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.
Constitute the relationship between the director and actor mainstay chock done to show art in film and television , both of which occupy what a big role in the mission accomplishment . The leadership of the director of the artwork in various joints require two features two important ( creativity and administration ) , The capabilities director of creative serves as an added intellectual and aesthetic saturated sensation that leaves its impact on all the technical elements involved in done. Either trait administration and leadership it is what requires multiple skills in dealing on according to technical standards and moral and humanitarian allow the transfer of ideas , concepts and visions to those elements to embody and implement the ki
... Show MoreMedicinal plants are a source for a wide variety of natural active compounds and are used for the treatment of diseases throughout the world. Conocarpus erectus L. widely planted all over Iraq and has different secondary metabolites, which has been used in treatment of anemia, cancer, fever and diarrhea. The present study aims to estimate the antibacterial activity of Conocarpus erectus leaves extracts on some microorganisms collected from patients with burn infection. The study began with the collection of Conocarpus erectus leaves in June 2018 from the trees in university of Baghdad. Maceration method was used to prepare aqueous extract, while Soxhelt apparatus was used to prepare methanolic extract. The results of phytochemical test show
... Show MoreObjectives: The present study aims at detecting the depression among nurses who provide care for infected patients with corona virus phenomenon and to find out relationships between the depression and their demographic characteristics of age, gender, marital status, type of family, education, and years of experience of nurses in heath institutions, infection by corona virus, and their participation in training courses.
Methodology: A descriptive study is established for a period from October 10th, 2020 to April 15th, 2021. The study is conducted on a purposive (non-probability) sample of (100) nurse who are providing care for patients with COVID-19 and they are selected from the isolation wards. The instrument of the study is develope
Is the subject of environmental analysis of the important issues that should occupy the attention of the departments of banks in general and banks in particular, the research sample, regardless of their size and the nature of its activity, So if the current era and witnessing rapid developments and changes, making the banking environment is more complex and interconnected than ever, And it became not possible for banks to be aware and understand the external environment variables without an analysis of the various constituent elements and influential heavily in its financial and administrative,Therefore research aims to find out the relationship between the external environment and banking facilities analysis application on the Rafidain
... Show MoreThe evolution of thought, planning for Urban Communities in the second half of the twentieth century, through several successive stages. He was thought of planning urban communities depends on identifying the general plan for land uses of the project area as a basis for drawing charts the physical, social, economic, and put the general plan for land uses based on the terms of reference set by the number of experts in the ministries and agencies. I have lived cities in the Arab-Muslim region, during the transition period the natural and historic environment, urban, sophisticated balanced ways mentioned in the cultural, social, inspired by the teachings of Islam and the customs and traditions of the Arab social, put forth a set of
... Show MoreCOVID-19 is a disease that has abnormal over 170 nations worldwide. The number of infected people (either sick or dead) has been growing at a worrying ratio in virtually all the affected countries. Forecasting procedures can be instructed so helping in scheming well plans and in captivating creative conclusions. These procedures measure the conditions of the previous thus allowing well forecasts around the state to arise in the future. These predictions strength helps to make contradiction of likely pressures and significances. Forecasting procedures production a very main character in elastic precise predictions. In this case study used two models in order to diagnose optimal approach by compared the outputs. This study was introduce
... Show MoreAbstract:
Humanitarian intervention has taken different forms included within the
peaceful and military means to stop the human suffering, whether caused by
natural disaster or humanitarian disasters.
Intervention can not be acquitted because it carries with it political cover,
but sometimes it may be legitimate cover for the occupation and the violation
of sovereignty. Therefore, the research worked to capture the legal and
political aspects of international law and the role of international organizations
to intervene and the right to use force.
The research concludes that international law had not been fairly
successful in controlling the behavior of some countries in the use of force,
and that there is
Research on geopolitical and geopolitical studies relates to a range of sciences that can be called auxiliary sciences, such as political science, international relations in particular, and history, but their focus is rarely on science and ethnography
That the issues and problems of the world today has become so large and complex that does not allow a specific field or knowledge to solve one of the need for the newly known knowledge integration (geopolitics and geopolitics) in particular to move towards cognitive integration to understand many of the problems and global issues that faced The importance of this study comes to clarify the relationship between Darwinism, geopolitics and geopolitics. The geopolitics in modern terms d
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