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
We investigate mathematical models of the Hepatitis B and C viruses in the study, considering vaccination effects into account. By utilising fractional and ordinary differential equations, we prove the existence of equilibrium and the well-posedness of the solution. We prove worldwide stability with respect to the fundamental reproduction number. Our numerical techniques highlight the biological relevance and highlight the effect of fractional derivatives on temporal behaviour. We illustrate the relationships among susceptible, immunised, and infected populations in our epidemiological model. Using comprehensive numerical simulations, we analyse the effects of fractional derivatives and highlight solution behaviours. Subsequent investigatio
... Show MoreEach sport has its own energy requirements that differ from the energy requirements of other sports, and a different method is used in each of them, so the trainer must first rely on the principle of privacy in training first, that is, privacy according to the working energy system, that is, he defines the controlling energy system In that event, and how the muscles use the available energy to perform according to the energy production systems. As we find the serving skill is the first volleyball skill with which the team starts the match in order to be able to gain points directly, through knowledge it turns out that there is a weakness in the skill performance, especially the skill of serving and being The key to victory for volle
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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
This study aims to test whether the institutions listed on the Iraq Stock Exchange have a significant correlation between the level of conservative accounting practice with the level of market share returns during the Coronavirus pandemic period as one of the policies to confront the economic repercussions of the Coronavirus pandemic. Furthermore, the sample included institutions listed on the Iraq Stock Exchange during the 2019 and 2020 years, i.e., the period before the Coronavirus pandemic and during the Coronavirus pandemic for the purpose of comparison. The market value to book value model was used, and the study found that conservative institutions had achieved the highest level of market share prices compared to non-conservat
... Show Moresome ecological (physical and chemical varible) of water samples were studies monthly from December 2008 to May 2009 at two stations( St.1) Al - Chibayesh marsh and (St.2) Abu – Zirik marsh which are located in the south of Iraq . These variables included : Temperature, pH, EC, Dissolved oxygen , Total alkalinity, Nitrate, Sulphate, and phosphate, Si-SiO2 and Ca ,Mg, Cl, The marsh Considered as fresh water and alkaline. Abu-Zirik less than Al-Chibayesh.