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.
Domestic Technique in Batik Art
Implantable drug delivery systems, such as drug pumps and polymeric drug depots, have emerged as means of providing predetermined drug release profiles at the desired site of action. While initial implants aimed at providing an enduring drug supply, developments in polymer chemistry and pharmaceutical technology and the growing need for refined drug delivery patterns have prompted the design of sophisticated drug delivery implants such as on-demand drug-eluting implants and personalized 3D printed implants. The types of cargo loaded into these implants range from small drug molecules to hormones and even therapeutic cells. This review will shed light upon recent advances in materials and composites used for polymeric implant fabrication, hi
... Show MoreThe goal of modern education is to achieve healthy growth of the individual and
society Since childhood is one of the most serious developmental stages in the human
identity, which is not limited to the threat to it stage the foundations of personal sound is
placed where the dimensions of the various components and based on the foregoing targets
Current Search: "Measuring the level of psychological health kindergartens"
And it included a sample search on the kindergarten children in the province of
Baghdad and achieve the objectives of research have been prepared in scale mental health and
concluded the researcher through the search results that kindergarten children suffering from
disorders in mental health, the
Background:The document on hypertension in the elderly promoted by the American college of cardiology and the American heart association (ACCF/AHA) was written with the intent to be a complete reference at the time of publication on the topic of managing hypertension in the elderly. More recently, the European society of hypertension (ESH) and the European society of cardiology (ESC) issued the 2013 ESH/ESC Guidelines for the management of arterial hypertension, followed by The 2014 Canadian Hypertension Education Program (CHPE), and the Eighth Report of the Joint National Committee (JNC8), all of which has endorsed specific recommendations for the management of elderly hypertensive patients.
إن تجسيد الشعراء للجمال واقامته تمثالا مصورا مرئيا ، كان الهدف منه اولا اشاعة جو نفسي مريح في مقدمات قصائد المديح ، فهو الجزء البصري الممتع لمدركات حسية اخرى ترافقه، وأما المرامي الاخرى
ﻓﮭﻲ إﻣﺘﺎع اﻟﻨﻔﺲ إﻣﺎ ﺑﺎﺳﺘﺮﺟﺎع أﺟﻤﻞ ﺻﻮرة أو أﻧﻤﻮذج ﻗﺎﺋﻢ ﻓﻲ اﻟﺬاﻛﺮة، وﺟﻌﻠﮫ ﯾﺤﯿﺎ ﻣﻦ ﺟﺪﯾﺪ ﻟﺪواﻋﻲ اﻟﺤﻨﯿﻦ للاماكن والازمنة الاثيرة . أو الميل للتعبير عن الوعي الجمالي الذي يتصل بموضوع الج
... Show MoreMost real-life situations need some sort of approximation to fit mathematical models. The beauty of using topology in approximation is achieved via obtaining approximation for qualitative subgraphs without coding or using assumption. The aim of this paper is to apply near concepts in the -closure approximation spaces. The basic notions of near approximations are introduced and sufficiently illustrated. Near approximations are considered as mathematical tools to modify the approximations of graphs. Moreover, proved results, examples, and counterexamples are provided.
Cinema has always addressed human issues from diverse perspectives. It covered biographies, philosophy, history, war, and sci-fi. These disciplines promote economic and artistic success. Since the 1930s, cinema has explored sexual transformation. These films have defended homosexuals, explored how homosexuality causes AIDS, and discussed transgenderism for decades. As widely recognised, animated films for adults and children worldwide have included this trend. This study will demonstrate how hormone imbalance affects sexual function. This study, "Promoting Physiological Transformations in Cinema," comprises four chapters: The first chapter (methodological framework) covers the study problem, "What are the foundations and necessities of p
... Show MoreCopulas are simply equivalent structures to joint distribution functions. Then, we propose modified structures that depend on classical probability space and concepts with respect to copulas. Copulas have been presented in equivalent probability measure forms to the classical forms in order to examine any possible modern probabilistic relations. A probability of events was demonstrated as elements of copulas instead of random variables with a knowledge that each probability of an event belongs to [0,1]. Also, some probabilistic constructions have been shown within independent, and conditional probability concepts. A Bay's probability relation and its pro
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