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 issue of the public in the directions and theories of the theater director in the world theater, especially after the emergence of realism and the crystallization of the term direction and the definition of the role of the director in 1850 AD by the Duke Max Mengen took different paths to the Greek, Roman and even Elizabethan audience because it was here subjected to the theatrical equation from its production and presentation due to the fact that the theatrical performance is a technical artistic production, and the audience participation, watching and consumption, and here the participation of the audience was subjected to three directions: the enlightenment in the sense of arousing sense, the incitement in the se
... Show MoreThe term ‘photometry’ refers to the accurate determination of the apparent brightness of an astronomical object. Until roughly 1980, nearly all astronomical photometry was done by means of analog measurements of photographic plates, or by analog or digital (photon-counting) techniques with photomultipliers. These photometers produced brightness readings which were typically displayed on dials, plotted on strip charts or printed on strips of paper, and it was often quite practical to analyse these raw data with pencil, paper and a slide rule or table of logarithms. However, during the late 1970s electronic area detectors for astronomy became more advanced: first, for a brief period, television-type cameras were employed, but these were s
... Show MoreThis paper includes the application of Queuing theory with of Particle swarm algorithm or is called (Intelligence swarm) to solve the problem of The queues and developed for General commission for taxes /branch Karkh center in the service stage of the Department of calculators composed of six employees , and it was chosen queuing model is a single-service channel M / M / 1 according to the nature of the circuit work mentioned above and it will be divided according to the letters system for each employee, and it was composed of data collection times (arrival time , service time, departure time)
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The objective of this research was to investigate the effect of replacing fat(shortening) with different percentages of tahena on the quality properties (physiochemical and sensory ) of shortened cake.The percentages of moisture,protein ,fat and ash of cake increased significantly(p<0.05) as the replacement was increased .The highest increase percentages were 10,48,5,and 90 %,respectivly, at 100% replacement .Carbohydrate,however,decreased by 10%at 100% replacement .these findings may indicate improvement of cake nutritional value.Standing height,as an indicator of cake volume, also increased significantly by 4% at the 50% replacement then it decreased by 4% 100% replacement level. Basic formula (control) has signific
... Show MoreThis study aimed to IQ test standardization of Marten Lother Johan which used with childreen of the one stage at primary schools who aged (6) years old in Baghdad (Resafaa and Kharh).
The importance of this study are :
1-The importance of childhood and its role to develop the personality.
2-The importance of this age as the child will exposure to different kind of official teaching .
3-The capability for early detection of special category for early intervention in order to provide the necessary care .
4-Using the current test could consider as a predictive tool to screen the intelligent children .
In order to achieve the study aim, the researcher had followed the follow
... Show MoreA comparison of double informative and non- informative priors assumed for the parameter of Rayleigh distribution is considered. Three different sets of double priors are included, for a single unknown parameter of Rayleigh distribution. We have assumed three double priors: the square root inverted gamma (SRIG) - the natural conjugate family of priors distribution, the square root inverted gamma – the non-informative distribution, and the natural conjugate family of priors - the non-informative distribution as double priors .The data is generating form three cases from Rayleigh distribution for different samples sizes (small, medium, and large). And Bayes estimators for the parameter is derived under a squared erro
... Show MoreThis study aimed to IQ test standardization of Marten Lother Johan which used with childreen of the tow stage at primary schools who aged (7) years old in Baghdad (Resafaa and Kharh).
The importance of this study are :
1-The importance of childhood and its role to develop the personality.
2-The importance of this age as the child will exposure to different kind of official teaching .
3-The capability for early detection of special category for early intervention in order to provide the necessary care .
4-Using the current test could consider as a predictive tool to screen the intelligent children .
In order to achieve the study aim, the researcher had followed the
... Show More