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.
In general, the importance of cluster analysis is that one can evaluate elements by clustering multiple homogeneous data; the main objective of this analysis is to collect the elements of a single, homogeneous group into different divisions, depending on many variables. This method of analysis is used to reduce data, generate hypotheses and test them, as well as predict and match models. The research aims to evaluate the fuzzy cluster analysis, which is a special case of cluster analysis, as well as to compare the two methods—classical and fuzzy cluster analysis. The research topic has been allocated to the government and private hospitals. The sampling for this research was comprised of 288 patients being treated in 10 hospitals. As t
... Show MoreThe Arabic calligraphy, in the early days of Islam, was used for the purpose of decorating the walls of mosques from inside and outside. Hence, this decorative art must be actively involved in enriching the designs of Islamic fabrics and costumes because it has a highly qualified and aesthetically pleasing look and expresses the originality of the Arab spirit. The research is divided into two section: the first section included the following topics: First "A historical overview of the art of decoration in Islamic Arab thought". Second "linear formations of decorative designs, and the subject of intellectual aesthetic taste of the art of decorating. This section tackles two subsections: first "the beauty of thought between the function an
... Show MoreWhat distinguishes the athlete in dealing with all stimuli is the ability to understand the cognitive rules through which he acts and directs behavior through thinking and regular planning methods in dealing with the environment in a realistic manner, and this comes through techniques and means based on modernity in obtaining information that makes the athlete arrange in His memory is the programs that are the most important crutch for relying on when he asks for them in applying and executing the skill assignment. One of the enhancers of awareness of variables is the ability of coaches to provide openness in modern ideas to find solutions, through which the player can sense and interpret events and produce outputs for quick and successful
... Show MoreBackground : Shoulder pain is a common problem that can pose difficult diagnostic and therapeutic challenges for the family physician It is the third most common musculoskeletal complaint in the general population, and account for 5% of all general practitioners musculoskeletal consults
Objective: To determine the diagnostic performance of ultrasonography compared with the physical examination for detection of rotator cuff tears in painful shoulder syndrome.
Method: Prospective study was done on seventy patients (48 male, 22 female), age ranged between 30-70 years (mean age 50 years), From February 2007 to July 2011, were subjected to comparative study in Al-Kindy teaching hospital with rotator cuff tears, including physical and ul
Filled the place thought philosophers and ancient is the identity that you know The value of belonging to a World Geography existential - the spiritual , and Which is characterized by the structure humanity from one another and the Rest of the organisms they interact with him alone by environmental Conditions - surrounding has to achieve time through continuous movement Localized or comprehensive . The place is exemplified by making special Natural Great Creator, I believe making structure humanity combined - Individual interactive because of its influential role in all daily consumer Productions and creative arts, specifically drama's TV , because the place in Aesthetic discourse - TV drama directly affect the creating and building the
... Show MoreThe research aims to presenting a number of scenarios for the investment of the marshes. The problem of research problem was that there is no in-depth analysis of the marshes environment. The traditional methods of the environmental analysis are insufficient. The research community is represented by the decision makers in Maysan Governorate. The research led to proposing of three scenarios with statement the requirements for the success of each one. The most important conclusions are that the three proposed scenarios for marshes investment depend on the availability of the required volunteers for each scenario. The higher the availability of the requirements, the more optimistic the scenario becomes. If t
... Show More(Use of models of game theory in determining the policies to maximize profits for the Pepsi Cola and Coca-Cola in the province of Baghdad)
Due to the importance of the theory of games especially theories of oligopoly in the study of the reality of competition among companies or governments and others the researcher linked theories of oligopoly to Econometrics to include all the policies used by companies after these theories were based on price and quantity only the researcher applied these theories to data taken from Pepsi Cola and Coca-Cola In Baghdad Steps of the solution where stated for the models proposed and solutions where found to be balance points is for the two companies according to the princi
... Show MoreThe objective of the research is to determine the nature of the strategic direction of the institution and its impact on enhancing the indicators of institutional performance. The strategic direction is the main purpose for which it was found. Therefore, it is the main engine for all activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. The promotion of corporate performance indicators is one of the major challenges that senior management must address in order to help the organization invest its human resources in the best possible way.
The research problem was determined by means of the intentional sample, consisting of (33) members
... Show MoreCyclophosphamide (CP) is a cytotoxic alkylating agent it's used associated with different side effects including lung toxicity. Vitamin B2 and vitamin B12 have lung-protective effects. This study was designed to evaluate lung-protective effects of both vitamins against lung toxicity induced by cyclophosphamide. seventy healthy adult albino male and female rats divided into seven groups each group containing ten rats were used in the present study and treated for seven days. On day eight rats were sacrificed and serum was obtained for glutathione and total antioxidant capacity measurement and lung extracted for immunohistochemical study; both vitamins significantly (P<0.05) increased glutathione and total antioxidant capacity in compar
... Show More