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.
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
... Show MoreThe postmodern ideas and concepts have produced social, political and economic variables that have been affected by wars, crises, the role of globalization and the information revolution. They have created many variables in concepts and great variables in technological, artistic and cultural innovations. All these changes have contributed to changing the form of the theatrical show aesthetically and intellectually, which cast a shadow over the nature of the actor's performance who has become more demanding to change his performance and to find the mechanisms and new nature of work governing him corresponding to those variables and this prompted the researcher to adopt the subject (the performance variable of the actor's techniques in pos
... Show MoreMedia, especially press plays an important role in fighting corruption and tackling this phenomenon, which has become widespread in our society, through its effective role in raising awareness of the seriousness of spreading of corruption of all its forms in society.
All international conventions and agreements stress the necessity of the role of media and its importance in the light of corruption. All countries also commit themselves to the necessity of guaranteeing the freedom of media and the circulation of information and preparing it as a prerequisite for activating the People’s Control Mechanism and supporting measures and means to prevent and combat financial and administrative corruption more actively and effectively.
Co
Faujasite type NaY zeolite catalyst was prepared from locally available kaolin, then the prepared NaY zeolite have been modified by exchanging of sodium ion with ammonium to produce NH4Y zeolite. NH4Y zeolite was converted to HY zeolite by ion exchanging with oxalic acid. Zinc and nickel promoters have been added to the prepared HY zeolite catalyst, and the effect of these promoters on the catalytic activity of the prepared HY catalyst was studied in fluid catalytic cracking process using light gas oil as a feedstock. The experimental results show that the promoted catalyst gives higher gas oil conversion and gasoline yield than HY zeolite catalyst at the same reaction temperature and WHSV. It was also found that the promoted catalyst gi
... Show MoreNative speakers of English from different parts of the world have different accents,but the differences of accents are mainly the result of differences in the sound of vowels and consonants . The actual use of all these sounds in combination leads the speaker to produce a number of segments which only appear on the production level and realized on the perceptual one . RP pronunciation represents the teachable variety in all Iraqi universities because it is the most acceptable and understandable accent all over the world and not only in South East London ..The structure of the English syllable in RP pronunciation is influenced by the appearance of certain allophones especially aspiration and glottalization which ch
... Show MoreThe Islamic Arts which include calligraphy and specifically the third line of the greatest
manifestation of Islamic civilization affair, and it was the mosques and mosques and holy
shrines scattered in the city of Baghdad, which had a deep impact in enhancing
communication
This means research study (third line aesthetics diversity of tactics in the architecture of
mosques) It is located in four seasons, which included the first chapter the research problem
represented by asking the following - :
-What are the methods of implementation of the third line in the architecture of mosques ?
And reflected the importance of research in it represents a serious attempt to investigate the
diversity in the organization des
In this research, the water quality of the potable water network in
Al-Shuala Baghdad city were evaluated and compare them with the
Iraqi standards (IQS) for drinking water and World Health
Organization standards (WHO), then water quality index (WQI) were
calculator: pH, heavy metals (lead, cadmium and iron), chlorides,
total hardness, turbidity, dissolved oxygen, total dissolved solid and
electrical conductivity. Water samples are collected weekly during
the period from February 2015 to April 2015 from ten sites. Results
show that the chlorides, total dissolved solid and electrical
conductivity less than acceptable limit of standards, but total
hardness and heavy metals in some samples higher than acceptabl
This paper aims to review the intellectual to the most important thought leaders administrative and strategic They both (Henry Fayol and Michelle Porter), who forward a lot of ideas that have helped countries in the advancement and progress their economies , has been drawing literature theoretical common border in Contributions ( Fayol ) philosophical and between applications ( Porter ), which reversed strategies of the three ( the leadership of the cost, differentiation, and focus ), so browse search how to apply and use the principles of Fayol in the implementation of strategies competitiveness of Porter, and stems from a problem ( ( to what extent a reflection of the principles ( Fayol) fourteen strategies (Porter ) competitiv
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