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
Social media has thrived recently and public organizations at Thi-Qar governorate across different levels are experimenting with launching government social media (GSM) to facilitating two-way interactions between the government and its citizens. Both scholars and practitioners are focusing on understanding the key success factors related to the create of GSM. This study aimed to identify the key success factors by exploring the formation mechanism of individuals’ continuous usage intention. Through the theoretical perspective of the uses and gratifications theory. We identify the gratification factors that stimulate users’ continuance intention toward GSM. Furthermore, we draw upon the stimulus–organism–
... Show MoreIn this paper, the penetration of the stone column was investigated in order to get the minimum length of the stone column above which the increase in length has little advantage. The effect of using different materials in column are also studied. The material used is granular of different angle of internal friction (). The results of the investigation indicated that the effect of stone column remains constant when the ratio of the thickness of the soft clay layer to the stone column’s diameter is more than 15. The results also indicated that a pronounced effect is obtained when the angle of internal friction of the stone column material is increased.
This research studied the effect of magnetized water in concrete preparation and its effect on the presenting of cement in concrete mixtures also to find the ability of reducing the amount of cement in preparing one cubic meter, this is not exceed than 10% in one mixture , The experiments showed the preparation of standard cubes from the concrete which was used two kind of water magnetized water which was prepared by passing the tap water through the systems of different magnetic strength in terms of (6000,9000) Gauss and the ordinary water . The velocity of water through the magnetic field, which gives us the highest value for the compressive strength, was up to 1m/sec. to determine the best magnetic intensity, we examined The comp
... Show MoreObjective: preparing educational units for the magnet poles strategy in learning the spiking skill in volleyball, and identifying the effect of the magnet poles strategy in learning the spiking skill in volleyball for female students.Research methodology: The experimental design with two equal experimental and control groups with tight control was also adopted in the pre- and post-tests. The boundaries of this research community are represented by fourth-grade middle school students at Basra Girls' Middle School (2024-2025), whose total number is (90) students, distributed by nature into 4 sections. Sections (A-B) were determined by lottery, so that Section (A) represents the experimental group and Section (B) represents the control
... Show Morerunning the requirement color important place in object of life activity both public and private, Fallon makes represents energy expressive and aesthetic in designing furniture street, especially (positions waiting buses passenger transport)which took looms large in attention receiver designer also, through civilized development and urban and change the city. Requirement, The positions of waiting progress jobs service and that would interact to produces Photos aesthetic Furniture for space street and understand receiver, affect the operation his life and the development of his environment and his psyche and culture of because they entity variable and sophisticated, impose on us to find foundations a design and conditions of chromatic esp
... Show MoreThe mark at the Children's Theater did not receive as much attention as in the adult theater, despite the great attention given to its visual system, but some of the directors of the Children's Theater approached the application of the same system of marking in the adult theater, without limiting a certain mechanism that identifies the mechanisms of mark operation and the modalities of its transformation in the visual display system, which called on the researcher to shed light in this study on the scientific shift in the visual display system and its functions in the children's theater. The researcher formulated a title for his research (the mark transformation of the visual display system in the chi
... Show MoreThis research aims to clarify the role of Iraqi nature in the style of the artist Ayath Al-Doori. Through it, the spotlight was shed on the aesthetic of Iraqi nature, its importance and its relationship to art, and its pioneering role in the style of the Doori artist. The research included two axes: the theoretical axis and the applied axis. The first theoretical axis deals with two topics: The first topic: the aesthetic of Iraqi nature as part of the life and methods of Iraqi artists from ancient times until today, including the periodic artist. The second topic: the league artist touched on the private life of the league artist. As for the second (applied) axis, it includes the research community, the research sample models, the resear
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This Paper aims to know the modern approaches of determining the Qiblah and its ruling in Islamic Faqah, as well as to find out the required in the identity of the Qiblah or the eye, and the care of the advanced Jurists in this matter, and to present some of their sayings on the issue. we have followed the Descriptive analytical method of the aspects of the jurists ’difference in what is required when facing the qiblah either the eye or aspect, the approach of several demands branched out from each topic, which were answered in the theoretical framework of the research, and the research concluded with the most important results: The need to receive the eye of the qiblah for the worshiper who is close to it and it is no
... Show MoreY Adnan, H Atiyah, IH Neamah…, International Development Planning Review, 2024
The current study aimed to identify the role of the theatrical technical supervisor in developing and enhancing the skills of middle school students in Baghdad. The sample consisted of 73% of the original community of theatrical technical supervisors, randomly selected from those working in the first, second, and third educational directorates in the Rassafa and Karkh areas. The sample size was 32 theatrical technical supervisors. The study used a questionnaire to collect data on three axes: the cognitive skills developed by the theatrical technical supervisor, the voice and speech skills developed by the supervisor, and the body movement skills developed by the supervisor. The results showed that the theatrical technical supervisor play
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