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 educational service one of activities which have great effect in the city life and it's community which considered as an affective instrument for the social and civilized construction and its role in the development of culture and determining the general features of the society. Therefore planning for educational service is considered as a necessary for economical, social and cultural conditions in the Arab community lives in general and the Iraqi community in special. The educational service buildings and distribution forms an insurmountable obstacle in the urban areas. So the balance distribution in Baghdad presents an indication to ensure the equality of educational opportunities besides the correlation of these institutes with th
... Show MoreEffective decision-making process is the basis for successfully solving any engineering problem. Many decisions taken in the construction projects differ in their nature due to the complex nature of the construction projects. One of the most crucial decisions that might result in numerous issues over the course of a construction project is the selection of the contractor. This study aims to use the ordinal priority approach (OPA) for the contractor selection process in the construction industry. The proposed model involves two computer programs; the first of these will be used to evaluate the decision-makers/experts in the construction projects, while the second will be used to formul
مدة تولي رئاسة السلطة في الفكر السياسي الاسلامي المعاصر
Current research strives to achieve the following aims:
- Develop a scale for dominant values of Tikrit university students.
- Measuring the dominant of Tikrit university students.
- Identifying the significant differences among dominant values of Tikrit university students according to(sex, specialty, time).
- Measuring the dominant values of each one of the six fields of the scale.
- Identifying the differences in dominant values of each field according to the sex variables.
The current research has limi
... Show MoreThe paper presents the results of precise of the calculations of the diffusion of slow electrons in ionospheric gases, such as, (Argon – Hydrogen mixture, pure Nitrogen and Argon – Helium – Nitrogen) in the presence of a uniform electric field and temperature 300 Kelvin. Such calculations lead to the value Townsend's energy coefficient (KT) as a function of E/P (electric field strength/gas pressure), electric field (E), electric drift velocity (Vd), momentum transfer collision frequency ( ), energy exchange collision frequency ( ) and characteristic energy (D/?). The following physical quantities are deduced as function s E/P: mean free path of the electrons at unit pressure, mean energy lost by an electron per collision, mean velocit
... Show MoreWrong behavioral deviations among youth witnessed an obvious growing, some of these deviations are, robbery, drug and internet addiction, and smoking. Additionally, intellectual extremism and the disrespect of the traditions and genuine customs, In light of this issue, the research aims to shed light on the educational and preventative role of the woman in protecting and immunizing children from the wrong behavioral deviations. The woman has a significant and influential role in the society in general and in her family, in particular to the responsibility lies on her. The research shed light on the manifestations of behavioral deviation in children and the mechanisms of prevention and treatment. The research concluded with a set of recom
... Show MoreThis research sheds light on the physical environment role in creating the place attachment, by discussing one of the important factors in the attachment creation, it is the concept place dependence, consisting of two important dimensions: the place quality and the place expectation; they contain a number of the supporter physical environment sub-indicators for place attachment. Eight physical indicators were reached; they were found to have a close relationship to the place attachment, including: the open and green spaces existence, land use diversity, diversity of housing types, dwelling / population density, accessibility, transport network development degree, transport multiple mo
El estudio se clasifica dentro los estudios teóricos sobre literatura que se ocupa del estudio de los métodos de la crítica literaria: El Estructralismo literario francés y el Formalismo ruso del siglo XX que se utilizan en la interpretación literaría. Las dos corrientes literarias estudian la literatura como ciencia que busca aplicar un método científico al estudio de la literatura. Dicho estudio trata de exponer las teorías críticas que surgen en el debate de la interpretación de los textos literarios como el de Susan Sontag, Ricoeur Paul y Mijail Bajitin, etc. Además se incluye algunos ejemplos implican el análisis estructuralista y formalista como Kafka y la tragedia Judía. y Sur Racine.
ABSTRACT:
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