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.
This study aims to create spatial balance between two Iraqi writers' novels (Maysaloon
Hadi, Alya Talib) technical and objective illustrates similarity points and difference in the
writers' style. We depended in our research on spatial classification considering the aggressive
and friendly, since the writers focused on them.
The research study concluded to many sides, some of which are similar and some are
different. Firstly, ingenuity description of the writers. Followed by the deep connection they
have. Because of the personal experience it emanated from alienation sensations and nostalgia
to deep roots to homeland.
On the other hand, difference aspects, we see Maysaloon takes symbols and illusions
unlike Aly
This study aimed to identify the attitudes of school teachers and principals at basic government schools in Ajloun governorate towards the inclusion of disabled students at basic schools, and investigate how they will accept the merger. To achieve the purpose of this study, a questionnaire containing 35 items was administered to school teachers and principals to measure their attitudes toward the inclusion of disabled students in regular schools. The sample of this study consisted of 43 male teachers and (74) female teachers and principals. The frequency, normal distribution, arithmetic means and t-test were used to analyze the data of present study. The findings showed that there
... Show MoreOften times, especially in practical applications, it is difficult to obtain data that is not tainted by a problem that may be related to the inconsistency of the variance of error or any other problem that impedes the use of the usual methods represented by the method of the ordinary least squares (OLS), To find the capabilities of the features of the multiple linear models, This is why many statisticians resort to the use of estimates by immune methods Especially with the presence of outliers, as well as the problem of error Variance instability, Two methods of horsepower were adopted, they are the robust weighted least square(RWLS)& the two-step robust weighted least square method(TSRWLS), and their performance was verifie
... Show MoreThe osseodensification (OD) drilling technique was suggested as an alveolar ridge expansion technique, so the aim of this prospective clinical study was to evaluate the amount of bone expansion obtained by the OD drilling technique and its effect on implant stability in patients with narrow alveolar ridges. The width of the alveolar ridge was measured at the crest before and after implant site preparation, whereas the implant stability was measured using Osstell Beacon implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. Twenty-three patients were included; they received 40 implants. The mean (± standard deviation [SD]) amount of expansion was 1.29 (± 0.41) mm, and the difference b
... Show MoreThe research utilizes data produced by the Local Urban Management Directorate in Najaf and the imagery data from the Landsat 9 satellite, after being processed by the GIS tool. The research follows a descriptive and analytical approach; we integrated the Markov chain analysis and the cellular automation approach to predict transformations in city structure as a result of changes in land utilization. The research also aims to identify approaches to detect post-classification transformations in order to determine changes in land utilization. To predict the future land utilization in the city of Kufa, and to evaluate data accuracy, we used the Kappa Indicator to determine the potential applicability of the probability matrix that resulted from
... Show MorePlatelet‐rich fibrin (PRF) has been widely used in regenerative dentistry due to many growth factors produced. Periostin, a matricellular protein, is a reliable marker for tissue regeneration. Periostin is part of the cellular matrix and regulates bone homeostasis. This study aims to explore the efficacy of PRF in improvement of the clinical periodontal parameters as an adjunct to the scaling and root planing and to evaluate periostin level in gingival crevicular fluid (GCF) at baseline, 1‐ and 3‐month recall visits. Fourteen periodontitis patients who met the inclusion criteria were recruited in this study. Two contralateral periodontal pockets with 4–6 mm in depth in each patient were sel
Monetary sterilization policies are one of the modern trends of monetary policy in rentier countries, specifically to confront the positive shocks in foreign assets flowing into the national economy and the impact of these shocks on monetary and real variables. And that the Central Bank contains these emergency increases in foreign exchange with the aim of avoiding the impact of this increase on the official local currency through its three main monetary tools, which are the rediscount rate, the legal reserve, and open market operations. As well as the relationship between the central bank and the objective of external balance, which is reflected in the balance of payments balance, the central bank resorts to managing the exchange rate
... Show MoreIn this study, we investigate the behavior of the estimated spectral density function of stationary time series in the case of missing values, which are generated by the second order Autoregressive (AR (2)) model, when the error term for the AR(2) model has many of continuous distributions. The Classical and Lomb periodograms used to study the behavior of the estimated spectral density function by using the simulation.
Abstract
The aim of the current research is to identify the effect of the effective reading strategy on the achievement of second-middle students in biology, as well as the imaginative thinking skills of students. The researcher adopted the experimental design with partial control to achieve the goal of the research. The current research community identified the second-middle students in the government schools of the Baghdad Education Directorate / Rusafa I for the academic year (2021-2022 AD). The Safina Intermediate School for Girls was chosen to be the research sample in the form of intentionally, two classes were randomly selected from a total of four classes, one of them is experimental and the other is con
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