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 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
Abstract
The research aims to identify the role played by the strategic mind of human resources managers in reducing the levels of strategic drift that can face the organization, as the problem of research to overlook the importance of this role in monitoring and follow-up all the changes that may face the organization during the implementation of its strategy, therefore highlights the importance Research in providing a set of solutions to the problems faced by the researched organization and as far as the research variables, the researchers have adopted the descriptive analytical approach in the applied side, as adopted the questionnaire as a main tool for data collection, which was prepared based on a number of ready me
... Show MoreThe form imposes its importance in the structure of the artwork through its indication of the type of relationship between the artist and his external world in all its aspects, as well as its manifestation of artistic and aesthetic values, and the multiplicity of experimental means of expression that include the artist's feelings and imagination. The form is also a recording of the events in their temporal and spatial circumstances, and in that it is of value in directing his artistic discourse with the aim of influencing the recipient with its connotations and emotional states. Horses in the drawings of Amer Al-Obaidi, and the research came within two frameworks: The first framework is the methodological framework that represents us t
... Show MoreThe problem of solid waste from domestic, industrial, commercial and medical sources is one of the most important problems facing the local administration in all Iraqi cities. The danger of this problem increases with the rapid increase in the population, changing lifestyles, consumption patterns, limited land suitable for landfill, and high costs of collection and disposal. This research aims to solve these problems by determining the locations of current landfills located in the outskirts of Baghdad Governorate. The ArcGIS program was used, where the sites of the landfills were determined on the map and through the available data about the areas. it was concluded that the existing landfill sites do not meet environmental conditions and
... Show MoreEndometriosis is an estrogen dependent inflammatory disorder plays a pivotal role in the reproductive system of the females which regarded as one of the most important gynecological disorders due to it is a key cause of infertility for women and also it has a remarkable impact on the women's life quality. Indeed, environmental pollution have an extremely importance in the etiology of endometriosis. Hence, the present article submits an abbreviated literature review to the biochemical role of environmental pollutants in the etiology and development of endometriosis. Anyway, this review article represented the major environmental pollutants: the organic pollutants of air, heavy metals, gaseous pollutants and the particulate matter. Th
... Show MoreA field experiment is conducted to study the effect of different levels of peat (0, 25, 50, 75, and 100 Mg ha-1 to uncropped and cropped soil to wheat. Soil samples are taken in different period of time (0, 3, 30, 60, 90, 120, and 180 days after cultivation to determine (NaHCO3-Exteractable P at 3 different depths (0-10, 10-20, and 20-30 cm). Field Experiment is conducted in a randomized complete block design (RCBD) with four replicates. Wheat, Al-Rasheed variety, is cultivated as a testing crop. The entire field is equally dived in two divisions. One of the two divisions is cultivated to wheat and the second is left uncropped. The effect of five levels of peat namely 0, 25, 50, 75, 100 Mg ha-1 is investigated. Soils are fully analyzed
... Show MoreSingled current study on the subject of shorthand in structure designs logos (Iraqi sports clubs model), as the current study Tdmt four chapters, was in the first chapter defines the research problem and its significance, as well as the aim of the research in the know shorthand formal in structure designs logos (Iraqi sports clubs model ), and identifies Find time limits: - slogans Iraqi sports clubs for the years (1956 - 1970), because it represented the years to include designs slogans official Iraqi sports clubs that have been elected in this period for the purpose of examining the reality of the design in the current search. And it represented the spatial limits: - the Republic of Iraq - Iraqi slogans designs sports
... Show MoreThe research deals with the problem of visual pollution, as it is one of the most important urban problems that cities suffer from. The concept of visual pollution has recently emerged to describe the deformation and degradation of the urban environment. Visual pollution is defined as any component of the surrounding environment that is inconsistent and not homogeneous with its natural and human components. The volume of visual pollution has doubled due to the non-compliance with the laws, regulations and controls set by the Municipality of Baghdad by the citizens, and to the weak municipal role that the municipality plays in implementing these laws. Therefore, it has become necessary to know the manifestations of visual pollution and th
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