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 study aimed to identification the effect of brainstorming in linguistically grow of garten child the sample of study is composed from (48)male and female children have been distributed for two groups,one of them is experimental and another is disciplined for every per of garten and pre education,and they have been awarded in a number of variations. For measuring the subordinate variation(linguistically grow)the researcher prepared ascale for this purpose that consist of two parts:the first part the scale of linguistically grow of garten child(4-5 years)and the second part the scale of linguistically grow of pre education child (5-6 years).Consist of every one from (20)shapes of linguistically grow shapes for garten chil
... Show MoreThis research aimed at studying the role of calculated knowledge an its efficiency in improving the performance especially most of the organizations are living within knowledge era which concentrate on new technology investment in different fields of modern live . Under the scientific trends towards the economy of calculated knowledge which depend basically on new computer program in order to utilize the knowledge to raise the level of work performance exploiting different resources in the best way that helps the organizations to achieve their objectives because the information technology and computer programs became a means of survival and indispensible instrument within the developed world which depend on prosperity . progress
... Show MoreThe curriculum is considered one of the most important corners for the educational process, it participates in achieving the educational equilibrium between its elements.
The curriculum of (History of the Art) in the college of Art Education / dept. of plastic art education and ceramic as the other curriculums and due to the subject of history of the art develop the knowledge, taste and experiment for art studier also this subject has a direct relation with practical educational activities like colors and growth the knowledge of the student in field of contents and symbols and evidences of meaning in old , medium and contemporary arts, due to the fact that this curriculum has been applied since long time more than four years, and
... Show MoreOld New York was Wharton's term to describe this wealthy and elite class at the top of
the developing city's social hierarchy, a society which was utterly intent on maintaining its
own rigid stability. Even though, the roles of women in American society changed drastically
from 1820’s to 1860’s due to the civil war and such a progression was due in part to the
revolutionary thoughts. Women started taking their right to speak up openly and frankly and
become more like men. The role of many women had changed from being homemaker to
being able to provide for the family by either getting a job or start to be allowed to have a
voice. They had important roles not only in helping the family, but in sharing to rebuild th
This paper studies the effect of contact areas on the transient response of mechanical structures. Precisely, it investigates replacing the ordinary beam of a structure by two beams of half the thickness, which are joined by bolts. The response of these beams is controlled by adjusting the tightening of the connecting bolts and hence changing the magnitude of the induced frictional force between the two beams which affect the beams damping capacity. A cantilever of two beams joined together by bolts has been investigated numerically and experimentally. The numerical analysis was performed using ANSYS-Workbench version 17.2. A good agreement between the numerical and experimental results has been obtained. In general, results s
... Show MoreThe study aimed to get acquainted with kindergarten teachers in the development of
emotional intelligence in children, To achieve this a study too, which consisted of 40 items,
within four areas was condncted: (managing emotions, emotional knowledge, empathy, social
networking) The study tool was applied to the sample amounting (200) teachers of the
kindergarten teachers in the province of Jerash and after analyzing the results statistically
using arithmetic averages standard deviations and variance analysis quartet the following
results were reached :
- presence of statistically significant differences at the level of (α =0,05) is attributable to the
impact of the educational level in the areas of empathy and so
In this study, some attenuation parameters of gamma shields were studied. This shields consisting of composite materials of Unsaturated polyester as a base material and Nano iron oxide (Fe2O3) and, micro iron (Fe) as reinforcement materials at different percentages (1, 3,5,7and 9)wt%, and with different thickness (1, 1.5, 2, 2.5, 3, 3.5and 4) cm. The results showed that the use of nanoparticles is better than the microparticales in the field of radiation shielding. It has been shown that the values of attenuation parameters of gamma it bitter in the case of nanoparticles than case of the use of micro material.