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.
Of the new concepts introduced by the decree of the amendment of the French Civil Code No. 131-2016 issued on 10 February 2016, which raised a debate in jurisprudence both at the level of French jurisprudence or the Arab, the concept of (the content of the contract), which seems to have emerged from the appearance of new legal articles ( 1162-1171) is the cornerstone of the contract and the contract in the contract, the two pillars which, over the course of 200 years and a half, have been one of the main pillars of the codification of Napoleon. Is that the decree of amendment has already abandoned these two pillars, or most of what he did is a change in terminology while preserving the content of these two pillars implicitly, this is what w
... Show MoreBackground: Gotu Kola (Centella asiatica) has been used as a traditional medicine for many years to cure different kinds of diseases. Studies have been reported that Gotu Kola extracts might be used as a cure for oral diseases such as periodontal disease. In the present study, Gotu Kola leaves extracted with water will be used to evaluate its effect on some microorganisms living in the human saliva using minimum inhibitory concentration (MIC) method. Material and Method:Gotu Kola fresh leaves extract have been used with water as a solvent, a rotary evaporator was used to separate the solvent from the extract. The following microorganisms: Streptococci, Lactobacilli, and Staphylococcus aureus have been isolated fromthe Saliva of ten voluntee
... Show MoreThe aim of this study is to investigate the protective effect of Radish (Raphanus sativus) seed alcoholic extract 70% against oxidative stress induced by sodium nitrite NaNO2 Twenty five adult male rabbits were devided into five groups of (five rabbits in each group) and treated daily for 30 days. Group T1: intubated orally 20 mg/kg NaNO2, Group T2: intubated orally 20 mg/kg NaNO2 + 50 mg/kg of alcoholic extract from Raphanus sativus seeds, Group T3: intubated orally 20 mg/kg NaNO2 + 100 mg/kg of alcoholic extract from Raphanus sativus seeds, Group T4: intubated orally 20 mg/kg NaNO2 + 200 mg/kg of alcoholic extract from Raphanus sativus seed as well as Group C: control intubated orally distilled water. In comparison with normal ra
... Show MoreThe problem of the study was to identify the possibility of benefiting from the application of the target cost system as a modern cost system to activate the environmental cost management instead of the traditional systems used in the company due to the great transformations witnessed by the business environment in all fields, which have resulted in the search for modern systems to provide more accurate and more appropriate information to reduce Costs, because accurate information makes the company have a complete vision to achieve the company’s goals. To solve this problem, the research was based on the following hypothesis (that the role of the target cost system leads to the activation of environmental cost management). Target c
... Show MoreBackground: The study was designed for the assessment of the knowledge of medical students regarding pandemics. In the current designed study, the level of awareness was checked and the majority of students were found aware of SARS-CoV and SARS-Cov2 (Covid-19).
Objective: To assess the awareness of SARS-CoV and SARS-Cov2 (Covid-19) among medical students of Pakistan.
Subjects and Methods: A cross-sectional survey was carried out in different universities of Pakistan from May to August 2020. A self-constructed questionnaire by Pursuing the clinical and community administration of COVID-19 given by the National Health Commission of the People's Republic of China was used am
... Show Morehe current research aims at showing the correlation and effect of the internal environment analysis in the quality of health service in AL_Elwiya Maternity Teaching Hospital, researcher depended on the integral method in the "analytical descriptive method" for the study of the relation between the main variables and the sub-variables throughout data collection required by the theme of this study, a case study" in tackling the data and information related to the financial aspects of the internal environment.
The problem of the study was manifested in the essential question, that is (is there internal struc
... Show MoreIn the period after the collapse of the Soviet Union in 1991, the Federal Republic of Russia witnessed a setback in the overall strategic performance of the country, as it went through a stage of performance flop between the orientation towards Europe in the era of President Boris Yelsen (1991-1999), or the change of direction towards Eurasia, as the Russian Federation managed After President Vladimir Putin assumed power in 2000, from rebuilding the same state and preserving national unity and social cohesion, as well as building a phased military doctrine that made clear moves in Russian strategic thought and future directions towards regions of eternal importance in Russian strategic perception Lack of a set of motivations based on it:
... Show Moreدور التدقيق الاستراتيجي لإدارة الموارد البشرية في بلورة القدرات التنظيمية دراسة استطلاعية في رئاسة جامعة بغداد
Samuel Beckett’s Happy Days (1961) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Samuel Beckett to use a lot of pauses and silences in all plays written instead of using words. To express the bewilderment of the modern man during the 20th century, Beckett adopts the use of no language strategy in the dramatic works. After World War II, people were without hope, religion, food, jobs, homes, or even countries. Beckett gave them a voice. He used a dramatic language out of everyday things, in which silence was part of the syntax as a poetic repetition. Language is no more important to the modern man; instead, he us
... Show More