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 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
... Show MoreThe current research aims to measure the level of entrepreneurial orientation and its dimensions (creativity, independence, proactivity, risk tolerance, and achievement) in the National Security Chancellery, as its importance and role in guiding senior leaders of the chancellery to make strategic decisions with high quality in various Iraqi concerns, more specifically the security aspect. The data was collected from 94 individuals (the research sample) from the research community (120) individuals at different administrative levels and intentionally where the questionnaire was adopted as a main tool for data collection and the primary data was analyzed through descriptive and inferential statistical methods (arithmetic mean, standard dev
... Show MoreWriting as a female playwright in theatre gives a deeper depiction of woman’s real- self. Beth Henley has succeeded in providing a new realist vision of women’s abilities to face their inevitable tragic fates and how to conquer their despair. In Crimes of the Heart, the playwright uses certain method to present the development of the heroines’ characters through blending the tragic events with a comic frame. In fact, Henley focuses on the simple humorous activities more that the importance of the tragic event to present her vision of how to survive and face the crisis of life.
Crimes of the Heart is a play that is concerned about three sisters whose lives are headed in distinctly different directions; howe
... Show MoreExpectation in poetry is the ability of the poet to exceed the existence of the universe . It is the revealing of the hidden and the familiar. This feature of expecting is not related to the modern poetry only . It is a well - known feature that has long been assigned to old poetry like Al-Mutannabi an Al-Mu`arri who had their own unique ways of expecting and going beyond the current time and touching the future and making it a reality. Based on their awareness ,mature thinking and talent , they had the ability of reading what is to come ,even if they were mere suppositions and tentative readings. As for the modern poetry , we have poets like Amal Dunqil , Adonis ,and Al-Sayyab whose poems became expectati
... Show MoreThe formal integration of the interior spaces in general and the commercial spaces of the watch shops in the large commercial centers in particular is the goal that the designers aim to reach in order for the interior space to become successful in terms of the design idea and its characteristics. Implementation mechanism. One of the reasons for achieving formal integration in the interior spaces of watch shops is the requirements of the design that must be available in these spaces to reach a state of formal integration between the interior and the exterior so that the space becomes fully integrated in all respects. Because of the aforementioned reasons for dealing with the research, through four chapters: The first chapter included the
... Show MoreThe 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
Praise be to God, Lord of the worlds, and prayers and peace be upon the best of the messengers, Muhammad, and all his family and companions. And after:
For when I had the pleasure of looking at the chapters of the Noble Qur’an, and its evident signs, my view fell on one of its brightest verses, and it is the Almighty saying: ﭽﯜ ﯝ ﯞ ﯟ ﯠ ﯡ ﯢ ﯣ ﯤ ﯥ ﯦ ﯧ ﯨﭼ (). The tag: (God’s Greatness in Creating a Hoopoe). The research methodology required that I divide it into four sections:
The first topic: an overview of birds.
The second topic: the characteristics and characteristics of hoopoe.
The third topic: the logic of the bird.
The fourth topic: Praise the bird.
This has relied in my research on
The process of granting loans by banks is the confidence they give to their customers, but this trust should not be a cornerstone in granting loans even if granted these loans on the basis of sound banking should involve risks that may be exposed to the bank because of the failure of the client to meet The bank's financial obligations to the bank due to the unexpected economic conditions affecting the customers, which makes them in a state of faltering, which weaken the ability of banks to provide loans, which are the most important sources of revenue and profits, so the problem of non-performing loans is one of the main problems facing most of the banks Which impede the functioning of its work and the reasons that led to the agg
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