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 search tried to achieve a major scientific goal represented by (Knowing the perspective that has been treated through press releases of woman articles in Al- Sabah newspaper), via:
- Specifying the rate of woman topics in Al-Sabah newspaper, compared with the other subjects.
- Revealing the nature of the topics of the woman that the newspaper dealt with.
- Identifying the ID of journalistic-product that dealt with the woman topics.
- Knowing the journalistic arts that the woman topics have been treated by.
- Standing on the cases which woman topics concentrated on, through Al-Sabah newspaper.
A composite section is made up of a concrete slab attached to a steel beam by means of shear connectors. Under positive and negative bending moment, part of the slab will act as a flange of the beam, resisting the longitudinal compression or tension force. When the spacing between girders becomes large, it is evident that the simple beam theory does not strictly apply because the longitudinal stress in the flange will vary with distance from the girder web, the flange being more highly stressed over the web than in the extremities. This phenomenon is termed "shear lag". In this paper, a nonlinear three-dimensional finite element analysis is employed to evaluate and determine the actual effective slab width of the composite steel-concrete
... Show MoreA study worthy of study and objective analysis of the relationship of formal synthesis and innovative effectiveness in the design of modern women's fabrics, which deals with the first chapter the problem of research based on the following questions: (What role of innovative thinking in the formal synthesis of women's clothing designs Modern)
The research objectives included the following:
1 - defines the concept of innovative thinking and its effectiveness in design
2 - Reveal the role of innovative thinking in the formal synthesis of the designs of modern women's fabrics
The theoretical framework which included the following parts:.
1 - Innovative thinkin
... Show MoreThe diabetic foot is considered one of the long term diabetes complications caused by a defect in blood vessel and nerve system. This requires dealing with diabetic foot with professional medical care, so as to prevent its development in advanced stages which could end to gangrene and amputation of the foot. This study has been initiated through follow-up of twelve patients with diabetes and the presence various occlusions in lower limb artery. One patient from them was chosen for investigation, this patient has stenosis in popliteal artery and presence multiple stenosis in superficial femoral artery. This study based on analysis present case of patient and prediction for progress stenosis in superficial femoral artery till arrive semi t
... Show MoreBackground: The aim of the present study is to evaluate the esthetic smile in sample of Iraqi adults and to assess the gender differences. Materials and Methods: 100 persons (50malesand 50 females had class I normal dental and skeletal selected for this study.Clinical examination and digital photograph with posed smile were performed for each individual. Six linear soft tissue parameters in each photograph using AutoCAD program 2011. Five visual and four quantitative evaluations of the smile were studied for eachsubject. The smile arch and index, buccal corridor spaces (BCSs) were studied.Descriptive statistics of the measurements were calculated. Independent student’s ttestswere used to evaluate the gender differences. Statistics: Desc
... 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
Alternative distribution to estimate the Dose – Response model in bioassay excrement
This research concern to study five different distribution (Probit , Logistic, Arc sine , extreme value , One hit ), to estimate dose –response model by using m.l.e and probit method This is done by determining different weights in each distribution in addition find all particular statistics for vital model .
The Research Aims To Clarify The Role Of Knowledge Innovation On The Administrative Process Represented by Managing Strategic Momentum, The Research Problem Focuses on Administrative leader Interest In And Implementation Of The Innovation Element Of Knowledge In The Organization By " Managing Strategic Momentum" As Well As The Focus By Management About The Innovators And Makers Of Knowledge And Strategic Planners In The Design And Formulation Of Strategic. Research does Contribute In Solving Part Of The Organizational Problems Of Vision, Innovation And Their Impact On The Momentum Management To Determine The Extent On Which The Procedures Of The Assessed Companies And Plan To Regulate Innovation Under The Momentu
... Show MoreAccording to so many previous studies, lack of sufficient information during prescribing steps may lead to medication errors. Thus, the presence of the clinical pharmacist during routine rounding process in the ward with intervention of patient care plan may reduce the probability of adverse drug events (ADEs).This study evaluate role of the clinical pharmacists, as a member of medical team with the physician, on ADEs and report their interventions in the internal medicine unit. This study was designed to compare between two groups of patients, those receiving care from a rounding team (physician, nurse, and clinical pharmacist) (study or intervention group with 51 patient); and those receiving c
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