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.
In this paper we have dealt with the word " בַּיִת" in the Book of Joshua because it makes one of those that highly employed the word בַּיִת" " in the Old Testament. The Book of Joshua comes sixth in the order of tanakh wich was written by Joshua son of Noon in Palestine during the fifteenth century B.C. and it covers a three-decade era extending from the death of Moses til the death of Joshua son of Noon.
The word " בַּיִת " in this paper refers to the place, where expressions are made by a noun modified by a noun . The modifier is"" בַּיִת , and the modified is another noun. Herein, we
... Show MoreBackground: Penetrating neck injuries are common problem in our country due to increasing violence, terrorist bombing and military operations.
These injuries are potentially life threating and need great attention and proper management.
Objective: The aim of this study is to focus on the importance of anatomical zonal classification of the neck in the management of penetrating injuries of the visceral compartment of the Neck.
Methods :70 patients with various injuries who were managed at causality unit and Otolaryngology department in Al-Kindy Teaching Hospital during aperiod from January 1st 2015 to October 31st 2015.
The study carried on those patient depending on proper clinical examination and their urgent management.
A survey conducted at Dalmaj marsh, Al-Diwaniya Province during 2013 revealed that the marsh encounters a considerable part of the Iraqi vertebrate fauna including 147 species belonging to five classes; Pisces, Amphibia, Reptilia, Aves and Mammalia. Some species are of globally conservation importance. The present results are discussed with the pertinent literature.
The current research aims to evaluate the level of inclusive leadership within the General Secretariat for the Council of Ministers, and its role in achieving integration in work through the need to improve relationships between different administrative levels, facilitate participation, expression of opinions, and belonging to the organization. In order to achieve the research objective, the descriptive analytical statistical method was chosen using the SPSS V.25 programs, with various statistical methods and measures, including mean, standard deviation, variance coefficient, relative importance, and simple regression, through a questionnaire tool for data collection. The research community included the leadership in the sample of resear
... Show MoreThe study aims at showing the effect of basil oil on the sensory properties of the laboratory biscuits. the results show the sensory valuation before and after the storage. the (A4) equation exceeds 15% of T exchange (3 , 4 , 5 g. basil 19 , 55 g . fats )in most of the studied sensuous qualities. Then, the (A5) equation of 20% exchange percentage (4.60g. basil oil + 18.40g. fats). Then, the (A3) equation of 10% exchange percentage (2.30g. basil oil + 20.70g. fats). Then the (A2) equation of 5% exchange percentage (1.5g. basil oil + 21.85g. fats). Finally, the control equation (A1) received the lower value of sensuous evaluation and general acceptance. Abstract differences also appeared at denotation level 0.05 between the (A2)
... Show MoreThis paper presents a numerical simulation of the flow around elliptic groynes by using CFD software. The flow was simulated in a flume with 4m long, 0.4m wide, and 0.175m high with a constant bed slope. Moreover, the first Groyne placed at 1m from the flow inlet with a constant the Groyne height of 10cm and a 1cm thickness, and the width of Groynes equals 7cm. A submergence ratio of the elliptic Groynes of 75% was assumed, corresponding to a discharge of 0.0057m3/sec. The CFD model showed a good ability to simulate the flow around Groynes with good accuracy. The results of CFD software showed that when using double elliptic Groy
... Show MorePOSSIBILITY OF APPLICATION THE BALANCED SCORECARD IN THE IRAQI INDUSTRIAL COMPANIES: A PROPOSED MODEL
Priority of road maintenance can be viewed as a process influenced by decision-makers with varying decision-making power. Each decision-maker may have their view and judgment depending on their function and responsibilities. Therefore, determining the priority of road maintenance can be thought of as a process of MCDM. Regarding the priority of road maintenance, this is a difficult MCDM problem involving uncertainty, qualitative criteria, and possible causal relationships between choice criteria. This paper aims to examine the applicability of multiple MCDM techniques, which are used for assessing the priority of road maintenance, by adapting them to this sector. Priority of road maintenance problems subject to internal
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