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.
When exercising their authority in the jurisprudence, judges are subject to a set of restrictions that they must adhere to, as they do not want their jurisprudence to be accepted and welcomed by law practitioners in general, and legal scholars in particular, and in contrast to it, the arrows of criticism and defamation will extend to that jurisprudence, and then they will have to reverse them . Perhaps the most important of those restrictions imposed on judges is their observance of justice between the parties to the lawsuit through their lack of bias for one of the parties at the expense of the other, in addition to their observance of public order and public morals, as well as their observance of the legal texts that they work under its u
... Show MoreThe current study aimed at identifying the impact of each of the full and part time summer enrichment programs on the performance of gifted students. Moreover, it aimed to study the difference between the full and part time programs on the performance of gifted students. The study sample consisted of (115) students from the full time programs and (137) students from the part time programs, they have been randomly selected from the gifted students participating in the full and part time summer enrichment programs. The researcher used the scale of student performance. The results indicated that there were statistically significant differences between the averages of the pre and post applications of the
... Show MoreThe form imposes its importance in the structure of the artwork through its indication of the type of relationship between the artist and his external world in all its aspects, as well as its manifestation of artistic and aesthetic values, and the multiplicity of experimental means of expression that include the artist's feelings and imagination. The form is also a recording of the events in their temporal and spatial circumstances, and in that it is of value in directing his artistic discourse with the aim of influencing the recipient with its connotations and emotional states. Horses in the drawings of Amer Al-Obaidi, and the research came within two frameworks: The first framework is the methodological framework that represents us t
... Show MoreTax revenues are considered one of the important sources of public revenues for the state as one of the tributaries that finance the public treasury to implement development plans. Real estate taxes are one of the sources of obtaining tax revenues in the state, as it follows that there are a number of factors that affect these revenues, which requires the development of necessary solutions and recommendations to address the resulting effects. Accordingly, this research sheds light on tax revenues in general and real estate tax revenues in particular to indicate the extent of their contribution to the total tax proceeds, as the tax proceeds of the real estate tax were analyzed into the total tax proceeds for the years (2017-2021). A numbe
... Show MoreBackground: Osteoarthritis (OA) currently seems
inevitable and unavoidable for a large swath of the
population .its etiology relates to a strong ,but
complex ,non mendelian genetic basis ,combined
with mechanical and metabolic factors that cause
molecular alterations the end results of which
affect the whole joint .Glucosamine and
chondrotin sulfate alone or in combination may be
of benefit to a subgroup of individuals who have
knee pain due to OA.
Glucosamine has been shown to alter cartiage turn
over in patients with OA undergoing physical
training
Aim of the study: To find the validity of
glucosamine chondrotin sulfate in treatment of
grade 1 and 2 OA.
Methods: the sample of 280 patients
This study aims at identifying thinking, its aspects, controls, thinker’s characteristics, and the attempts that followed by Ibrahim’s people. This was achieved under Ibrahim’s story, (peace and blessing be upon him), in the Holy Qur’an. The study used the descriptive method through induction and deduction. The study reached the following results: thinking is an organized reasonable human action, which includes all human life in the fields of science, knowledge, and calling for Allah. It depends on remembering what is already in the memory and it should be subjected by revelation and Islamic legislation. The study illustrated that the most important thinking controls are monotheism, piety, Islamic legislation, the Holy Qur’an,
... Show MoreThe study aimed to identify the role of the teacher in confronting intellectual extremism in high school students, and identify the differences of statistical significance in the role of teacher in confronting intellectual extremism in secondary school students according to gender variable (males, females) and the duration of service (less than 5 years more than 5 years), the sample was consisted of (100) teachers with (50) male and (50) female in the city of Bayaa, Dora and Sadiya, the measure of intellectual extremism was applied by the researcher, and the study reached a role of the teacher in facing the intellectual extremism at Secondary school students, and the existence of differences of statistical significance in the role
... Show MoreIn this paper, we studied the resolution of Weyl module for characteristic zero in the case of partition (8,7,3) by using mapping Cone which enables us to get the results without depended on the resolution of Weyl module for characteristic free for the same partition.
This study investigates the challenges encountered by first-grade intermediate students in learning the Arabic language. It aims to identify specific obstacles that hinder language acquisition and proficiency among this demographic. Through qualitative and quantitative methods, including surveys and interviews with students, teachers, and parents, the research highlights key issues such as limited vocabulary, difficulties in grammar, lack of engagement with the material, and inadequate teaching resources. The findings reveal a complex interplay between cognitive, social, and educational factors that contribute to these challenges. The study underscores the need for targeted interventions, such as enhanced pedagogical strategies and improved
... Show MoreThe operation of production planning is a difficult operation and it's required High effect and large time especially it is dynamic activity which it's basic variables change in continuous with the time, for this reason it needs using one of the operation research manner (Dynamic programming) which has a force in the decision making process in the planning and control on the production and its direct affect on the cost of production operation and control on the inventory.