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.
Many behavioral researchers pointed out the importance of relaxation techniques in the treatment of different psychological disorders where find the importance of these techniques in reducing anxiety and stress and the resulted of behaviors and habits, with the development of these techniques are being used to gain public health, whether mental health or physical or mentality, and one of these techniques is music therapy that reduces tension and anxiety and operates a state of relaxation, which is used in the treatment of patients of dental clinic.
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... Show MoreThe body concept in the human sciences received significant attention through study and investigation, and has been dealt with by many studies, yet this research is an attempt to reveal the body transformations and its concept in the visualized picture (drawing field) in general and in the drawings of the artist Muhammed Mehraddin in specific. Therefore, the approach of the body, philosophically and technically, in this field has its nature and specificity in revealing the structures and relations in employing the body as a visual, spatially and temporally indicator through the drawing fields of the artist Muhammed Mehraddin, assuming that the body, for the artist's works, constitutes a cultural, artistic performance focus in his a
... Show MoreDrug –induced nephrotoxicity is an important cause of renal failure. Aminoglycoside antibiotics, such as amikacin, which causes ototoxicity and nephrtotoxicity as a main side effects, this is focused on the use of natural materials as antioxidants against the toxic oxidative action that exert a cell damaging effect. The most important one of these materials is the honey. The aim of this work is to evaluate the antioxidant effects of honey against amikacin – induced nephrotoxicity.18 albino rats divided into 3 groups (6 rats per each group), group 1 received I.P daily dose of normal saline (control), group 2 received (35 mg/kg/day) I.P dose of amikacin ,and group 3 received (35mg/kg/day) of amikacin I.P dose in combina
... Show MoreThis investigation was undertaken to evaluate the effectiveness of using Hydrated lime as a (partial substitute) by weight of filler (lime stone powder) with five consecutive percentage namely (1.0, 1.5, 2.0, 2.5, 3.0) % by means of aggregate treatment, by introducing dry lime on dry and 2–3% Saturated surface aggregate on both wearing and binder coarse. Marshall design method, indirect tensile test and permanent deformation under repeated loading of Pneumatic repeated load system at full range of temperature (20, 40, 60) C0 were examined The study revealed that the use of 2.0% and 1.5 % of dry and wet replacement extend the pavement characteristics by improving the Marshall properties and increasing the TSR%. Finally, increase permanent
... Show MoreThis research aims to test the relation and effect of the process of organizational change as an independent variable (change in human resources, technological change, change in tasks, change in organizational structure) in organizational performance as a variable of success (financial performance, operational performance, customer satisfaction, growth). And learning) in the Office of the province of Baghdad, as well as determine the existence of differences of statistical significance between the variables of research, and then try to come out with a set of recommendations to contribute to the strengthening of organizational performance, and carried out this research on the eye of the vertical number (75) individuals, The
... Show MoreThis research was conducted to study the histological structure of the eye in the tree frog (Hyla arborea savignyi) and showed that it is composed of the eyeball and the lens and optic nerve. Appeared eyeball is surrounded by three Tunica from the inside to the outside are Tunica Interna, Tunica vasculosa, Tunica fibrosa. The tunica interna consists of the retina that consists of 10 layers are from outer to inner pigment epithelial layer, rods and cones layer, external limiting membrane, outer nuclear layer, outer plexiform layer, inner nuclear layer, inner plexiform layer , ganglion cells layer , nerve fibers layer, internal limiting membrane .The vascular tunic or Uvea consists of the choroid, ciliary body , and iris . The fibrous coat co
... Show MoreBackground: Dental implant is one of the most important options for teeth replacement. In two stage implant surgery, a few options could be used for uncovering implants, scalpel and laser are both considered as effective methods for this purpose. The Aim of the study: To compare soft tissue laser and scalpel for exposing implant in 2nd stage surgery in terms of the need for anesthesia, duration of procedure and pain level assessment at day 1 and day 7 post operatively using visual analogue scale . Materials and methods: Ten patients who received bilateral implants participated after healing period completed, gingival depth over each implant was recorded and then implant(s) were exposed by either scalpel or laser with determination for th
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