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.
Constitute 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 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
The 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 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 MoreResearch on geopolitical and geopolitical studies relates to a range of sciences that can be called auxiliary sciences, such as political science, international relations in particular, and history, but their focus is rarely on science and ethnography
That the issues and problems of the world today has become so large and complex that does not allow a specific field or knowledge to solve one of the need for the newly known knowledge integration (geopolitics and geopolitics) in particular to move towards cognitive integration to understand many of the problems and global issues that faced The importance of this study comes to clarify the relationship between Darwinism, geopolitics and geopolitics. The geopolitics in modern terms d
... Show MoreAbstract:
Humanitarian intervention has taken different forms included within the
peaceful and military means to stop the human suffering, whether caused by
natural disaster or humanitarian disasters.
Intervention can not be acquitted because it carries with it political cover,
but sometimes it may be legitimate cover for the occupation and the violation
of sovereignty. Therefore, the research worked to capture the legal and
political aspects of international law and the role of international organizations
to intervene and the right to use force.
The research concludes that international law had not been fairly
successful in controlling the behavior of some countries in the use of force,
and that there is
The evolution of thought, planning for Urban Communities in the second half of the twentieth century, through several successive stages. He was thought of planning urban communities depends on identifying the general plan for land uses of the project area as a basis for drawing charts the physical, social, economic, and put the general plan for land uses based on the terms of reference set by the number of experts in the ministries and agencies. I have lived cities in the Arab-Muslim region, during the transition period the natural and historic environment, urban, sophisticated balanced ways mentioned in the cultural, social, inspired by the teachings of Islam and the customs and traditions of the Arab social, put forth a set of
... Show MoreThe purpose of this paper is to gain a good understanding about wake region behind the car body due to the aerodynamic effect when the air flows over the road vehicle during its movement. The main goal of this study is to discuss the effect of the geometry on the wake region and the aerodynamic drag coefficient. Results will be achieved by using two different shapes, which are the fastback and the notchback. The study will be implemented by the Computational Fluid Dynamic (CFD) by using STAR-CCM+® software for the simulation. This study investigates the steady turbulent flow using k-epsilon turbulence model. The results obtained from the simulation show that the region of the air separation behind the vehicle
... Show MoreThe purpose of this study is to investigate the histopathological response of dentinopulpal
response of human teeth to the Er: YAG laser cavity preparation in comparison with the conventional
class I cavity preparation. Thirty five sound human upper and lower first premolar teeth which were
needed to be extracted for orthodontic purposes were used in the study. Regarding to the method of
cavity preparation, the teeth were grouped into three groups; Group1; Control group which consists of
seven sound teeth without cavity preparation, Group2; Conventional cavity preparation group and group
3; Er: YAG laser cavity preparation group. Each of Group2 and3 consists of fourteen teeth that is
subdivided into: A. 7teeth that e
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
... Show More