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.
A new class of biologically active nanocomposites and modified polymers based on poly (vinyl alcohol) (PVA) with some organic compounds [II, IV, V and VI] were synthesized using silver nanoparticles (Ag-NPs). All compounds were synthesized using nucleophilic substitution interactions and characterized by FTIR, DSC and TGA. The biological activity of the modified polymers was evaluated against: gram (+) (staphylococcus aureus) and gram (-): (Es cherichia coli bacteria). Antimicrobial films are developed based on modified poly (vinyl alcohol) MPVA and Ag-NPs nanoparticles. The nanocomposites and modified polymers showed better antibacterial activities against Escherichia coli (Gram negative) than against Staphyloc
... Show MoreThe inelastic C2 form factors and the charge density distribution (CDD) for 58,60,62Ni and 64,66,68Zn nuclei has been investigated by employing the Skyrme-Hartree-Fock method with (Sk35-Skzs*) parametrization. The inelastic C2 form factor is calculated by using the shape of Tassie and Bohr-Mottelson models with appropriate proton and neutron effective charges to account for the core-polarization effects contribution. The comparison of the predicted theoretical values was conducted with the available measured data for C2 and CDD form factors and showed very good agreement.
Abstract
The changes that happened in the environment of business have great effects upon organizations with different activities specially the banks which requires the existence of an able opinion resources can adapt with the changes . Accordingly importance put upon intellectual capital which become one of the basic resources for organizations and one of success and growth elements with the availability of expertise , skills and capability of making essential changes in different process due to the presentation of innovations and creations of the to support banks activities .Therefore the intellectual capital represents the more r
... Show MoreBackground: Avascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. AVN is associated with numerous conditions and usually involves the epiphysis of long bones, such as the femoral head. In clinical practice, AVN is most commonly encountered in the hip. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. Without treatment, the process is almost always progressive, leading to joint destruction within 5 years.Treatment of a vascular necrosis depends mainly on early diagnosis which mainly base
... Show MoreThe problem of the damage caused by terrorist acts has raised many difficulties in many countries, including Iraq, which requires the existence of a law that sets out sufficient rules for compensating the victims of terrorist acts, in order to compensate them for the harm they have not suffered. It may be difficult or impossible for them to identify causing damage, and therefore unable to obtain compensation by applying the traditional rules of liability that require proof of fault and identify the culprit. The security funds come as an appropriate alternative that pays compensation in such cases for victims to reparation for the damage they suffered. Therefore, this problem remains one of the most problems that Iraq suffers from it, which
... Show MoreThe study aims to identify the bargaining differences between the governmental and private kindergarteners; the rivalry differences between the governmental and private kindergarteners; the rivalry and bargaining differences among private kindergarteners; and the rivalry and bargaining differences among governmental kindergarteners. The researchers had raised a question; is there any difference of rivalry and bargaining between governmental and private kindergarteners?. A total of (150) kindergarteners ranged from 5 to 6 years old, (90) student from governmental kindergarten and (60) student from private kindergarten, were selected as a sample of this study. Fifteen governmental and private kindergarten were chosen from al-rasafa directo
... Show MoreThe new media scene reveals that the unprecedented overlap of a number of technical, economic, and political factors has made the new media a very complicated issue; and the focus of specialized and public debates about its impact on traditional means of communication and forms of social media and social relations. Then, the same scene discloses the reality of the relationship between the new and the traditional. These are the axes that will be will be discussed in this study.
Both religions have urged (honoring parents and kin) through the texts that came in their original sources, as honoring parents means showing respect to them In word and deed, and carrying in our hearts an appreciation for their status, and God commands to honor parents; Becausee this is Important in the eyes of God that he includeincludeed it in the Ten Commandmen.