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 research deals with the interchange of the sign transformed from the universal to the local in the theatrical show through the direction processing in the production of a communicative artistic discourse and message, thus making the process of reading the speech and recognizing it by taking into account the cultural differences, customs and local rituals of each country, region, or area. The problem of the research was focused on answering the following question: What are the requirements for the sign in terms of its transformation between the universality and locality in the read-out?
The importance of research is to determine the requiremen
... Show MoreIn front of the serious deterioration of the elements of the environment, new convictions arose the need to integrate into the global environmental concerns as being one and the issue of shared responsibility and the impact of this conviction, the evolution of the environment protection law in many countries, including Algeria. Due to the multiplicity of perceptions about the environmental result of multiple scientific disciplines, the legislative concept emerged to protect the environment, which includes prevention and rational management and conservation and restoration and repair.
Environmental planning for the various governments and countries aims to avert disasters and achieve the
... Show MoreThe research deals with an important issue that many people are working on, namely the sanctification of the texts on which the timings of the time and the different conditions of the place took place. Do not live up to the ranks of perfection and perfection, and every effort has explanations according to the mind machine, which is not protected by infallibility from error. The great downfall is to put these intellectual efforts in the Bible without separating them from the Word of God. The situation and the place on the adherents of a religion and mixed with the trick of the average individual only to be subject to the words of the teachers of Sharia and docility.
Decision-makers in each country work to define a list of internal and external interests, goals and threats to their countries according to the nature of their awareness of these interests, goals and threats.
Hence, Iraq is not an exception to this rule, and the process of evaluating its interests and the objectives of its foreign policy is subject to the pattern of awareness of decision-makers and the influencing forces in defining its basic interests, which often witness some kind of difference in defining them, evaluating their importance and determining the size of the threats they face. And among these interests and threats that have witnessed a difference in the assessment of their
... Show MoreAbstract The relative pronoun in Hebrew language is an important pronoun use anciently and recently, it developed and it's usage and meanings differed so, it was not confined to the particle "אֲשֶׁר" as a relative pronoun, but beside it appeared other pronouns giving the relative meaning. Hence, the topic of this research was on this basis through studying the relative pronouns in old and modern Hebrew, the way of using them and their connection with preposition particles, as well as studying the relative clause.
Background: A review of articles of method in treating compound phalangeal fractures by using mini-external fixator, elaborating the anatomy, mechanics, modalities of treatment, and complications of these types of fractures. Also, it compares between different studies regarding the functional results and final outcome. External fixation of phalangeal fractures is a good method for osteo synthesis in certain situations. The simplicity of the surgical procedure and the minimal disruption of the normal bone architecture also make it appealing. Objectives: Evaluating the functional results of the use of mini-external fixator for the treatment of compound fractures of phalangeal bones of the hand. Method: Our study consists of 15 patients, 12 we
... Show MoreBackground: A review of articles of method in treating compound phalangeal fractures by using mini-external fixator, elaborating the anatomy, mechanics, modalities of treatment, and complications of these types of fractures. Also, it compares between different studies regarding the functional results and final outcome. External fixation of phalangeal fractures is a good method for osteo synthesis in certain situations. The simplicity of the surgical procedure and the minimal disruption of the normal bone architecture also make it appealing.Objectives: Evaluating the functional results of the use of mini-external fixator for the treatment of compound fractures of phalangeal bones of the hand.Method: Our study consists of 15 patients, 12 w
... Show MoreBreast cancer is the most common malignancy affecting women's health, with an increasing incidence worldwide. This study aimed to measure the intracellular concentration of the hypoxia-inducible factor 1 α (HIF-1α), tumor suppression protein p53, and estradiol (E2) in tumor tissues of adult females with breast cancer and their relation to tumor grade, tumor size, and lymph node metastases (LNM). The study was conducted on 65 adult female participants with breast mass admitted to the operating theater in Al-Hussein Teaching Hospital and Al-Habboby Teaching Hospital in Nasiriyah, Iraq, from January to November 2021. Fresh breast tumor tissues were collated and homogenized for intracellular biochemical analysis using the enzyme-linked immuno
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