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 MoreDiscourse is a form of communication, and It carries with it an Intellectual framework, and It is a form of expression to communicate Ideas to people through an interactive process.The interest and analysis of discourse Is one of the most important fields of linguistic studies, and It has a basis In ancient studies, and It has become one of the most Important topics of the study, and (Sayyid al-Sadr) often uses guidance In his sermons.
By extrapolating and analyzing a set of examples received, from the perspective of the deliberative approach and the theory of speech acts, and the statement of the extent to whichh (Sayyid al-Sadr) relied on linguistic elements, and the use of the rank of the speaker In issuing directives, and the
... Show MoreBackground: Dietary intakes are critical during pregnancy, because inadequate amounts of key nutrients may compromise fetal development or maternal health. In addition to that maternal diet could be one of the methods to select the gender of the baby. The aim of the study is to correlate the level of the minerals in the mother’s blood with the gender and wellbeing of the baby after delivery.Patients and Methods: Fifty women were involved in this study with a mean age (23.92 ± 4.75), collected from the labor room during labor in the period between December 2013 and May 2014, in Baghdad teaching hospital. After taking a full history from the women, 10 ml of blood was withdrawn from them, 2ml in EDTA tubes for lead estimation and 8 ml in pl
... 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
Abstract
The Umayyad poets tried to invest all artistic tools in order to achieve a measure of creativity in their texts. The phenomenon of visual composition is breaking the familiar writing system, with the aim of increasing the number of possible connotations. The visual in the Umayyad poetry tries to replace it through expression with the visual image, and its manifestations were manifested by the multiplication of punctuation marks in the body of the poetic text and the tearing of the single poetic line by cutting it into several sentences or repetition.
Keywords: visual formation, poetic writing, Umayyad poetry, recipien
The subject of the listen to the voice of the customer of topics relatively new in management thought, as it won the attention of many organizations of different types, because it is important to achieve success and to continue and superiority to them, so there is a need to study this term in the Iraqi organizations and try to diagnose the implementation of the study sample to listen voice of the Customer and its
... 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 MoreWe need to know the basic facts concerning planning top and bottom limits including any critical levels or the threshold over which the cost would be much higher for land development. Therefore this paper concerned with Baghdad Municipality decision No.2/1004 dated 7/12/2004. The reason behind this decision is the hope to face up at least in the severe housing crisis in the city of Baghdad. This paper attempts to know the attitude of the local community in the general through a field study of people living near such dwelling where third floors are added of. This might indicate any positive or negative effects whether on short or long-term including its effect on the theoretical side including the population growth of Baghdad, the
... Show More