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.
Postmodern arguments, formed a critic case of what modernity brought in several levels. Postmodern practice was considered as a proactive case having amorphous concepts and features to what entiled as an intellectual trends postmodern philosophically and intellectually. But, what postmodernism architecture broughts in it essence, was not isolation from the intellectual context and entrepreneurship case, and it was not disconnecting from the intellectual and philosophical era of that period. Lliteratures and philosophical argument precede what (Robert Venturi) and (Charles A Jencks) had brought, albeit it was closer to critics and correction the path of modernity from crystallizing a direction that exceeds modrinity to wh
... Show MoreIn spite of the contemporary development over the world in pertaining of modernization and its differences about the transformation of the knowledge but, the important instrument to transfer the thoughts and information did not have change except the language. So the evolutionary process became as a torrent or fusillade above the cliff which drifted anything. So that the objective inquiry and impressed with varieties of development the casement to evaluate the linguistic or re - correction highlight article in order to preserve on the origins of the language and its sobriety.
Today, we have different correspondence and social media as
Extension of bandwidth for high reflectance zone for the spectral region (8-14pm) was studied adapting the concept of contiguous and overlapping high reflectance stacks. Computations was carried out using the modified characteristic matrix theory restricted to near-normal incidence of light on dielectric , homogenous and isotropic symmetrical stack. Certain precautions must be taken in the choice of stacks to avoid deep —reflectance minima from developing within the extended high reflectance region. Results illustrate that the techniques of extending the high reflectance regions are applicable not only to mirrors , but also to short-and long-edge filter and to narrow band pass filters.
The unemployment is considered from the most danger problems that our society face them in current time & in the near future , because it makes prodigality for element of human being , particularly age of youth who have ability to work & producing , that resulted in negative effects forecast to dire consequences social and economical dangers . In the same time as will be stated in our explanation in the following in our research , because the unemployment has ability to help to prepare good environment to grow crime , actions of violence that mostly are main cause to decrease living level of majority of citizens & in increasing numbers who became under poverty , the unemployment is economical problem as it is psycholo
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The prophet said that it anybody burdened any of the people or the book more than they could endure he would ben his opponent until the day of judgment.
-under the rightly guided caliphs the Christians had much freedom .this is shown by a letter attributed to ishu-yab III. The Nestorian catholics.
-The third caliph,Uthman favoured the Christians either because of the spcial skills or abilities which they possessed or through the imfluence of his Christian wife Na'ila.
-Under the early Umayyade,the christiansins the Isalamic umma had as much freedom as they had previously enjoyed under the best of their Christians governments because they restorted their churches and appointed many Christians to the
... Show MorePasses the Arab order moment political precision of disruption and discord and
differences of countless between its components and its parts because of the suffering he
endured and the suffering now from internal disturbances as a result of lack of cohesion
relations intra-and cultural, historical and lack of interaction between these components so
that became the focus of the policies and interests is an unprecedented degree , reduced with
the joint Arab action to the minimum, and began to focus on the interests of special
regulations.
This is with regard suffering internally, but externally the regime Arab Regional is absent the
biggest influence on international decisions because of the courtesies which were ca
The Islamic nation accuses these days of cruelty and extremism, and this is not strange. Every nation comes out
Including the hardline and the extremist, but the self-pity is that these charges have become
It went beyond the example and the mercy of the gift that the Almighty said (and you are to create great)
Al-Qalam: 4, and accusing him of not touching him in dealing with the people of the book and others, so try
It is our humble quest to urge our small speeches to clarify the position of Islam and its Prophet (peace and blessings of Allaah be upon him)
And deal with all human beings, and to show the low level of rights that our prophet has proved
Western laws are parts of his administration and adopted in the field
Aim: The Aim of the study is to compare between Er,Cr:YSGG 2780 nm laser and carbide fissure bur in root-end resection regarding the morphological variations, temperature changes and the duration of resection process.
Settings and Design: 5 W, 25 Hz, 50% water, 80% air,25.47 J/cm2 .
Material and method: twenty-one extracted single rooted teeth endodontically were treated, twenty teeth were obturated and divided into two groups according to method of resection. Group 1 root-end resected using cross cut carbide bur while group 2 root-end resected using laser with MGG6 sapphire tip of 600 μm diameter. Temperature on external root surface and duration of resection were recor
... Show MoreThe environmental surfaces hygiene of college premises like classrooms play role in spreading different pathogenic bacteria, furthermore a Medical students are often potential vectors for resistant bacteria to their entourage. This study aimed to assess bacterial contamination and their susceptibility to various antimicrobial agents in the educational classroom of Al-Kindy College of medicine in two classrooms: one occupied by clinical visitor and non-clinical visitor students to evaluate and determine its health risk. In this cross-sectional study, different sites of the educational classroom of Al-Kindy College of medicine were studied. Ninety-sex Different swab samples were collected from 8 different sites of college across bot
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