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 mysterious letters, the philosophy of existence and the meaning of these letters in the Qur'an is one of the mysterious issues that has always occupied the minds of Interpreters. Each Interpreter has tried to provide his own interpretation and understanding of these mysterious letters. Since these letters are part of the surah of the Qur'an and at the same time, the appearance of these letters, unlike other verses, does not indicate meaning, the commentators have approached these verses with their preconceptions. In this article, an attempt has been made to investigate the role of pre-interpreters of descriptors in a descriptive and analytical method in finding the meaning of syllables. However, each of them has tried to interpret th
... Show MoreThe researcher tried to show the importance of obligation with the rules of professional conduct set by the Association of Accountants and Auditors of Iraqis when expressing an opinion the financial statements submitted tax administration and enhance the confidence of these lists, and adopted in the tax settling accounts process and its impact on tax revenues, and touched a researcher at the theoretical side of the search to the problem of research and of my Is there a trace of non- not to obligation by the rules of professional conduct in Iraq affect the tax revenue with the rules of professional conduct in tax revenue for companies research sample, the research aims to study the rules of professional conduct set by the Associatio
... Show MoreBackground: Bone regeneration in dehiscence and fenestration defect can be improved with the use of platelet rich fibrin (PRF) that provides a scaffold for new bone regeneration. This study was conducted to assess the effectiveness of PRF as a graft material and membrane in dehiscence and fenestration defects. Materials and Methods: This prospective clinical study included patients who received dental implants that demonstrated peri-implant defects which were augmented using Leukocyte- PRF (L-PRF) or Advanced-PRF (A-PRF). Twenty four weeks postoperatively the defect resolution and the density of regenerated bone were assessed by CBCT and re-entry surgery. The assessment also included measurement of primary and secondary implant stability
... Show Moreيؤدي عرض معلومات مضللة او محرفة ضمن القوائم المالية والتي تعد أهم مصادر المعلومات الموثوقة التي يُعول عليها لاتخاذ القرارات السليمة الى عدم قدرتها على عكس نتيجة النشاط والمركز المالي لها او اعمال الوحدة الاقتصادية لتلك الفترات الزمنية بصورة صادقة وعادلة نتيجة لنوعية المعلومات المفصح عنها في القوائم المالية لذلك زاد الاهتمام بتطوير الممارسات المحاسبية لتتضمن افصاحات كافية بغرض اعطائهم صورة صادقة وعادلة
... Show More: The aim of this research is to investigate the impact of Woods ' strategy in collecting second graders average for physics. To achieve the objective researcher coined the following hypothesis: there was no statistically significant difference at a level (0.05) between the average grades of the experimental group students studying physics as Woods and strategy between the average control group students who are studying the same article in the regular way. Test collection. Search sample amounted to (83) students and (42) students for the experimental group, and (41) students for the control group. Students were subjected to test experiment is composed of (30) after the completion of the experiment. And use appropriate statistical methods re
... Show MoreA substantial matter to confidential messages' interchange through the internet is transmission of information safely. For example, digital products' consumers and producers are keen for knowing those products are genuine and must be distinguished from worthless products. Encryption's science can be defined as the technique to embed the data in an images file, audio or videos in a style which should be met the safety requirements. Steganography is a portion of data concealment science that aiming to be reached a coveted security scale in the interchange of private not clear commercial and military data. This research offers a novel technique for steganography based on hiding data inside the clusters that resulted from fuzzy clustering. T
... Show Moreالخلاصة
یعد والت وتمن شاعرا استثنائیا سواء أكان ذلك في المكانة التي یحتلھا في الأدب الأمریكي او في نمط
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The city of Samawah is one of the most important cities which emerged in the poverty area within the poverty map produced by the Ministry of Planning, despite being an important provincial centre. Although it has great development potentials, it was neglected for more than 50 years,. This dereliction has caused a series of negative accumulations at the urban levels (environmental, social and economic). Therefore, the basic idea of this research is to detect part of these challenges that are preventing growth and development of the city. The methodology of the research is to extrapolate the reality with the analysis of the results, data and environmental impact assessment of the projec