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 ACTUAL SOCIETY MODEL
Our society model has been showing signs of exhaustion since the end of the XX century. The recent appearance of the Covid-19 virus is another consequence of humanity's distance from Nature and the environment it inhabits. Also, climate change, environmental deterioration, loss of biodiversity, overexploitation of natural resources, and social inequality are some of the consequences derived from this separation between society and Nature. We must change our operating habits. Inevitably from a society based on the market, hyper consumption, fossil energy and individual enrichment at all costs, we will have to change to another
... Show MoreA new way to Systems concentrates have been clarified and that allows a concentration high and analysis to automatically wavelengths of the spectrum of this system analyst of the spectrum and the center is built on Holucram Nafez gives less absorbency with efficient diffraction high when the wavelength (900 nm), which will be useful for Khallaya solar
The study aims at figuring out the intended meaning of intonation in some English conversational utterances together with identifying pitch variations that are determined by various syntactic constructions that impart the same illocutionary force of utterances. However, intonation is needed to delimit the communicative forces of utterances by virtue of its structure which the speakers intend to convey .This paper consists of four sections .Section one deals with phonology and its types .Section two discusses intonation in relation to style , forms and functions. Section three sheds some light on pragmatics. Section four deals in details with the intended meaning of intonation in some English conversational utterances. This paper comes up wi
... Show MoreIn life in general and in the press, especially the success of a particular message depends heavily shipments carried by, and images idyllic suggestive, how many meanings that reaching an audience, and is the magazines and one of those media that target a broad audience, trying to please Him and the acquisition of his attention through a form of aesthetic granted pleasure and satisfaction from this point of view, read image ad as Date pure incident of everyday life, and here was placed this research about the aesthetic image advertising in the covers of women's magazines, which has been briefing them through the Four Seasons included in the search, was the first chapter Batarh systematic talked about problem Find the placing on the form
... Show MoreEach art has its own language. Per his style as an artist, which is characterized by the other. The methods differ and vary expressive art to another depending on the tools and methods used, and is a theatrical phenomenon did, and see, and touch, grasp, understand, and imagine, and emotion, and the blending of ideas and images. When unable to speak the language of the traditional theater For the delivery of a specific meaning or a single non-current at the time the highlight of our new language with a very wide area up to the extent of the unification of the languages of the world as it is in fine painting, it's the body of actor language, so it has become a mime art, which expressed Representative meanings reference and movement of vari
... Show MoreThe research Concentrates on modern Variable in the organizations that is 6 sigma. The field study is two of Iraqi industrial organizations, The first is state company of …………… , the other is the state company of ……
The problem of the research determines some questions and hypotheses, The data was Collected by question air, which contains 5 dimensions and (10) critical Successful factories .
The sample contains (42) who Works in that organizations. The points out many conclusions. The main of it, there is significant differences among the two organizations Then The research concluded with a number of important recommendations serve it's objectives .
... Show Morentroduction. Finding a safe innate immune response stimulator is one of the greatest challenges facing immunologists and vaccine manufacturers. Gap statement. The role of sterile bacterial secretions (SBSs) of Pseudomonas aeruginosa in stimulating the innate immune response was not investigated previously. Aim. The comparative effect of SBSs and bacterial cells of P. aeruginosa isolates isolated from freshwater (PAE) and infected wounds (PAC) on the respiratory tract innate immune response. Methodology. Four test mice groups were instilled intranasally (i.n.) with 106 c.f.u of PAC, 106 c.f.u of PAE, SBS of PAC, and SBS of PAE. Two control groups were given i.n. either LB broth or PBS. Time-course changes in IL-1 beta mRNA, TNF-alpha mRNA, I
... Show Morethose affected by technological development risks within the scope of medical works. The unprecedented technological development the world witnesses nowadays has been providing brilliant medical service to the human being including examination, diagnosis and the treatment or follow up. However, such works hide behind potential risks threatening people's lives and such risks my be discovered within the limits of now – how and technical knowledge prevailing the time of rendering the medical service. Also this the question is raised on how to keep up between the safety of the patients and such risks are being unknown by the provider and questioning them contradicts the justices. subsequently, can the patients (affected) acquire the compensat
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