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 MoreConstitute 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 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
... Show MoreAbstract:
Under the state scenario, fiscal policy will not be able to use the oil surpluses optimally and economically and society, as long as these surpluses are not directed by public expenditure towards new productive investments and by following the path of fiscal policy after one year 2003 and until 2013 we note that it is based on the method of spending (excessive) consumption, and did not take any action towards the budget deficit planned at the beginning of the fiscal year, and the actual surplus at the end of the fiscal year, which represents the highest expenditure in the budget, Salaries and wages of workers in various government agencies with the expansion of spending on the security side.&n
... Show MoreThe researcher of human history finds that the first social relations on earth were represented by the violence of Adam, peace be upon him, Cain and Abel. Violence has been a phenomenon of life and society. The history of history is full of all forms of violence and its forms. It speaks of cruelty, oppression and states. History began, in some of its chapters, written with the blood of the victims. It is a testimony to the cruelty of human beings. His human nature and his sin have played a major role that can not be overlooked in the development of important and fundamental developments in some historical turning points where violence was a necessity for life, and its launching change, renewal and reform, and major revolutions in human h
... Show MoreThe recent escalation in Southeast Asia showed that the region is on the verge of political and economic crises through the United States and its allies imposing economic sanctions against China, and a military escalation that may begin with China’s invasion of Taiwan, especially since two-thirds of the American forces in the world are located in the Taiwan Strait and the South China Sea.
The United States claims that it is ready to defend the island of Taiwan in the event of the start of Chinese military operations, but the reality shows that the United States supports Taiwan militarily by equipping it with modern weapons to defend itself. Supporting Taiwan economically by engaging it in trade agreements with US allies in the r
... Show MoreThis study seeks to uncover the aesthetics of the internal rhythm and its effectiveness in
enriching the poetic text with the music tone at represented in the art of repetition and the
permit and recycling division and put back on the chest and the naturalization interview and
counterpoint.
And try to stand on the impact of internal rhythm to highlight the meaning of spelling and
irony with poet Ibn Bassam Al-Bagdadi and have a close look at the literary and
psychological motivations that led the poet to employ these colors in his ridicule and the
extent of its contribution to intensify the poetic alphabetic flush.
And deepening the meanings and provide poetic text in different aesthetics, there is no doubt
tha
Abstract:
Most of the studies on this subject, small industrial projects, by researchers and scholars in the economic field show the great and increasing importance of doing this kind of projects, the extent of which can be determined by the contribution of these projects to indicators and macroeconomic and sectorial variables. So this research aims to show the extent of the economic contribution of projects in selected international experiences and in the Iraqi economy. As international experiences have provided the opportunity for the progress and growth of small projects in their economies, which led to an increase in the contribution of these projects in the recruitment of economically active manpower, in added
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