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.
Abstract : This research has tackled about the role of Russia in the international policies which concerning with energy , So the most important states in the world that possesses huge energy resources to be more able in the control over the reality and future production programs and the distribution of global energy alike , the latter had effectively influence on the economic and developmental aspects within many countries in the world and its impacts on political decisions and perhaps effected too much in the dimensions of strategic policies . In this context of research , Russia has been developed a high energy policy of strategic planning in order to restoring Russia position and its global role by using its potential powerful streng
... Show MoreThis study aims to determine the extent to which Palestinian elites use digital diplomacy to confront the Israeli narrative by exploring the motives for usage, patterns, essential digital diplomatic tools, and achieved satisfactions. The study adopted a survey methodology and employed a questionnaire distributed to a sample of 110 Palestinian political and media elites.
The study arrived at several key findings, including: Palestinian elites allocate a substantial (%67) of their efforts towards employing digital diplomacy as a response to the Israeli narrative. The foremost platforms employed for this purpose are Facebook and Twitter. The primary motivation for utilizing these digital platforms is to present
The research aims to build a training program to develop the willpower in the kindergarten children. In order to achieve the objective of the research, the two researchers have developed a Training Program according to the following steps:
- Determining the general objective of the Training Program.
- Determining the behavioral objectives of the Training Program.
- Determining the content of the Training Program.
- Implementing the content of the Training Program sessions.
- Evaluating the Training Program.
The training program consisted of (15) sessions, each session included a set of parts (title, general objective, methods, time and place to implement the sessions, behavioral goals, tool
... Show MoreThe slums one of the main problem plaguing the city of Baghdad in general and
the unity of municipality of New Baghdad, especially, where the characteristics of the study
area a prominent role in population growth and the emergence of slums where a private,
although the region suffer from the housing crisis is the lack of the number of housing units
compared to the number of families in which, With high land prices and the level of rent
which was accompanied by the absence of the law, which was followed by the year 2003, has
become the study area and one of the most municipalities of the city of Baghdad Contain
slums which took fills abandoned buildings and acquires vacant land agricultural ones and
allocated to d
The images and drawings reduce the intellectual, symbolic and cognitive dimensions inside them that make them an intermediary that imposes itself on the educational method, as they have become responsive to all the needs of the student in the modern era unlike the previous periods. The artistic direction of the illustrations in the scientific books meets the educational and pedagogical needs of the learner and their frame in an illustrative educational method that contributes in developing the student's abilities to benefit from the scientific curricula in the age of scientific and cognitive development.
Here, the researcher finds that the artistic direction of the illustrations lacks the achievement of scientific and technical p
... Show Moreeclaration has become today has an important and active and influential role in the recipient public life، and are concentrated advertising on the creativity component manufacture to attract his attention toward what to be announced from a variety products ، and is dominated by television commercials tempo and imagination، and display them a variety of ways catches the attention and an impressive simulates the their senses of hearing and sight ، to influence in the receiver and the public paid for purchase. Through it crystallization the subject of our research on the importance of creativity in television advertising and effective for attracting the attention of the public towards the receiver advertised products، and in
... Show MoreThis study aims to identify the concepts of financial crisis and its reasons of creation , also explain the effects of the accounting disclosure and the International Accounting Standards in current financial crisis, In addition to, indicate the role of accounting in the reform of the financial system from the impact of financial crisis.
The methodology of this study orientied to two main aspects, the first is an identifying approach through exploring the opinion of financial experts, the second aspect is based on an analytical approach to satisfy the requirements of experts to get there opi
... Show MoreAbstract
The current research aims to identify the level of organizational relaxation among the employees of educational directorates in the Sultanate of Oman. The descriptive approach was used, as well as a questionnaire of two parts to collect data. The questionnaire consists of (15) items divided into three themes about the relaxing level. It was applied on a sample of (406) male & female employees of the educational directorates who were randomly selected. The results of the study showed that the level of organizational relaxation was low. The study results also found that there were no statistically significant differences at the level of significance (α ≤ 0.05) of the study sample in the level of org
... Show MoreThe problems of modeling the signal and dispersion properties of a second order recursive section in the integer parameter space are considered. The formulation and solution of the section synthesis problem by selective and dispersive criteria using the methods of integer nonlinear mathematical programming are given. The availability of obtaining both positive and negative frequency dispersion of a signal in a recursive section, as well as the possibility of minimizing dispersion distortions in the system, is shown.