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.
There is no doubt that the advertisement picture and the written text play a key role in the formation of the language of the communicative discourse as the main pillars of the design of commercial advertising and the main entrance for the advertising message awareness... Hence the researcher chose the title of her research (Integrative Relationship between the Picture and the Written Text in the Printed Commercial Advertisement) starting from following questions: What is the relationship between the picture and the written text in the printed commercial declaration? Is there functional, aesthetic and interactive integration between them?
&n
... Show MoreThis research study Blur groups (Fuzzy Sets) which is the perception of the most modern in the application in various practical and theoretical areas and in various fields of life, was addressed to the fuzzy random variable whose value is not real, but the numbers Millbh because it expresses the mysterious phenomena or uncertain with measurements are not assertive. Fuzzy data were presented for binocular test and analysis of variance method of random Fuzzy variables , where this method depends on a number of assumptions, which is a problem that prevents the use of this method in the case of non-realized.
يكشف هذا المقال عن مشكلة الصفات ذات المكون الكمي والتي تعتبر واحدة من اقوى الموارد المكونة للكلمات التعبيرية والتقويمية و يتم تحليل التركيبات الدلالية ذات الاوجه المتعددة التي تنشا من عملية توظيف الصفات المشتقة بمساعدة اللواحق والتي تدل على الاتجاه العام للغات السلافية وذلك لتطوير الدلالات العاطفية والتقييمية في الكلمات ذات معنى الميزة او الخاصية يتم تقديم تعريف انماط تكوين المعاني الضمنية في دلالات
... Show MoreBanks face different types of banking risks that limit the performance of its functions and achieve its objectives, including the financial risk that is based on current research into two types including a credit and liquidity risks. And established credit risk due to the possibility of delaying the borrowers to fulfill their obligations to the bank when due or non-payments on according to the terms agreed upon, while liquidity risk arises as a result of the inability of the bank to fund the financial needs, any inability to provide cash to pay its obligations short on credit without achieving tangible loss or the inability to employ the funds properly and show the liquidity risk in the event of inadequate cash inflows to the bank for an
... Show MoreThe current research aims to identify the risk management and its impact on the quality of service in the Salahalddin Sewerage Directorate, This is due to the great impact that the service provided by this institution plays in preserving health and the environment in the community, which has faced many administrative challenges, problems and issues as a result of the rapid and continuous environmental changes, and therefore, the adoption of administrative concepts such as risk management and knowledge of their impact on the quality of the municipal service is necessary to reach this service To the required levels. To achieve the research objectives, two main hypotheses have been formulated, the first of which is to find the extent of the li
... Show MoreThe present research included synthesis of silver nanoparticle from(1*10-3,1*10-4 and1*10-5) M aqueous AgNO3 solution through the extract of M.parviflora reducing agent. In the process of synthesizing silver nanoparticles we detected a rapid reduction of silver ions leading to the formation of stable crystalline silver nanoparticles in the solution.
The research problem has crystallized and in light of these capabilities, the level of performance depends on the application of modern training methods based on actual experimentation, and those methods aim to develop the components of achievement in this competition, including the quantities of exerting the distinctive strength with speed for the arms and feet, which reflects on good skillful performance because the skill of shooting by jumping forward and high forms A major role in achieving goals during the competition that qualifies the team to win, and through the follow-up of the researcher in the field and academic field, I noticed that there is a weakness in some physical abilities, which affects performance and skill level
... Show MoreBackground: Despite the importance of vaccines in preventing COVID-19, the willingness to receive COVID-19 vaccines is lower among RA patients than in the general population. Objective: To determine the extent of COVID-19 knowledge among RA patients and their attitudes and perceptions of COVID-19 vaccines. Methods: A qualitative study with a phenomenology approach was performed through face-to-face, individual-based, semi-structured interviews in the Baghdad Teaching Hospital, Baghdad, Iraq, rheumatology unit. A convenient sample of RA patients using disease-modifying anti-rheumatic drugs was included until the point of saturation. A thematic content analysis approach was used to analyze the obtained data. Results: Twenty-five RA pa
... Show MoreArchives of Razi Institute (ARI)