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.
The research aims to know the extent of the impact of the risks of foreign exchange centers represented in the risks of commitment, exchange rate changes and liquidity risks in audit procedures, and accordingly the research will provide an applied framework of knowledge that shows the relationship between the variables addressed, and the importance of the research lies in the light of its presentation of intellectual, cognitive and applied contributions On the risks of foreign exchange centers and audit procedures, the research community is represented in the banking sector. The sample included nine private commercial banks listed in the Iraqi Stock Exchange. The research relied on a time series consisting of four years that extended fro
... Show MoreIn light of the limited sources of funding suffered by the Iraqi economy, it highlights the importance of enhancing the efficiency of public expenditure, and if the measurement of the efficiency of public expenditure and identify benchmarks first step of promoting efficiency, the adoption of scientific methods of analysis imperative in promoting the efficiency. Under this framework, the focus was on the methodologies used to measure the efficiency of public spending and supply analysis with trying statement strengths and weaknesses, and make use of it in the measurement of the efficiency of public spending in the Iraqi economy. As well as devise measurable indicators take into account the specificity of the Iraqi economy and the
... Show MoreConcentrated research topic in the study of variables key to the work of offices of inspectors Amyin ، a (re- design function، and performance Organisational ) and took this message to know the nature of the relationship and the impact of the dimensions of the re- design function as a variable interpretative through its dimensions، is ( the diversity of skill، selecting the task ، the importance of task، autonomy، feedback )، and performance Organisational variable responsive through two dimensions are ( effectiveness ، efficiency )، and in order to test the research hypotheses were absorbed variables in the form of a questionnaire and were questionnaire primary means of gatheri
... Show Moreسلمان، ندى نجيب. 2015. التباين المكاني السكان الأميين في الوطن العربي للمدة 1990-2009. مجلة آداب ذي قار،مج. 4، ع. 15، ص ص. 101-126.
The duty of care is the essence of the error of negligence under the English legal system, and without it, responsibility for negligence cannot be judged, regardless of the extent of the damage incurred. contained in English law. In view of the importance of proving the existence of the duty of care on the defendant so that it is possible to judge his responsibility for negligence, the need arises to find a general principle to which the defendant is subject in order to decide whether he owes the plaintiff with the duty of care and therefore responsible for the negligence, and this is what we will explain in the research topic the study.
Receipt date:3/13/2021 accepted date:5/26/2021 Publication date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
energy is one of the strategic resources within international politics, and this is through the existing competition between the international powers on it, and the global powers have begun to rely on interest in new areas, such as import, depending on new projects an
... Show MoreThe present study aims at knowing the reasons of the student of secondary school abstention from participation in the theatrical activity, and to know the reasons that resulted in this abstention. In addition to that, the study aims at knowing the differences according to variables (gender, scholastic stage, and major of study). The sample of the study was chosen from the secondary schools in Baghdad in the random manner from Al-Karakh and Al-Rusafa districts of (147) students. The questionnaire was used to collected data.
The result showed that all the items are intense, the item of (Students do not know how to use their leisure time) obtained the hi
... Show MoreThe current research deals with the specificity of the interior design of the classes of art education in the schools of excellence for the province of Muthanna and its center of the city of Samawah. In the first chapter، the problem of research was determined by the lack of internal spaces of the classes of art education to designs that meet the requirements and needs of students in these educational stages. The importance of the research in being an addition to knowledge in the field of interior design and engineering department of the general directorates of the Ministry of Education. The objectives of the research were determined through.
- Identifying the reality of the halls of art education for sch
It is very necessary for the political theater to be within the space of every theatrical performance, so that the theater carries the diverse and enlightened values and cultures of this world. political theatre. In the first chapter, the researcher dealt with (the methodological framework), which includes the research problem identified by the researcher with the following question (the functional diversity of the directorial vision in the political theater)
Importance, purpose, limits and seal by defining terminology.
In the second chapter, the researcher dealt with the theoretical framework on two topics, the first (transformations of directorial vision in theatrical performance) and the second topic (aesthetic experiences i
Highlighting the role of the movement and its dramatic dimensions, as an artistic product, whether at the level of cinema or television in general, and the stages of its influence within the structure of the cinematographic scene in particular, had an effective role in the continuation of the structure of the event according to its dramatic and aesthetic process, and from this the research problem crystallized in the following question: What is How the kinetic diversity of the camera in the structure of the cinematographic scene is achieved to achieve the maximum possible benefit by extrapolating all opinions in line with the objectives of the research, the research presented and two topics and the introduction were divided, which
... Show More