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.
حضيت القيادة باهتمام كبير من قبل الباحثين ودورها الإيجابي في التأثير على الموظفين ونجاح المنظمات، في الآونة الأخير بدأت الدراسات تركز على الجانب المظلم للقيادة وتأثيرها على التابعين وبيئة العمل، وقد تم تحديد القيادة السامة بأنها أخطر الأساليب القيادية التي تتسبب بتكاليف مادية ومعنوية على المنظمات بمختلف جوانبها، ان القيادة السامة تأثر على دوافع المرؤوسين وقدرتهم على انجاز المهام، ورغبتهم في الاستمرار في
... Show MoreThat researchers in the play Science Find a theatrical form of an experimental creative, and these experiences taken from the innovation space aesthetic dialogue with the receiver, especially since with previous theatrical experience and is an extension of her, because the interactive theater theatrical terms that assume a pattern do from the depth of the relationship between supply playwright and the audience, which alters the receiving skills actually change, and to monitor these differing divided into three classes that include research, methodological framework (Chapter I) and includes, research problem, the importance of research and the need to him, the goal of the research, the limits Find it border, and the theoretical framework
... Show MoreTo investigate the relationship between increased lipid peroxidation, and the lowering of both plasma total proteins and albumin in lead-exposed workers, and the effectiveness of antioxidants (vit. C and E) in modulating oxidative stress in those workers.
Thirty male and females workers employed in the Iraqi storage battery (age range 20-40 years) were participating in this study. Additionally, 11 healthy subjects were served as healthy controls, with the same age range compared to workers group, to avoid the effects of age variations on the studied parameters. Blood lead levels, erythrocytes and plasma MDA, erythrocytes and plasma GSH, total protein and albumin levels in healthy controls and lead-exposed workers pre- and post-tr
... Show MoreThe Sacrament of Marriage in the Christian Religion
في بداية الستينيات ظهرت شبكة الإنترنت لاستعمالها في أغراض غير تجارية ، ثم تطورت بشكل مذهل خلال السنوات الأخيرة، فبعد أن كانت مجرد شبكة صغيرة أصبحت الآن تضم ملايين المستخدمين حول العالم ، وتحولت من مجرد شبكة بحث أكاديمي إلى بيئة متكاملة للاستثمار والعمل والإنتاج والإعلام والحصول على المعلومات .
وفي بداية تأسيس الشبكة لم يكن ثمة اهتمام بمسائل الأمن بقدر ما كان الاهتمام ببنائها وتوسيع نش
... Show MoreEducation is the most powerful and important weapon in fighting poverty and unemployment because it provides students with new skills that appropriate the new market requirements and fair distribution of natural resources. It also transfers knowledge, skills, and ethics over generations. Education aims to create effective leaders who go under training and rehabilitation process, create a new human and instill faith, generate the creativity and innovation, and keep abreast with scientific process, updating curriculum, and finally, applying the technical education
The novel was generally distinguished from other literary arts in its connection with the living reality as an imaginative practice that relies on political, economic, social, intellectual and cultural references and as a crucial tool in reading cultural references and dive deep into reality. As every novelist has a vision to embody this reality. As every novelist has a vision to embody this reality. The novel of ("Exceeded border by Hammed Al-Kafa’i) is a considered a fertile field for presenting social issues in their apparent structure and revealing the cultural patterns behind them which lies in its deep structure. The novel here moves its characters in its imaginary world in a way that it becomes more capable of adaptation and crysta
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Balance is a psychological need and a requirement of importance as the individual seeks to maintain it. The research problem is summarized in the question: do students in the kindergarten department have a cognitive balance? The research aims to identify the cognitive balance of students in the kindergarten department and to identify if there are differences among students of the four stages according to the cognitive balance. The research community was limited to the students in the kindergarten department at the University of Baghdad / College of Education for Women and Al-Mustansiriya University / College of Basic Education and Iraqi University / College of Education for Women for the academic y
... Show MoreEmbedded advertisement constitutes a special kind of communication. As it performs many important roles such as giving information, highlighting the value of the product, and urging the target consumer to buy it by influencing his/ her behavior using an attractive manner of mind and conscience. Both cinema and television are the most prominent and powerful advertising media that enjoy the interest of all audiences and capture most of the advertising spending. As advertisers have paid attention to the importance of indirectly incorporating their products into content that the audience loves and is keen to follow, since the actual impact lies in the inclusion of the product within content that the audience appeals to. Hence, this leads to
... Show MorePersonification in Arab poetry is not confined to the abstract items in nature: it trespasses them to include more than that. We found after reviewing the anthologies of the poets tens of the personified items are full of human attributes - via personification- such as speaking, moving, feeling human feelings.. Personification formed a remarkable feature in the relationship between poets and war, which was clear in the Pre-Islamic poetry, because it occupied the minds of the ancient Arab mindset. The poets have envisioned war as ugly as a force that brings destruction and devastation. The paper aims at stating the position in which poets personified war with female tributes. Thus, it is impregnated, conceived, and produced birth like a w
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