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.
This research shows the importance of Baghdad in the field of urban heritage and was demonstrated in the Ibn al-Fiqh al-Hamdani's book Baghdad the City of Peace in which he focused on many urban aspects and reviewing its historical importance by connecting them with modern events and the role they play in cultural and civilized construction which included: mosques, schools and markets etc. and the service providing institutions and other pillars of the Islamic cities through showing the development back then and its importance as an integral part of the urban and cultural heritage of the Islamic cities in general and Baghdad city in particular.
In his book Baghdad the City of Peace, Ibn al-Faqih Hamadhaani
... Show MoreImage of landsate-7 taken by thematic mapper was used and classified using supervised method. Results of supervised classification indicated presence of nine land cover classes. Salt-soils class shows the highest reflectance value while water bodies' class shows the lowest values. Also the results indicated that soil properties show different effects on reflectance. There was a high significant positive relation of carbonate, gypsum, electric conductivity and silt content, while there was a week positive relation with sand and negative relation with organic matter, water content, bulk density and cataion exchange capacity.
Abstract Background: Articular cartilage lesions in the knee joint are frequently seen,its treatment represents a challenge for orthopedic surgeons especially in young age patients and if left untreated,then they can progress to advanced osteoarthritis that may affect the functional status of the patients.Many treatment modalities had developed for these lesions, in the current study arthroscopic micro fracture plus intra articular whole bone marrow(WBM) injection was used as modality of treating these lesions. Objectives: to assess the effectiveness of arthroscopic micro fracture plus WBM intra articular injection as a treatment modality for knee articular cartilage lesions. Patients and Methods : a prospective experimental study was perf
... Show MoreScience occupies great importance in Islamic thought. Science and learning are considered an essential part of Islamic teachings, and this importance appears in several aspects,Among them is thatScience as a means of understanding religion :Science is a means of understanding the teachings of the Islamic religion. Islam encourages thinking and rational research to understand the Holy Quran and the Sunnah of the Prophet, enabling Muslims to direct their lives and actions in accordance with the directives of their religion,And also to encourageResearch :Islam encourages scientific research and the use of reason in understanding the nature of the universe and God’s signs in it. Muslims are encouraged to study the natural and social s
... Show MoreThe research aims to define the main and subsidiary criteria for evaluating the industrial market sectors and proposing a model for arranging these criteria according to priority and knowing the highest criteria in terms of relative importance in the General Company for Automobile Trade and Machinery, and for the purpose of establishing this model, experiences in the concerned company were approved, and this study proposes a multi-criteria decision model According to the FEAHP, the expanded fuzzy hierarchical analysis method enables the commercial company to develop clear strategic policies on which the company’s management system depends on determining criteria for evaluating and selecting market sectors and making appropriate
... Show MoreThe importance of the study stems from the fact that it deals with a very important subject, namely, the pivotal role played by E-banking in achieving the competitive advantage of the banking institutions operating in Algeria. By adopting the banking institution and adopting the elements of the electronic marketing mix and developing it as required by the environment The banking system of developments will inevitably be able to achieve excellence from its competitors as each of these elements have an important role in achieving competitive advantage, we relied in this study on studies and research that directly affect the problem of the study and we have put Estep In order to activate the contribution of e-banking in achieving competitiv
... Show MoreThe aim of the research is to identify the level of both organizational trust and decentralized performance of those in charge of managing local championships for the Iraqi Athletics Federation, and to identify the effect of organizational trust in decentralized performance from their point of view. The descriptive approach was based on the method of relational relations on a sample of those in charge of managing local championships for the Iraqi Federation In athletics, represented by each of (coaches, referees, members, president and members of the administrative body of the central federation, and the president of members of sub-federations) for the sports season (2020/2021) of 260 individuals, all of them were intentionally chosen by (1
... Show MoreThe issue of measurement of operational efficiency and productivity plays a major role in determining the weakness of the company, especially in relation to the productive processes, and thus starting to address these points and improve their performance. Hence the problem of research on how to determine the constraints in the production process, to identify weaknesses in the company. The research aims to clarify the role of throughput accounting in measuring the operational efficiency of the company in addition to clarify some of the constraints and causes behind them. The study concluded a set of conclusions, the most important of which is the availability of throughput accounting indicators that help in measuring operational efficienc
... Show MoreThe efficiency of Nd:YAG laser radiation in removing debris and smear layer from prepared root
canal walls was studied. Fifty-seven human extracted single rooted anterior teeth were divided into three
groups. A group that was not lased is considered as a control group. The remaining teeth were exposed to
different laser parameters regarding laser energy, repetition rate and exposure time. For the case of the set of
parameters of 7 mJ laser energy, the cleaning was maximum at 3 p.p.s. repetition rate for 3 seconds exposure
time for, the coronal, middle and apical thirds. Above and below this energy level, there was an overdose
(melting) or under dose (no effect). Nevertheless for 10mJ laser energy case, the cleaning effi
We have provided in this research model multi assignment with fuzzy function goal has been to build programming model is correct Integer Programming fogging after removing the case from the objective function data and convert it to real data .Pascal triangular graded mean using Pascal way to the center of the triangular.
The data processing to get rid of the case fogging which is surrounded by using an Excel 2007 either model multi assignment has been used program LNDO to reach the optimal solution, which represents less than what can be from time to accomplish a number of tasks by the number of employees on the specific amount of the Internet, also included a search on some of the
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