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.
Over the last two decades, several sustainability assessment methods have developed as key accelerators for the development and improvement of sustainable industrial buildings. Some of these systems, like as LEED or BREEAM, are considered international, whereas others, such as Pearl Rating Systems (PRS), are local. Although they all share similar goals, they can lead to the construction of green buildings or the improvement of the efficiency of existing conventional buildings. Each technique has its structure, certification process, and weighting norms. The inequalities have prompted various questions about whether global assessment systems appropriately consider the country’s national settings. This study aims to compare the Pear
... Show MoreThe rapid increase in the number of older people with Alzheimer’s disease (AD) and other forms of dementia represents one of the major challenges to the health and social care systems because of a large number of people affected. Early detection of AD makes it possible for patients to access appropriate services and to benefit from new treatments and therapies, as and when they become available, and to plan for the future. The onset of AD starts many years before the clinical symptoms become clear. A biomarker that can measure the brain changes in this period would be useful for early diagnosis of AD. Potentially, the electroencephalogram (EEG) can play a valuable role in early detection of AD. Damage caused to the brain due to AD leads t
... Show MoreThis research Sought to Determine the Relationship and impact between the tax knowledge in dimensions of the tax compliance costs (monetary costs, time costs, psychic costs) Since the sample included 81 individuals represented by the Executive directors and Financial and Accountant working in the Joint-stock company, A questionnaire was used as a tool for data collection and its analysis. For the purpose of analyzing the research data the statistical package for social science, SPSS. The most important tools used in the statistical analysis are:(standard deviation, and simple linear regression, percentages, arithmetic mean, Cronbach's alpha, F-test, T- Test). The research found a weakness attenti
... Show MoreSocial interaction is the platform that enables people to connect and practice language. Active listening stimulates them to understand the language they are speaking. The problem of the study highlights that less attention to listening among speaking, reading, and writing skills causes the weakness of collaborative learning. This paper contributes to characterizing the effectiveness of collaborative learning in developing learner’s listening skills. It aims to underscore the role of target language learners as members of the learning groups and of the teacher in the collaborative learning process. 130 Iraqi EFL teachers from different colleges at the University of Baghdad participated in this study. The scores in the statistical data wer
... Show MoreConflict is a common but complicated phenomenon. It has been extensively researched in many domains, including philosophy, sociology, psychology, and linguistics. Using the Critical Discourse Approach, this study examines the issue of self-society conflict in The Handmaid’s Tale. The significance of this work lies in the identification and explanation of the discursive strategies that force the ideological polarization of the positively portrayed self versus the negatively portrayed other. The purpose of this study is to answer two questions: what are the discursive strategies used in The Handmaid’s Tale to create a positive or negative representation, and how are these strategies implemented? Five extracts from The Handmaid’s
... Show MoreMotives: The research deals with the issue of urban sprawl on agricultural lands. It is an urban problem caused by rapid urbanization and poor planning. It is considered one problem that threatens cities with environmental and health disasters. It also threatens agricultural life and the green belt surrounding cities. Changes in urban sprawl on agricultural land are associated with complex processes that lead to multiple social, economic, political, and environmental risks and thus pose a threat and an obstacle to the sustainability of cities. Aim: The research aims to study and evaluate the reality of the city of Baghdad and the extent of its ability and flexibility to withstand the disaster of urban sprawl on agricultural lands. T
... Show MoreThis study aimed to knowledge of the effects of the Traditional ore upon the structure of sculpture form, as well as to knowledge of new materials that was used for the contemporary sculpture. This study included four chapter: first chapter was specialized for methodical frame. such as problem of research. that it was abstracted by question about the reason that lead the sculptor to search from new raw to carry out his sculpture works? As well as the important of research and its limits was that define between year 1950 up to 2000. The second chapter included the theoretical field and previous studies, that formed from three researches, such as the fist about the materials, as it was considered master element at the sculpture formal. the
... Show MoreIn our current era, women need to practice sports activities in order to compensate for the lack of movement. The development of life and the introduction of technology in all fields contributed to reducing body movements to the maximum. Many movements were also shortened, and some parts of the body became almost static. All machines became available in homes. Necessary to help women clean and cook. The presence of transportation also restricted women, so the walking sport that women used to practice when they went shopping in nearby places or to visit friends disappeared. As a result, many health problems emerged, prompting some developed countries to allocate financial aid with the help of insurance companies to these patients.The researc
... Show MoreWe deal with this essay about religious mystic poetry of Atika Al-
Khazraji. We think she imitates Rabia Al-Adawiyya. We do not deny that our
poetess lived in a conservative society although she lives in reality a liberal
life, so she tries to satisfy her society. In fact these mystic poems are pure
love. Poems in men.
This double standard behavior is quite clear in women’s poems in the
Arab world of this era.