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.
Praise be to God who has guided us, and we would not have been guided had it not been for the guidance of God Almighty. The life of the Commander of the Faithful, Imam Ali bin Abi Talib, peace be upon him, represented the highest meanings of sacrifice, redemption, courage, heroism, patience, altruism, and truth, which were embodied in his unique personality, whose counterpart is rare, if not unparalleled in history. Except for the person of the Holy Prophet Muhammad (may God bless him and his family and grant them peace). In this research, we have presented pictures from the life of Imam Ali bin Abi Talib (peace be upon him), as we have clarified his life, upbringing, conversion to Islam and his ma
... Show MoreMany risks have adverse consequences for construction projects’ objectives such as quality, schedule, and cost. As engineering procurement construction (EPC) contracts gradually become one of the most common types used in implementing major large-scale construction projects, identifying common risk types and analyzing their root causes is important for developing measures to decrease and eliminate future risks in these types of contracts. The information about the main causes of risks was collected
In this research, that been focused on the most important economic benefits expected when applying the three standards of sustainability in construction projects (economic, environmental and social). Fuzzy AHP, a multi-decision decision-making technique for evaluating construction projects. Which when used we get the speed and accuracy in the results. Using this technique will reduce uncertainties decisions significantly (fuzzy environment), that found in most projects .The results of the data analysis showed that the economic standards take the greatest relative importance (60%) among the three sustainability standards. Therefore, the implementation of any standards need a cost so the economic benefit of any proje
... Show MoreThe novel has recently received great attention from readers and before them writers, due to the role it is playing, and this indicates an important rule, which is whenever there is art or creativity, there must be a criticism of its own, and this criticism is certainly no less important than its owner, so we find There are critics who have their distinguished literary position in following up the narrative development, and trying to describe the transformation of its elements, including Professor Fadel Thamer, and whoever wants to approach an element of the novel as an explorer, he must stand on the visions of this critic about it, and this is what made us take the element (personality) Tracking the most important opinions of the critic
... Show MoreMalaysia will be an ageing population by 2030 as the number of those aged 60 years and above has increased drastically from 6.2 percent in 2000 and is expected to reach 13.6 percent by 2030. There are many challenges that will be faced due to the ageing population, one of which is the increasing cost of pensions in the future. In view of that, it is necessary to investigate the effect of actuarial assumptions on pension liabilities under the perspective of ageing. To estimate the pension liabilities, the Projected Unit Credit method is used in the study and commutation functions are employed in the process. Demographic risk and salary risk have been identified as major risks in analyzing pension liabilities in this study. The sensitivity
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Research summary
Backbiting pronouns have gained great importance in contemporary textual linguistic studies, as they play a coordinating function in the text and link its parts.
Interpreters did not overlook the role of backbiting pronouns in achieving the function of consistency and coherence in the Qur’anic text, as they referred to this, including Ibn Ashour, who had many analytical practices related to referral issues and their complexities. The Qur'anic reference to the pronouns of backbiting, so the researcher traced these phenomena and their evidence in the Holy Qur'an, aiming to clarify their role in enriching the significance and in the coherence and harmony
... Show MoreCommercial fish catch in the Iraqi marine waters from December 2018 to December 2019 was investigated. The study is based on three stations: the first station is located at the Shatt Al-Arab estuary, the second represents the area between the Shatt Al-Arab Estuary and open marine waters, and the third is associated with the Iraqi territorial marine waters. The total weight of the catch was 1881 kg, represented by 500, 654, and 727 kg in the first, second and third stations respectively. The third station was the highest with a majority of the family Sciaenidae by 464 kg, while the lowest was the family Scombridae by 0.5 kg. The total number of species included 37 species, belonging to 27 genera, 19 families, and 6 orders, the largest ord
... Show MoreThe Internet of Things (IoT) is an expanding domain that can revolutionize different industries. Nevertheless, security is among the multiple challenges that it encounters. A major threat in the IoT environment is spoofing attacks, a type of cyber threat in which malicious actors masquerade as legitimate entities. This research aims to develop an effective technique for detecting spoofing attacks for IoT security by utilizing feature-importance methods. The suggested methodology involves three stages: preprocessing, selection of important features, and classification. The feature importance determines the most significant characteristics that play a role in detecting spoofing attacks. This is achieved via two techniques: decision tr
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The current study was conducted to assess the effect of advancing age on total serum IgE level in asthmatic patients. To this purpose, 90 asthmatic patients and 30 healthy individuals ( control group ) were enrolled. Asthmatic patients were categorized into four groups. Group A consisted of asthmatic patients (9) whose age was more than 20 and up to 30 y. Group B contained asthmatics (13) of age more than 30 and up to 40 y. Group C comprised those (23) of more than 40 and up to 50 y. Group D consisted asthmatic patients (45) of age more than 50 y. Total serum IgE level significantly changed in group D patients when compared with those of
Background: Atrophic postoperative and traumatic scarring are common cosmetic problems for patients. Combining CO2 laser ablation with a fractional photothermolysis system in a treatment known as ablative fractional resurfacing fulfilling the new demands for a lesser risk of side effects and minimal or no downtime.Objective: To assess the safety and efficacy of ablation fractional CO2 laser treatments for surgical scarring .methods: Twenty one patient ( 14 women, and 7 men ) with various skin types , I to IV , aged 3 to 48 years , presents with 24 scars between June and December 2012 , four patients excluded from study because they are not continued in follow up , the remaining 17 patient completed all 3 treatments & 6 months follow
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