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.
Abstract: The world witnessed the speed of a dangereuse virus now as Corona or Covid 19, which left many deaths in light of the inability of local and international Heath agencies to find a suitable vaccine to eliminate it and limit its spread, which negatively affected humain life in its various fields, and remains adopting healthy behaviors and habits A healthy Heath is the best solution to face the spread of the epidemic until realistic solutions that eliminate the virus are found.
The tourism industry, with its two sides (recreational and religious), is one of the important investment fields in Iraq, it is represented Iraq as the second economic source after the oil sector. So a need for serious efforts to develop the tourism sector and maintain its sustainability. This paper will be one of the important contributions in this field; the paper aims to explore the extent of the impact of the sustainable strategy on the level of overall performance in the Iraqi tourism sector. The field of research was some Iraqi tourist institutions at Iraqi tourism, Which covers the field of study on the one side, and can be studied on the other side, for the developing study methodology and organizing its main parts, the research pap
... Show MoreSignification with its different aspects constitutes various aesthetic pictures for human and nature creations over different periods of time. It was a focal around which logical thinking loops on the interpretation level of the signification movement according to its structural context expresses its hidden entities with which a human being deals according to two symmetrical levels while interpreting to attain meaning. Sense was the first passing window for the picture of signification which thought deals with. While trying to decode it and because art in general and theatre in particular are considered as the basis of creating signification through its visual and aural elements, so it was necessary to consider one of the elements of cre
... Show MoreThe aim of the research is to:. Preparation and implementation of special educational units using multimedia to learn the skill of scrolling from below. 2 to recognize the impact of the use of multimedia in learning the skill of scrolling from below. 3 to identify the differences between the tests after the two groups research in learning the skill of passing from the bottom volleyball. The research represented the students of the first stage and the sample of the research was drawn randomly and the number of (50) students were divided into two experimental and control groups and each group (25) students were used standardized tests and conducting pre-tests and the implementation of the main exp
... Show MoreWhen we try to navigate the experiment in search of the repressed and to find the dream of creativity by changing the modularity of the presentation, and the relationship of the characters with the rest of the elements according to a visual vision that reflects the product of the presentation system through the formation of visions and ideas within the textual structure.
We find that the expression of the theatrical act may need to exclude narrative dialogues and turn them into a tangible visual language. Physical and visual expression, and movement review, thus producing a “picture language” through which it is possible to form a new vision, and this is called (image theater), which translates the language of dialogue through lig
the first part of the research involves investigate the aspect of the radiation superposed on the one bright soliton pulse propagated on ideal single mode
The research aims at determining the type of educational dimensions to be broadcasted in children's television programs, clarifying the technical forms used in children's TV programs, analyzing the educational dimensions provided by children's television programs, and studying the educational dimensions of children's television programs. The researcher used a sample of children's programs: all of us heroes, which is a daily program on the mbc3 channel as well as the program of Tel flowers on the Algerian channel. The researcher designed an analysis content form included categories of analysis. Spss program was used to process the collected data. The research reached several results; the concentration of educational dimensions in
... Show MoreThe Mesopotamian artist conversed the functions of idols with multi-formation, varied pictured and structural significances sign momentum. Each phenomenon had an idol and each event had an idol. So multiplicity contributes in the enrichment of the Mesopotamian thought by the full and comprehensive familiarity of the characterization of the religious space which reached up to realize the start point of creation and formation and specify the concept of unification in such a way that considered as pagan multiplicity and Atheism according to what brought by most of the previous studies.Such a research as ( The Sign Reading of the Structure of Unification in the Civilization of Mesopotamia) aims to clarify this confusion through decoding the
... Show MoreSports risk has become a threat to the sports sector in general and the impact on an efficient player and the old stadiums in particular. So have such a thing fertile ground of global insurance companies to exploit it optimally exploited through the development and marketing of insurance lids for the provision of protection for athletes of different risks they may face, which contributed to the growth and development of the performance of these companies and helped in the emergence of sports insurance specialist firms. And through the insurance process in the field of sports and where the insurance is a type of social solidarity. The main problem is this spirit manifested search in question is whether to embrace sports institutions sport
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The research aims to measure, assess and evaluate the efficiency of the directorates of Anbar Municipalities by using the Data Envelopment Analysis method (DEA). This is because the municipality sector is consider an important sector and has a direct contact with the citizen’s life. Provides essential services to citizens. The researcher used a case study method, and the sources of information collection based on data were monthly reports, the research population is represented by the Directorate of Anbar Municipalities, and the research sample consists of 7 municipalities which are different in terms of category and size of different types. The most important conclusion reached by the research i
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