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.
This study examines the syntactic and semantic functions of the conscience of the chapter and the grammatical disagreement in its diagnosis between two famous linguists: Sibuyh and fur. Also, the conscience of the chapter occupies an important synthetic space in the construction of the Arabic sentence, identified by the Arab scientists, as linguistic analysts, have a strong sense of language and careful observation, they revealed it in their linguistic composition through the analysis of nominal structures, and found that it I come in specific syntactic patterns and grammatical templates that have certain characteristics that are unique to them because of the conscience of separation in their compositional space.
The entrance process re-engineering one of the main entrances of administrative and technology appropriate to keep pace with scientific progress and the continuing changes in business environment and for the purpose of achieving the goal sought by the organizations in the pursuit of rapid developments and renewable energy in the market competition by changing its operations and activities of the radical change which contributes to an effective contribution to reducing the cost of product or service taking into account the quality improvement in the management of change to keep the increase value and speed of placing on the market to meet customer needs and desires to achieve a
... Show MoreIn this paper, customers’ expectations are continually shifting due to the business environment’s growing competition and substantial changes. As a result, organisations no longer viewed it as a static objective but as an ever-evolving aim. From this vantage point, the research has explored the accounting literature in search of novel approaches to addressing the strategic dimensions of quality, cost and time. Getting them to respond positively to the customer’s requests also requires recognising their needs and controlling their impact on these dimensions. With the removal of operations that do not contribute any value to the product’s value chain and a reduction in manufacturing costs through continuous improvement, the ou
... Show MoreIs 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
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This study aimed to survey fungi associated with the product Indomie and Chips being the trades Iargely by a very important segment of society who are the children, beside consumed by adults, but less so, as the survey results to accompany some fungui samples sterile showed proportions presence included various fungi like. Aspergillus flavus, Aspergillus niger, Penicillium Spp., Fusarium graminearum, F.moniliforme, Alternaria alternate and Rhizopus Spp., and other fungi sterile are not diagnosed. The results showed large dominion fungi A. niger by presence sterile samples of both producers, followed by infection in Fusarium Spp., Penicillium Spp., and A. alternata by infection percentage 55, 20 and 17% respectively for the pr
Plasma alkaline phosphatase isozyme in Iraqi fowl was studied by acrylamide gel electrophoresis. Two phenotypes fast and slow, were observed. These two phenotypes have been shown to be controlled by one single autosomal locus with two allel AKPF and AKPS. The gene frequency of AKPS is dominant over the AKPF. The result indicated that gene frequency of AKPF in leghorn and new hamshire was more frequent than in local Iraqi birds. Birds of fast isozyme type had higher 90 – day's egg production and egg weights as compared to those with slow isozyme. It is concluded that the fast isozyme can be used as gene marker for spotting out pullets with high body weight sexual maturity, high egg production and high egg weight.
Current Thesis has aimed to identify : The Psychological barriers for university students , Differences in psychological barriers depending on the variable sex (Males – Females) , Adjustment to College life for university students, Differences in Adjustment to College at university life depending on the variable sex (Males – Females), and finally, The correlation between psychological barriers and Adjustment to College life. The researcher has prepared a sample consisted of (100) male and female students who were randomly selected from university students, The researcher has adopted a measure of (2002) to measure the psychological barriers, also the researcher adjustment scale with university life.
The results showed that universi
This paper deals with numerical study of the flow of stable and fluid Allamstqr Aniotina in an area surrounded by a right-angled triangle has touched particularly valuable secondary flow cross section resulting from the pressure gradient In the first case was analyzed stable flow where he found that the equations of motion that describe the movement of the fluid
It is recognized that organisms live and interact in groups, exposing them to various elements like disease, fear, hunting cooperation, and others. As a result, in this paper, we adopted the construction of a mathematical model that describes the interaction of the prey with the predator when there is an infectious disease, as well as the predator community's characteristic of cooperation in hunting, which generates great fear in the prey community. Furthermore, the presence of an incubation period for the disease provides a delay in disease transmission from diseased predators to healthy predators. This research aims to examine the proposed mathematical model's solution behavior to better understand these elements' impact on an eco-epidemi
... Show MoreBackground: Cigarette smoking (CS) is a periodontal disease risk factor, affecting clinical parameters such as bleeding on probing (BOP), plaque index (PI), gingival index (GI) and proinflammatory cytokines level. This study examines the impact electronic cigarette use on proinflammatory cytokines and periodontal parameters. Methods: In this non-randomized study, ninety participants diagnosed with gingivitis were assigned into three groups. examined the effect of oral hygiene instructions on periodontal parameters and inflammatory biomarkers. Thirty CS (n=30) vaping electronic-cigarettes (e-cig) (n=29), and non-smoker (NS) (n=31) was included. Clinical parameters including PI, BOP, and GI were recorded at baseline and after 3 weeks
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