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.
Abstract The wavelet shrink estimator is an attractive technique when estimating the nonparametric regression functions, but it is very sensitive in the case of a correlation in errors. In this research, a polynomial model of low degree was used for the purpose of addressing the boundary problem in the wavelet reduction in addition to using flexible threshold values in the case of Correlation in errors as it deals with those transactions at each level separately, unlike the comprehensive threshold values that deal with all levels simultaneously, as (Visushrink) methods, (False Discovery Rate) method, (Improvement Thresholding) and (Sureshrink method), as the study was conducted on real monthly data represented in the rates of theft crimes f
... Show Morethe first part of the research involves investigate the aspect of the radiation superposed on the one bright soliton pulse propagated on ideal single mode
This study deals with the intellectual representations whose intellectual systems are incarnated in the Jewish personality, which is considered one of the complex intellectual systems that has caused controversy throughout the ages because of the ambiguity due to the religious and psychological factors that were reflected directly and strongly on the intellectual structure of the Jewish community in general and the Jewish - Zionist personality in particular, in an attempt (to create new dimensions embodied by intellectual representations of a human nature embodied by what that - peaceful - religiously oppressed - psychologically and socially isolated character presents, because of the curse of the peoples of the world that was a cause fo
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The research the impact of the application of some of the production system tools in the specified time, which can be adapted in the service sectors (banking sector) over the improvement and increase the quality of banking services, and highlights the research problem in the low quality of banking services provided to customers because of the reliance on traditional banking systems in the provision of services Because of the lack keep pace with global developments in the banking industry, and the goal of research is to clarify the applicability of the production system in the time specified in the service sector and th
... Show MoreSports risk has become a threat to the sports sector in general and the impact on an efficient player and the old stadiums in particular. So have such a thing fertile ground of global insurance companies to exploit it optimally exploited through the development and marketing of insurance lids for the provision of protection for athletes of different risks they may face, which contributed to the growth and development of the performance of these companies and helped in the emergence of sports insurance specialist firms. And through the insurance process in the field of sports and where the insurance is a type of social solidarity. The main problem is this spirit manifested search in question is whether to embrace sports institutions sport
... Show MoreDuring his tenure in Iraq, al-Hadjjaj bin Yusif undertook administrative and economic reforms as well as linguistic reform.
The efforts exerted by Abu al-Aswad al-Dawali to control the reading of the Holy Quran were not sufficient, so the melody and error continued and became more pronounced, especially since the letters were written until then without any distinguishing features.
Al- Hadjjaj bin Yusuf realized the seriousness of the continuation of these errors and what he talked with the days of the causes of division and disagreement between the Muslim community ordered his book to put these suspicious characters marks was at the head of the book Nasr bin Asim and Yehi bin Muammar
Complexity is the inherent characteristic of contemporary organizations. It is characterized by the intertwining and expansion of its relations, by the severe disorder and rapid change in its environment, which makes it suffer from a state of uncertainty in determining the direction of its future or the assessment of the rules governing its paths. All organizations tend to evolve with increasing sophistication, And to take measures that contribute to the simplification of the system as it moves towards complexity, allowing the administration to easily control its movement and directions, and the problem of complexity in the university is based on the entanglement and overlap in the goals and processes betwe
... Show MoreThe tourism industry, with its two sides (recreational and religious), is one of the important investment fields in Iraq, it is represented Iraq as the second economic source after the oil sector. So a need for serious efforts to develop the tourism sector and maintain its sustainability. This paper will be one of the important contributions in this field; the paper aims to explore the extent of the impact of the sustainable strategy on the level of overall performance in the Iraqi tourism sector. The field of research was some Iraqi tourist institutions at Iraqi tourism, Which covers the field of study on the one side, and can be studied on the other side, for the developing study methodology and organizing its main parts, the research pap
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