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.
Medina was according to its importance and religious status the basis for the emergence and emergence of historical schools, it is the emigration of the Prophet and the presence of the companions , and it was natural to shine the beginnings of historical codification, whether in the process of collecting and codification of the verses of the Koran or the Hadith, and once the pillars settled Islam in the Islamic areas until the Muslims began to go to the city to provide a broader knowledge of the Islamic religion and everything related to the biography of the Prophet and the significance and actions, and in return took the jurists and preservation and readers of the companions and followers to undertake the task of teaching in work
... Show MoreA theoretical analysis of mixing in the secondary combustion chamber of ramjet is presented. Theoretical investigations were initiated to insight into the flow field of the mixing zone of the ramjet combustor and a computer program to calculate axisymmetric, reacting and inert flow was developed. The mathematical model of the mixing zone of ramjet comprises differential equations for: continuity, momentum, stagnation enthalpy, concentration, turbulence energy and its dissipation rate. The simultaneous solution of these equations by means of a finite-difference solution algorithm yields the values of the variable at all internal grid nodes.
The results showed that increasing air mass flow (0.32 to 0.64 kg/s) increases the development o
The research problem is that the traditional methods of internal auditing are somewhat heavy with long and rigid procedures for the members of the audit process team, especially in light of the current developments that are reflected in the business environment and internal audit reports, so it is necessary to reconsider the traditional internal audit work method and assess the extent of its development by agile methods to reduce the time of the audit process on the activities and elements that add value and direct the effort and time to the activities and elements that add value to the work of the economic unit and the report of the internal auditor.
The research aims to study the possibility of applying agile internal auditing
... Show MoreIn The Bluest Eye (1970) , Toni Morrison addresses a timeless problem of white racial dominance in the United States and points to the impact it has on the life of black females growing up in the 1930's. Morrison in this novel explores how Western standards of ideal beauty are created and propagated with and among the black community. The novel not only portrays the lives of those whose dark skinned and negroid features blight their lives; it also shows how the standards of white beauty are imposed on black youth to cause a damage of one's self-love and esteem which usually occurs when beauty goes unrecognized
The construction process of reception containing rebuild educated new gloss within the context of real-time knowledge with previous experience and learning environment, accounting for all of the real experiences and information beside Education backbones structural climate (olive 0.2002: p. 212 .) Based on two basic principles - : I: - The natural science that we do know from our experiences, we can not say for sure Bhakaigah realism and clearly, but built by creative minds of certain interpretations be applicable in light of our expectations. Other: - The knowledge built effectively active learner who adapts new knowledge with the conceptual framework has, since everyone has a conceptual framework can break at any time and replaced by a ne
... Show MoreChest X-rays have long been used to diagnose pneumothorax. In trauma patients, chest ultrasonography combined with chest CT may be a safer, faster, and more accurate approach. This could lead to better and quicker management of traumatic pneumothorax, as well as enhanced patient safety and clinical results.
The purpose of this study was to assess the efficacy and utility of bedside US chest in identifying traumatic pneumothorax and also its capacity to estimate the extent of the lesion in comparison to the gold standard modality chest computed tomography.
This research sheds light on the physical environment role in creating the place attachment, by discussing one of the important factors in the attachment creation, it is the concept place dependence, consisting of two important dimensions: the place quality and the place expectation; they contain a number of the supporter physical environment sub-indicators for place attachment. Eight physical indicators were reached; they were found to have a close relationship to the place attachment, including: the open and green spaces existence, land use diversity, diversity of housing types, dwelling / population density, accessibility, transport network development degree, transport multiple mo
Raghad Fattah RADHI
This study comes as: The responsibility of the Iraqi newspapers in promoting the political culture inside society, an analytical study in newspapers: Al-Sabah, Al-Ittihad, Al-Aalam for 2/ 3/ 2013 to 31/ 3/ 2013 to spot light on the extent to which the three mentioned newspapers are compliance with the promotion of the political culture inside society which is seen as one of the essential requirements for the success and promotion of the democratic process inside society.
The study aims to: finding out the extent to which these newspapers are compliance with their responsibility in the promoting the political culture inside society; knowing the nature of their role in pr
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