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 theatrical image represents one of the tools of communication with the other to create a communicative language that is produced and transmitted by the actor and his body through the theatrical space to convey the meaning in all its forms and types. The actor is concerned with the composition and construction of these images. My girl, the image is fragmented and multiple and different. Therefore, based on the foregoing, the researcher has divided his research into four chapters, representing the (methodological framework). First, the research problem, which is manifested in the following question (what is the structure of the fragmented image of the actor's performance? The Iraqi playwright), and secondly: the importance of the resea
... Show MoreIn the cuurent article, the photophysical properties of 3,6-bis(5-bromothiophen-2-yl)-2,5-bis(2-ethylhexyl)-2,5-dihydropyrrolo[3,4-c]pyrrole-1,4-dione were investigated. The visible absorption bands at 527, 558 and 362 nm in propylene carbonate and the compound was found to be fluorescent in solution and in the plastic film with emission wavelengths between 550- 750 nm. The Stokes Shift of P.C., acetonitrile, diethyl ether, Tetrahydrofuran THF, cyclohexane, dibutyl ether, and dichloromethane DCM are 734, 836, 668, 601, 601, 719, and 804 cm-1 in respectively. The Stokes Shift Δ was less in THF and cyclohexane, than the solvents, which indicates that the energy loss is less between the excitation and fluorescence states. The
... Show MoreCentral and Eastern European Online Library - CEE journals, documents, articles, periodicals, books available online for download, Zeitschrfitendatenbank, Online Zeitschriften, Online Zeitschriftendatenbank
Aim: The purpose of this study is to compare the effect of epineurotomy of median nerve with just division of the transverse carpal ligament in the treatment of carpal tunnel syndrome. Patients & Methods: We conducted a prospective, random study to evaluate the effect of epineurotomy on the outcome of operative treatment of established median-nerve compression in the carpal canal. Fifty hands (forty-four patients) were selected randomly into two groups: group I had a release of the transverse carpal ligament alone, and group II had a release and adjuvant epineurotomy of the median nerve. The groups were similar with regard to age group, gender, duration of symptoms, and preoperative physical findings. All patients had electrophysiological e
... Show MoreOf non-Muslim minorities In the Muslim community
Means the current research study in the direction iconic structures plates Ottoman calligraphers , as they took turn in this area and because it excelled in the form of a strong incentive and motivation to seek calligraphers in this direction so as to simulate the skill of the artist and parallel to the side of his creativity as well.And iconography , RECEIVED of objective vision and aesthetic and semantic in the output of compositions written according to the specific significance and this has a clear impact on the propensity to develop technical and aesthetic and expressive in the output of the structure of synthetic iconography is limited by rules or building in the form of public panel linear . And that all forms , whether animal , h
... Show MorePraise be to God, and may blessings and peace be upon the Messenger of God, his family and companions, and from his family and after ...
It is the right of every nation to be proud of its heritage, science and civilization among the nations, taking pride in the efforts of its construction and the keenness of its scholars and dedication to serve their nation and their history, and from the great sciences that boast and honor our great nation and distinguish it over others the science of attribution and the preservation of the novel over generations and ages. The novel is preserved from the plagiarism of the nullified, the excess of the deceitful and the liars, and the science of isnad from religion as the scholars said, and without the
<p>There is an Increasing demand for the education in the field of E-learning specially the higher education, and to keep contiuity between the user and the course director in any place and time. This research presents a proposed and simulation multimedia network design for distance learning utilizing ATM technique. The propsed framework determines the principle of ATM technology and shows how multimedia can be integrated within E- learning conteext. The first part of this research presents a theoretical design for the Electricity Department, university of technology. The purpose is to illustrate the usage of the ATM and Multimedia in distance learning process. In addition, this research composes two entities: Software entity
... Show MoreReceipt date:10/8/2019 acceptance date:18/12/2019 Publication date:31/12/2021
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This research is concerned with the concept of identity in general "Overall definition" and is not exposed to the classifications of identity or concepts that deal with their types and classifications, only the concept in terms of the initial picture as well as the views of thinkers on the proof of
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