatly to this development from the collective and individual aspects, as the goalkeeper is the most important position in the team, the use of devices gave objective readings about the goalkeeper’s ability in terms of skill and physical aspects, as the importance of the research lies in designing an electronic device to measure the degree of bending of the knee angle because of its great importance in developing the skill of catching and dimensions of the high ball for football goalkeepers.
... 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 MoreThe problem of the research came through the following question (what is the effectiveness of active design in contemporary industrial products), and it emphasized the importance of research to make society with its members in a positive state of activity, and what can help the industrial product design to achieve this, but the goal of the study is (determining the characteristics and principles of design Active and its effectiveness in the industrial product), and the study was determined by industrial products related to daily, recreational and sports activity, The researcher relied on a form to determine the axes of analysis for the sample models, in order to reach the results of the research, the most important of which are: Realiz
... Show MoreWere not experience Khalil Hawi capillary module as presented or routine in the format
of the implications , but was saturated transitions quality that targeted built by visionary and
mechanisms expressive , Valgosaidp when the container is a clash between two worlds world
Nahdi to promote world on the ashes , and often strained poet himself to achieve an approach
between worlds , and in the midst of those caesarean section exhausted poet in touch his tools
and visions , and this is why the poetry Hawi toward westernization expressive as a result of
the conflict concepts chronic , be sure to researcher not engaged in the overall qualitative
changes in the structure and content, but the goal Acetknah level that qualit
Profiles of indignation and indiscretion in pre-Islamic poetry
In this research design was treated gap laser mathematically and practically Bashaddam model Raasi simple and new and we have found that there is a good match in the practical and theoretical results
The 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
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