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.
Wrong behavioral deviations among youth witnessed an obvious growing, some of these deviations are, robbery, drug and internet addiction, and smoking. Additionally, intellectual extremism and the disrespect of the traditions and genuine customs, In light of this issue, the research aims to shed light on the educational and preventative role of the woman in protecting and immunizing children from the wrong behavioral deviations. The woman has a significant and influential role in the society in general and in her family, in particular to the responsibility lies on her. The research shed light on the manifestations of behavioral deviation in children and the mechanisms of prevention and treatment. The research concluded with a set of recom
... Show MoreEffective decision-making process is the basis for successfully solving any engineering problem. Many decisions taken in the construction projects differ in their nature due to the complex nature of the construction projects. One of the most crucial decisions that might result in numerous issues over the course of a construction project is the selection of the contractor. This study aims to use the ordinal priority approach (OPA) for the contractor selection process in the construction industry. The proposed model involves two computer programs; the first of these will be used to evaluate the decision-makers/experts in the construction projects, while the second will be used to formul
Abstract :-
The aim of the research is to explain the role of quality costs their importance and their classification, and to clarify the most important tools that help to reduce costs.
In order to achieve the objective of the research and test hypotheses adopted the descriptive approach, as well as the adoption of the analytical approach in the study of applied data has been relied upon in providing data on the financial and production reports of the research sample company, the data were used to study and analyze financial and productivity reports . A number of conclusions have been reached the most important being the following
... Show MoreThis paper is a part of a cytological studies of the genus Bromus L. in Iraq . Cl number for 103 specimens ropro^eming l^species determined . The course of meiosis including an analysis of chromosome configuradon for 27 collections belonging to 8 species were investigated . Meiosis was regular in most species . Tetraploid for B.scoparius L. (new cytotype ) and hexaploid ?'or " Kunth. were re^rted for the first time, cytological findings were supported the view of maintaining the closely related species B.danthoniae Trin. and B.lanceolatus Roth, as distinct species .
Business Ethics play a major role in explaining the behavior of those interested in the management of tourism enterprises in the field of management gains, which sometimes turn to manipulation in the specification of the service of tourism and influence in the technical characteristics at the expense of the brand and market share, as well as misleading beneficiaries about the fact that the performance of the service of tourism, may depend activities tourist dramatically when submitting and sharing various services on the types of mutual relations the framework for moral distinct, in interaction or direct contact between producers of tourism services and tourists or their beneficiaries, in order to provide comfort and recreation a
... Show MoreKurdish language multifunctional morphemes indicate the different functional morphological, syntactical, and semantic tasks of the morphemes. The present study discusses the multifunctional task of the Morpheme Le in Kurdish Language. The Morpheme Le has marginally been included in other studies, yet up to the present times, there has not been a research inclusively dedicated to thoroughly discuss and clarify its multifunctional aspects. The present study is divided into two chapters: Chapter one discusses the theoretical aspect of chapter two that is entirely concerned with the practical aspect of the morpheme Le. The first part of chapter one sheds light on the morphological aspect of the morpheme while part two discusses
... Show MoreThis research is intended to high light the uses of political content in foreign Arabic / speaking websites, such as “ CNN “ and” Euro News“, The research problem stems from the main question: What is the nature of the use of the websites in the political content provided through them? A set of sub-questions that give the research aspects and aims to achieve a set of objectives , including the identification of topics that included , the political content provided through , the sample sites during the time period for analysis and determine that the study uses descriptive research based on the discovery of the researcher, describing it accurately and defining the relations between the components.
The research conducted the des
Negotiations are distinguished in that they are an easy and simple means between the conflicting parties, and it is an effective means at the same time as the conflicting parties seek understanding on the most effective way to solve their dispute, but negotiations are not always appropriate to resolve international disputes, especially when there is a disparity in power between the negotiating countries, or when it is missing Goodwill, or even when one of the parties is absent or less flexible, and the internal circumstances of one of the conflicting countries may play a negative or positive role in the success of the negotiations, away from the influence of the role of external variables in that, a
... Show MoreBackground: Plants used in folk medicine for
the treatment of peptic ulcer diseases is a very
promising approach to overcome the limitations of
classical medicines.
Aim: To explore the efficacy of medicinal
plants, namely turmeric, garlic and marshmallow,
in eradication of H. pylori.
Methods: This prospective study was carried out
on 225 of well-known dyspeptic patients who were
divided into four groups; a control group (received
classical medical therapy) and three other groups
that received one of the three medicinal plants,
plus the same therapy used in the control group.
The follow up was done by using a questionnaire
form, endoscopic examination, and determination
of serum levels of anti