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 importance of the study stems from the fact that it deals with a very important subject, namely, the pivotal role played by E-banking in achieving the competitive advantage of the banking institutions operating in Algeria. By adopting the banking institution and adopting the elements of the electronic marketing mix and developing it as required by the environment The banking system of developments will inevitably be able to achieve excellence from its competitors as each of these elements have an important role in achieving competitive advantage, we relied in this study on studies and research that directly affect the problem of the study and we have put Estep In order to activate the contribution of e-banking in achieving competitiv
... Show MoreThis research mainly aims to analyze local development strategy in Baghdad Governance, build the Strategic Model based on the study area's spatial interaction, and achieve the Trinity of Excellence based on the global model of excellence.
This research applied SWOT strategic analysis for the strengths and weaknesses of the internal environment and opportunities and threats of the external environment for the provincial council. In conclusion, the research specifies appropriate alternatives and choosing the best in line with the reality of the Baghdad Provincial Council. Also, the strategic goals in the national plan and the spatial interaction of the development goals,
... Show MoreThe increase of the scenographic designer role on account of the character of the director in the Iraqi theater constituted a clear phenomenon that has been manifested in many shows, which necessitated a stance on the nature of this relation and delimiting the work space for each one of them inside the theater show. The research focuses on determining the work relation between the directorial vision and the scenographic proposal in the Iraq theater show. The research is divided into four chapters, the first one addressed the methodological framework, where the research problem was stated in the following question (has the scenographic designer been able through his scenographic proposal to remove the director from his position being the
... Show MoreImage of landsate-7 taken by thematic mapper was used and classified using supervised method. Results of supervised classification indicated presence of nine land cover classes. Salt-soils class shows the highest reflectance value while water bodies' class shows the lowest values. Also the results indicated that soil properties show different effects on reflectance. There was a high significant positive relation of carbonate, gypsum, electric conductivity and silt content, while there was a week positive relation with sand and negative relation with organic matter, water content, bulk density and cataion exchange capacity.
The research aims at identify the role of the electronic trading system used in the Iraq stock exchange to promote trading activity for the stocks of listed companies in this market.
To prove the hypothesis of research, it was selected the main trading indicators for the market to be a main field in test the research hypothesis.it was selected as the period of time for (9)years span between the years (2005-2013) because they represent the first two articles of equal time periods represent aperiod that preceded the introduction of electronic trading system while the second represents the period of time that followed
The research found a number of conclusions but the mo
... Show MoreThe efficiency of Nd:YAG laser radiation in removing debris and smear layer from prepared root
canal walls was studied. Fifty-seven human extracted single rooted anterior teeth were divided into three
groups. A group that was not lased is considered as a control group. The remaining teeth were exposed to
different laser parameters regarding laser energy, repetition rate and exposure time. For the case of the set of
parameters of 7 mJ laser energy, the cleaning was maximum at 3 p.p.s. repetition rate for 3 seconds exposure
time for, the coronal, middle and apical thirds. Above and below this energy level, there was an overdose
(melting) or under dose (no effect). Nevertheless for 10mJ laser energy case, the cleaning effi
We have provided in this research model multi assignment with fuzzy function goal has been to build programming model is correct Integer Programming fogging after removing the case from the objective function data and convert it to real data .Pascal triangular graded mean using Pascal way to the center of the triangular.
The data processing to get rid of the case fogging which is surrounded by using an Excel 2007 either model multi assignment has been used program LNDO to reach the optimal solution, which represents less than what can be from time to accomplish a number of tasks by the number of employees on the specific amount of the Internet, also included a search on some of the
... Show MoreStudied the effect of foliar fertilizers Alaongrin results showed that spraying fertilizer Alaongrin and Fertilizers and Ministry of Agriculture and rack licorice extract every three weeks after thirty days from planting seedlings
Background: Prolonged use of low-dose estrogen ''20 micrograms or less" Combined oral contraceptive pill (that have estrogen and progesterone steroid hormone) had an effect on bone turnover .Bone mineral density is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk. The aim of the study: The aim of this study was to investigate the effect of low dose oral contraceptive pill on the cortical thickness (in millimeter) and bone mineral density at the mandibular cortex of mental and gonial regions in Hounsfield unit(HU) using spiral computed tomography. Material and method: This prospective study was conducted on computed tomographic image of 100 women aged between (20-40) years .The collected sample includes
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