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.
Victorian age is known as a time of perpetual change. It is a time of new industrialization, increased urbanization and new technology. Therefore, one of the strongest undercurrents of this is the position of women. Woman at that time was viewed as “an angel in the house” especially this who belongs to the upper-middle class. She is described in such term because she spends much time in her domestic domain. Therefore, she should be passive, obedient and dependent. Despite the Victorian society contains several classes; women are defined under two labels: the angel and the demon or the whore. The angel woman can be any woman from the lower middle class to the aristocracy, while the whore refers to any working class woman. The differen
... Show MoreIntroduction: The use of screw-retained hybrid arch bars (HABs) is a relatively recent development in the treatment of mandibular fractures. The purpose of this study is to compare the clinical outcome between HAB and the conventional Erich arch bar (EAB) in the closed treatment of mandibular fractures. Materials and methods: This study included 18 patients who were treated for mandibular fractures with maxillomandibular fixation (MMF), patients were randomly assigned into a control group (n = 10) in which EAB was used and study group (n = 8) in which HAB was used. The outcome variables were time required for application and removal, gingival inflammation scores, postoperative complications, and incidence of wire-stick injury or gloves perf
... Show MoreCivil environment in nursing education enhances achieving learning outcomes. Addressing incivility can be crucial to improve academic achievements. The purpose of this study was examining the psychometric properties of the Arabic version of the Incivility in Nursing Education-Revised scale regarding nursing faculty.
This cross-sectional study conducted in five Arab countries using a convenience sampling st
Abstract
Through this study, I tried to identify the grammatical efforts of one of the most important authors of the footnotes that were built on the luminous benefits marked with (Explanation of Mulla Jami in Grammar), and he is Sheikh Isamah Allah Al-Bukhari, who died in the eleventh century AH, trying as much as possible to stay away from the path of tradition in repeating the efforts of Those who preceded me in explaining the grammatical efforts of many grammarians, and perhaps what helped me in this is the characteristics that characterize the notes owners that may distinguish them from other owners of grammatical authorship, as a result of what characterized the personality of the notes owners from the predominance of the in
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The research aims to build an integrated frame of knowledge for the basic research topics, represented by (assimilation of knowledge, strategic clarity) and their basic variables, by examining the most important scientific propositions on these topics in administrative thought, and framing the knowledge contained in them, in a serious attempt to provide appropriate answers to questions The research dilemma, and the research was applied in the Iraqi Airways Company, whose number is (1200) employees, and the descriptive and analytical approach was adopted in conducting the research. A valid form for statistical analysis, i.e., with a retrieval rate of (92%). The two researchers used the (SPSS & AMOS) program for
... Show MoreThe aim of the study was to know the factors analysis of scale Bar-On & Parker, post analysis is found fourteen factors for the first degree of the scale. Also we extracted five factors from the second degree.
The scale consists of (60) items , applied on sample of (200) students (Male &Female ) age (15-18) years randomly chosen from preparatory schools . The scale unveiled satis factors validity and reliability. An others aims is to low the emotional Intelligence level and know the difference of statistical in sex , age variable and the specialization variable .The result was no difference of statistical in sex and specialization variable , but the difference appear
... Show MoreThe art of batik is one of the ancient arts that has a long history in East Asian countries, especially in Indonesia, where it was considered a traditional craft with which many Indonesian tribes lived. This art began to move to other continents and develops and progresses due to the artist’s connection to the surrounding technological and intellectual development, as art became more outgoing and liberated, it helped the artist to create and innovate in his designs. In this research, he focuses on modern performance methods through which print paintings can be produced through design elements, especially calligraphy, to create aesthetic and creative effects in the productive work. The current research aims to identify the various perfo
... Show MoreShallow foundations are usually used for structures with light to moderate loads where the soil underneath can carry them. In some cases, soil strength and/or other properties are not adequate and require improvement using one of the ground improvement techniques. Stone column is one of the common improvement techniques in which a column of stone is installed vertically in clayey soils. Stone columns are usually used to increase soil strength and to accelerate soil consolidation by acting as vertical drains. Many researches have been done to estimate the behavior of the improved soil. However, none of them considered the effect of stone column geometry on the behavior of the circular footing. In this research, finite ele
... Show MoreThis study aimed to investigate the effect of total suspended solids (TSS) on the performance of a continuously operated dual-chamber microbial fuel cell (MFC) proceeded by primary clarifier to treat actual potato chips processing wastewater. The system was also tested in the absence of the primary clarifier and the results demonstrated a significant effect of TSS on the polarization curve of the MFC which was obtained by operating the graphite anodic electrode against Ag/AgCl reference electrode. The maximum observed power and current densities were decreased form 102.42 mW/m2 and 447.26 mA/m2 to 80.16 mW/m2 and 299.10 mA/m2, respectively due to the adverse effect of TSS. Also
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