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 excellent specifications of electrodes coated with lead dioxide material make it of great importance in the industry. So it was suggested this study, which includes electrodeposition of lead dioxide on graphite substrate, knowing that the electrodeposition of lead dioxide on graphite studied earlier in different ways.
In this work the deposition process for lead dioxide conducted using electrolytic solution containing lead nitrate concentration 0.72 M with the addition of some other material to the solution, such as copper nitrate, nickel nitrate, sodium fluoride and cetyl trimethyl ammonium bromide, but only in very small concentrations. As for the operating conditions, the effect of change potential and temperature as well
... Show MoreValues are penetrating or interfering in the lives of individuals and groups and are connected to them in the sense of life itself, because they are closely linked to the motives of behavior, hopes and goals, and can be said that values are everything. The concept of values is one of the concepts that have received the attention of researchers from different disciplines. This has resulted in a kind of confusion and variation in use from one specialization to the other, and uses multiple uses within one specialization. Therefore, there is no uniform definition of values because they relate to individuals. Individuals differ in many things, such as perception,
... Show MoreThe main objective of the audit is The asset is maintained and operated efficiently and is done through to detect fraud and errors in the financial statements and to verify the accuracy and accuracy of the information contained therein and to give a neutral technical opinion on the basis of that, thus the auditor has a professional responsibility in achieving this goal, and that the effects of issuing a wrong opinion works on The loading of the beneficiaries is significant damage, And therefore the presence of any error or bias of the auditor when taking personal judgments in relation to the determination of the relative importance and the selection of audit samples and determine the adequacy and validity of evidence and implemen
... Show MoreThe artistic process operates whether in general in all arts or specifically in one type of arts or one of the genres of arts types on the preoccupations of the pressing artistic references as the founder of the artistic work in the material formulations on the one hand and on the other hand as a translator to understand the artistic achievement in general and plastic art in particular and for the importance The researcher chose the title of her research tagged (the preoccupations of the pressing reference and its impact on the formations of postmodern arts).
The first chapter of the methodological framework deals with the problem of research, importance, objective, limits, and then terminology and its definition, and then the secon
The theory of the psychologist’s Piaget states that man passes through four stages; other says that mankind passes through five. At each stage, human learn new characteristics, values, skills, and cultures from different environment that differ from one society to another. Therefore, the cultures of societies vary according to the diversity of the environments. These environments also vary depending on the circumstances surrounding them, e.g., in war environment, the individual learns what he does not learn from living in safe environment. As the environment changes, the communicative message also changes. This message is subject to person, groups, organizations and parties and directed to a diverse audience in its orientations and bel
... Show MoreThis research addresses the relevance of men and women and the consequent provisions
such as dowry and alimony ... Of the like, marriage is to organize links masculinity and
femininity any sexual meeting between men and women a special system that must be
produces reproduction him and alone, which gets its reproduction in human kind, and has no
family and on the basis of private life is being organized.
The importance of the topic see Islam has urged marriage and forbade celibacy, and ensure
that the Lord of Glory Almighty married subsidy nor the origin of the differences between
men and women in money or workmanship or blue-chip Every Muslim inept any Muslim and
every Muslim efficient for any Muslim.
The impor
The study aims to follow modern methods in teaching rhythmic gymnastics skills by directing learners to develop their perceptions and absorb what the world deals with today and develop intelligence among learners, the researchers searched for the strengths of the learner by providing them with an opportunity to form their kinetic formation, hence the problem came by introducing a method of self-intelligence and social to guide the learner in the search for ways and solutions to overcome boredom and economy Time and effort in the educational process in learning and give them the freedom to express their ideas And their skills and here came the role of social and self-intelligence to teach the individual and collective kinetic formati
... Show MoreThe emergence of mixed matrix membranes (MMMs) or nanocomposite membranes embedded with inorganic nanoparticles (NPs) has opened up a possibility for developing different polymeric membranes with improved physicochemical properties, mechanical properties and performance for resolving environmental and energy-effective water purification. This paper presents an overview of the effects of different hydrophilic nanomaterials, including mineral nanomaterials (e.g., silicon dioxide (SiO2) and zeolite), metals oxide (e.g., copper oxide (CuO), zirconium dioxide (ZrO2), zinc oxide (ZnO), antimony tin oxide (ATO), iron (III) oxide (Fe2O3) and tungsten oxide (WOX)), two-dimensional transition (e.g., MXene), metal–organic framework (MOFs), c
... Show MoreBackground: Carpal tunnel syndrome
(CTS) is the most common neuropathy of the
upper limb due to compression of the median
nerve at the wrist.
Objectives: to test the benefit of steroid
irrigation of the wound to alleviate the post
operative pain.
Methods: Forty patients had carpal tunnel
release were divided into two groups with and
without steroid irrigation.
Results: Forty patients 38 female and 2 male
with forty CTS had open surgical release were
studied for postoperative pain at the wrist area.
Group 1 (patients treated with surgery alone)
and group 2 (patients treated with surgery and
steroid).In group1, 11 patients (55%) had
persistent agonizing pain at the ulnar side of
the wrist