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 two objectives of the current research are :-
- Uncover the views and opinions of the students of Artistic Education Department about the relation between educational novelty and its relation with visual .
- Identifying the capabilities of the students of artistic education department .
The society of the research is the fourth class students of artistic education department - College of Fine Arts ( 83 students from both sexes ) . It was chosen ( 60 ) students sample of from both sexes by the researcher in order to conduct test upon them .The researcher has adopted descr
... Show MoreThe authentic traditional architecture proved that it is very convenient to the environmental and social regulations where it appeared and lasted for hundred of years.
This traditional architecture got the intelligence in providing thermal comfort for their occupants by the intelligent usage of the building materials and the intelligent planning and designs which took in consideration the climatic condition and the aerodynamics of the whole city as one ecological system starting from the cold breeze passing through its narrow streets till it enters the dwelling units and glides out through the wind catchers.
This architecture had been neglected and replaced by modern imported architecture which had collap
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The decision maker needs to understand the strategic environment to be addressed through different means and methods. It is obvious that there is a difference between the three strategic environments (conflict environment, peace environment, post- peace environment) in terms of inputs and strategies to deal with each one of them. There is an urgent need to understand each pattern separately, analyze its inputs, and identify the factors and variables that affect the continuity of this situation (conflict, peace, post-peace). It is not appropriate to identify treatment without diagnosis of the condition, so it is very important to understand the type of strategic environment to be dealt with it.
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Abstract
Rayleigh distribution is one of the important distributions used for analysis life time data, and has applications in reliability study and physical interpretations. This paper introduces four different methods to estimate the scale parameter, and also estimate reliability function; these methods are Maximum Likelihood, and Bayes and Modified Bayes, and Minimax estimator under squared error loss function, for the scale and reliability function of the generalized Rayleigh distribution are obtained. The comparison is done through simulation procedure, t
... Show MoreThis narrative review focused on research investigating the impact of loneliness on the prevalence of dementia and its relationship with other risk factors. A comprehensive and rigorous search was conducted using a variety of scientific databases with specific keywords to identify all prior studies that examined the correlation between dementia and loneliness. The inquiry was confined to articles published in English from January 2017 to March 2024. The narrative review identified a consensus regarding the role of loneliness in enhancing the risk of all‐cause dementia, with a particular emphasis on the subjective perception of loneliness. This phenomenon may be caused by the sensations of exclusion, discrimination, and alienation that are
... Show MoreAbstract Introduction: Aphthous stomatitis is a recurring oral ulceration condition that affects a significant proportion of the population. While several factors have been proposed to contribute to its occurrence, the link between caffeine consumption, anxiety levels, and the development of aphthous stomatitis remains unknown. This survey-based study aimed to understand the association between coffee, anxiety, and the development of aphthous stomatitis in this specific demographic, which can provide useful insights for medical management as well as preventive strategies. Material and methods: A structured online questionnaire was distributed via various social media platforms targeting a sample of the Armenian population. The quest
... Show MoreThe nature of the political system of any country in the international system must have an impact on the policy of the State, whether in the interior or exterior, both regional and international, Turkey is one of the most important countries in the Middle East, which have a place and effectiveness on the surrounding environment, hence the importance of research lies in its political system and the transfer of power in it and its transformation from the form of the parliamentary system to the presidential system of the repercussions of the task and mutual effects between Turkey and the countries of the surrounding region in terms of the extent of achieving political stability in the Turkish interior or not and how this can be refl
... Show MorePurpose: In view of the trend toward using international financial reporting standards when generating financial statements, we looked at the interaction between audit services and non-audit services for auditors in the context of actuarial services for insurance firms. CPAs are authorized to work in banks and insurance businesses, but those with a practicing license obtained after earning a higher academic degree are not. Design/methodology/approach: A small number of auditing firms control the decisions issued by the Iraqi Accountants Association, monopolizing audit services in banks and insurance businesses. In the case of actuarial services used in reserve estimation, they are credited to an external party's account withou
... Show MoreThe "Corona" pandemic that strikes the world has cast a shadow over contractual obligations, whether between individuals or companies, and emergency accidents and force majeure circumstances have a direct impact on them. Here, the legislation intervenes and sets the legal mechanisms to restore the obligations to their equal status and achieve the economic balance of the contract. Health crises are among the material facts whose effects are reflected and their features can be monitored on legal relations in general and contractual relations in particular, including the extent of the impact that this pandemic can have on the obligations that arise within the framework of a contractual relationship, which can be talked about in my theory Force
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