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 researcher has studied in his research (International Public Relations methods in building the state's image through Cyberspace)
, analytical study of the Facebook and twitter pages for British foreign office , the role was played by the International Public Relations in building the mental image of British , especially after the new media and internet have became influential role in political life . and became an important tools used by political institutions as ministries of foreign affairs in the twenty: one century .
The researcher identified the problem of this study with the following question:
(what is the role of the International Public Relations in building the mental image of state through Cyberspace)
To answer
Background: Blood vessels injury is one of the most
common causes of medical emergencies that admitted to
hospitals and at the same time it regarded as one of the
most important causes of death. They may represent less
than 15% of all injuries; they deserve special attention
because of their severe complications.
Objective: The aim of the present study is to assess
anatomically the injures of major arteries and veins in the
lower limb with their management.
Methods: The present study extended from April 2006 to
February 2007, in which 65 patients with lower limb
vascular injury were examined in Emergency Department
and Forensic Medicine Department of Tikrit Teaching
Hospital in Salah-Aldin governora
Abstract :
This research aims to examine the correlation and the impact of Cultural Intelligence with their dimensions (Strategy, Knowledge, Motivation, Behavior) on Drawing Local politics and their dimensions (Empowerment, Flexibility, Organizational Justice, Local Funding) In Dhi Qar Provincial Council To determine the extent of the presence of significant statistical differences between research variables Due to the recent experiment which requires clarification of the role of the pivotal and important carried out by the provincial council in the exercise of his work in light of the diversity of cultures and the peculiarities of the local community, which may impede the provision of equal services to all those parties
... Show MoreHigh-power density supercapacitors and high-energy–density batteries have gotten a lot of interest since they are critical for the power supply of future electric cars, portable electronic gadgets, unmanned aircraft, and so on. The electrode materials used in supercapacitors and batteries have a significant impact on the practical energy and power density. Metal–organic frameworks (MOFs) have the outstanding electrochemical ability because of their ultrahigh porous structure, ease of functionalization, and great specific surface area. These features make it an intriguing electrode material with good electrochemical efficiency for high-storage batteries. Thus, this review summarizes current developments in MOFs-based materials as an elec
... Show MoreA Classical allusion refers to myths in ancient Roman and Greek works of literature. Christopher Marlowe (1564-1593), utilized mythological allusions in The Tragical History of Doctor Faustus (1588- 1592) to create a connection between ideas. Dr. Faustus wanted the infinite. He sold his soul to the devil to gain it. He rejected theology and embraced magic and mythology that epitomized pseudo-divinity. Classical mythology invites moral and theological discussion. It intensifies the aesthetic purpose and the spiritual evaluation of Dr. Faustus‟s ambition
The research dealt with the study of the element of time in the cinematic language and the role it plays in creating the aesthetic meanings in the documentary film by means of the various structural constructions with which time is constructed. The research included the introduction and the problem of research, which was represented by the following question: (Did the documentary film adopt the values of time formats in the fiction film or it created for itself special linguistic formulations and models which achieve the aesthetic concept?). It also included the importance of research, the need for it and its goal in addition to clarifying the limits of research.The theoretical framework included three sections the first of which is the
... Show MoreRecent reports of new pollution issues brought on by the presence of medications in the aquatic environment have sparked a great deal of interest in studies aiming at analyzing and mitigating the associated environmental risks, as well as the extent of this contamination. The main sources of pharmaceutical contaminants in natural lakes and rivers include clinic sewage, pharmaceutical production wastewater, and sewage from residences that have been contaminated by drug users' excretions. In evaluating the health of rivers, pharmaceutical pollutants have been identified as one of the emerging pollutants. The previous studies showed that the contaminants in pharmaceuticals that are widely used are non-steroidal anti-inflammatory drugs, ant
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