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.
Background: Axillary lymph node (ALN) enlargement with diffuse cortical thickening and conserved echogenic hilum may represent a diagnostic and therapeutic challenge. Sonographic strain elastography may help the characterization of borderline ALN.
Aim: To evaluate the strain elastography of borderline ALN and to calculate a cutoff value of strain ratio (SR) that can identify suspicious ALN with the highest sensitivity and specificity to reduce unnecessary invasive procedures.
Subjects and Methods: A prospective study included 45 patients who attended the Breast clinic in Oncology Teaching Hospital with borderline axillary lymphadenopathy (intact hilum and diffusely thic
... 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 MoreAbstract:
In its theoretical farm, the research adobet the subject of human resource management strategies and the cognitive skills. It comes as result of the rapid development which considers it human resource. as main axis in organization , the research in includes ,connective analysis , between human resource management strategies and cognitive skills which is considers one of the new concept that should be studied widly so that the organization can be able recognize it as concept and type and its importance for people in the organization.The study method was descriptive and analytics , it identified collation of hypothesis which were by statist too
... Show MoreThis review focuses on conservation agriculture (CA) and its effects on increasing the soil’s resistance to erosion. CA involves minimum soil disturbance (minimum tillage/ no-till), diversified crop rotation, and maintenance of the soil cover to increase soil fertility and reduce erosion. CA reduces soil loss by up to 90% and water erosion by approximately 50 to 70% from runoff as it increases the health of the soil, yield of crops, and water-retention capacity of the soil by incorporating soil organic matter and promoting biodiversity. Crop rotation prevents the replenishment and depletion of soil nutrients by atmospheric fixation of nitrogen/biological nitrogen fixation. Controlled traffic farming (CTF) is a new strategy in which travel
... Show MoreBackground: 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
Inclination Of The Lumbosacral Angle In Normal Individuals: An Mri Study,GJRA - Global Journal For Research Analysis(GJRA) GJRA is a double reviewed monthly print journal that accepts research works. 36572+ Manuscript submission, 9855+ Research Paper Published, 100+ Articles from over 100 Countries
In most of Beckett’s plays , there are prominent elements of absurdity that are landmarks of his style and the way of his writing like : the physical and the spiritual decay of characters, the disintegration of language as it becomes no longer a means of human communication because there is an inability to establish any kind of mental contact among them. These elements are quite apparent in Beckett’s “All That Fall”. The play exhibits a list of conflicts: one is between powerful forces as that between the force of life represented by Maddy and the forces of death represented by Dan .The second is the conflict and contempt between the old generation and the new one in the case of Dan’s desire to kill the boy fetching
... Show Moreتحلل الورقة الحالية تمثيل كاريل تشرشل للصورة النمطية للمرأة في Top Girls (1982). تُظهر المسرحية كيف وصلت النساء في نضالهن لمحاربة اضطهاد الرجال عبر التاريخ ، إلى مستوى من القوة والحرية يستخدمان للسيطرة على جنسهن دون شفقة. مارلين ، الشخصية المركزية في هذه المسرحية ، هي امرأة تبنت الصفات الذكورية إلى أقصى الحدود. لتسلق سلم النجاح إلى قمته ، تضحي مارلين بطفلها وعائلتها وحبها. كما تعرض المسرحية النساء الصامتات والم
... Show MoreDrug-induced acute kidney injury is a serious disorder. Oxidative stress has a key role in its initiation and progression. In this study, the possible ameliorative effect of fimasartan against methotrexate-induced nephrotoxicity was investigated in comparison with α-tocopherol in rats. Wistar rats were allocated into six groups and treated as follows: group Ӏ received water on a daily basis for 8 successive days; group ӀӀ received methotrexate (20 mg/kg) on day 1, followed by water for 7 successive days; group ӀӀӀ received fimasartan (3 mg/kg/day) for 7 successive days; group IV received α-tocopherol (1 g/kg/day) for 7 successive days; group V re
... Show MoreÖNSÖZ
Karagöz , tarihin derinliklerinden düşünülmüş bir hayal oyunu’dur . Beyazperde üzerine , birtakım tasvirlerin gölgelerini yansıtmak suretiyle gösterilentemaşa çeşididir. Meddahlık ile orta oyunu’na yakınlığı ve aşağı yukarı aynıteatral unsurları , komik temaları kullanması dolayısı ile karagöz’de sözlü tiyatrogeleneklerisayabiliriz . Nitekim bu hayal oyunu’nun perde arkasına yerleşerekhüner gösteren bir tek aktörüvardır . Bu aktörün oyun için kullandığı malzemeperde , şema (mum) ve tasvirler’dir. Altı yüzyıldır canlı kalan karagöz , dünyanın eneski en zengin ve en güzel halktiyatrolarındandır. Türk toplumunun yüz
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