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.
Expectation in poetry is the ability of the poet to exceed the existence of the universe . It is the revealing of the hidden and the familiar. This feature of expecting is not related to the modern poetry only . It is a well - known feature that has long been assigned to old poetry like Al-Mutannabi an Al-Mu`arri who had their own unique ways of expecting and going beyond the current time and touching the future and making it a reality. Based on their awareness ,mature thinking and talent , they had the ability of reading what is to come ,even if they were mere suppositions and tentative readings. As for the modern poetry , we have poets like Amal Dunqil , Adonis ,and Al-Sayyab whose poems became expectati
... Show MoreTax revenues are considered one of the important sources of public revenues for the state as one of the tributaries that finance the public treasury to implement development plans. Real estate taxes are one of the sources of obtaining tax revenues in the state, as it follows that there are a number of factors that affect these revenues, which requires the development of necessary solutions and recommendations to address the resulting effects. Accordingly, this research sheds light on tax revenues in general and real estate tax revenues in particular to indicate the extent of their contribution to the total tax proceeds, as the tax proceeds of the real estate tax were analyzed into the total tax proceeds for the years (2017-2021). A numbe
... Show MoreThe Arab literature in Andalusia was distinguished by its special nature, in addition to the distinction of its influencing rhythm in our souls, it represents the natural extension of the Arab-Islamic civilization in Morocco, that civilization that collapsed with insecurity and stability and the exit of Muslim Arabs from those countries and the defeat of Muslims, their civilization has ceased, and only remains of them witnessing For its leaders in a safe and stable life, but literature in Andalusia underwent many experiences that express the lives of Arab Muslims there, especially what distinguished the Andalusian Muslims from their many battles and conquests, but they did not suffer as their support during the fall of Andalusia and the
... Show MoreThe operation of production planning is a difficult operation and it's required High effect and large time especially it is dynamic activity which it's basic variables change in continuous with the time, for this reason it needs using one of the operation research manner (Dynamic programming) which has a force in the decision making process in the planning and control on the production and its direct affect on the cost of production operation and control on the inventory.
Play a movie role now is very dangerous on a large scale, in the transfer of data in a language of thought and life -strong common understanding , tools and more permeable and effectiveness in the formation of thought and conscience of recipients. Which is an instrument of culture and knowledge , and a means of effective educational tools that aim to improve the community , also plays a prominent role in shaping society's values , and customs , and the arts , as well as used as a means of guiding , counseling and cultural enlightenment , cinema and TV gives the viewer the ability to move from one place to another by the watch and compare it to what it is , which raises the desire to improve the level , where nearly movie scenes in variou
... Show MoreLeaching scheduling techniques are one of the suggested solutions for water scarcity problems .The aim of the study is to show the possibility of using leaching scheduling, when applying the irrigation scheduling program for a certain irrigation project, which was prepare by Water Resources Engineering –University of Baghdad with some modifications to generalized it and it make applicable to various climatic zone and different soil types.
The objectives of this research is to build a system that concerns the prediction of the leaching scheduling (depth and date of leaching water), illustrating the main problems (soil salinity, save the amount of leaching requirement, and to maintain crops growth).The other objective is to compare be
The research deals with the important and modern two subject (career path and the type of training program), and tries to find identify the extent of the impact of the requirements of a career path in determining the type of training program in the Ministry of Oil.
In order to achieve the aim of the research was the formulation of the following hypothesis: the impact of the requirements of the career path a meaningful moral influence in determining the type of training program.
The survey was adopted in the search, and sample consisted of (75) people were a factor in the Oil Ministry of People's managers and officials and staff, and used the questionnaire as an es
... Show MorePraise be to God, Lord of the worlds, and prayers and peace be upon the best of the messengers, Muhammad, and all his family and companions. And after:
For when I had the pleasure of looking at the chapters of the Noble Qur’an, and its evident signs, my view fell on one of its brightest verses, and it is the Almighty saying: ﭽﯜ ﯝ ﯞ ﯟ ﯠ ﯡ ﯢ ﯣ ﯤ ﯥ ﯦ ﯧ ﯨﭼ (). The tag: (God’s Greatness in Creating a Hoopoe). The research methodology required that I divide it into four sections:
The first topic: an overview of birds.
The second topic: the characteristics and characteristics of hoopoe.
The third topic: the logic of the bird.
The fourth topic: Praise the bird.
This has relied in my research on
The accounting system of government is considered an important tool to follow up the financial transactions that reflect the activities of governmental units and by which the useful information for estimating governmental annual revenues and expenditures are provided through the state public budget because it is an information system that provides detailed past performance, as well as measures the efficiency of the governmental agencies performance in implementing the budget, and the of success governmental units is measured through the type of services and programs offered, their size and the possibility of achieving the objectives assigned to them. The medical evacuation program is one of the medical and curative health services provid
... Show MoreThe city suffers from the weakness of the civil defense to provide services where there are clusters of residential Guy covered services for that requires the study of the geographic distribution of the civil defense centers in Baghdad care great because they take care of Protect the population and their own property and protect state institutions. Through a review of the problems faced it is expected that this study will help decision-makers to take appropriate steps to develop this service core