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 main purpose of this research is to diagnose the role of the Knowledge Accumulation of Human Resources KAHR in Strategic Performance SP, and for that, the research was applied to the represented sample by the administrative leaders consisting of (108) individuals distributed according to their positions and the organizational structure of the ministry. Correlations, effects, and benefits from generalizing the results in the field of research. The research involved a mixed-methods approach through two stages. During the first stage, the researcher gathered quantitative data from a questionnaire. The second stage gathered qualitative data to explore the survey results more deeply by conducting individual interviews with a sub-sample of
... Show MoreMotives: The research deals with the issue of urban sprawl on agricultural lands. It is an urban problem caused by rapid urbanization and poor planning. It is considered one problem that threatens cities with environmental and health disasters. It also threatens agricultural life and the green belt surrounding cities. Changes in urban sprawl on agricultural land are associated with complex processes that lead to multiple social, economic, political, and environmental risks and thus pose a threat and an obstacle to the sustainability of cities. Aim: The research aims to study and evaluate the reality of the city of Baghdad and the extent of its ability and flexibility to withstand the disaster of urban sprawl on agricultural lands. T
... Show MoreThe present study aims at answering the following questions:.
1-Which is more effective in enriching students. Vocabulary ,the use of short stories or the traditional way?
2-What extent has the use of short stories an effect upon the students. achievement in vocabulary test?
3- Is there any significant difference between the male and female student of the experimental group in vocabulary achievement test?
 
... Show MoreTeresa Fitzpatrick presents a connection between oppressed women and the plant of Wisteria in gothic fiction in her article “Wisteria: A Female Eco-Gothic Metaphor in American Fiction Through the Ages.” The connection between women and nature is common in literature as women are usually compared to the beauty or ferocity of flowers, rivers, or natural phenomena in general. The connection extends to the architecture and sort of plants that appear in gothic literature. Gothic novels have routinely been connected to the secrets and life stories of women who cannot have the liberty to live or share them outside their homes. A fearful house with a prisoned person, ghost, or a secret is mostly normally found in gothic writing. Women have exce
... Show MoreCaryl Churchill's Top Girls (1982) reveals how women have achieved a point of strength and independence in their battle to face men's oppression throughout history. Churchill has replicated recent transitions in the 1980s and 1990s in works that depict these movements' central concerns and contradictions as they change. Similarly, her theater is a result of many problems and shifts in hegemonic modes of production during this time. This paper traces the achievements of the major character of Top Girls, Marlene, in her way of life and her handling of the struggles of other women around her. Because of this strength, Marlene is compared to the British Prime Minister, Thatcher. Therefore, this paper will shed light on the term of T
... Show MoreSubjected Find winged bull Assyrian monetary analysis in order to identify the formative relations in terms of percentages, movement and public swab for being aesthetic values upon which the mechanisms of artistic composition, which did not give researchers artistic interest that affects the status of these sculptures and the like of the achievements of the Iraqi civilization in Assyria.
Resulting analysis to a number of the most important results, the percentages approved in the calculation of the parts to do with all when viewed status horizontal with a realistic formulas while in the case of considering frontally clear for Ras stylized proportions and head size larger in length, a ratio confirmed by previous studies, and
... Show MoreCrop coefficient for cherries was evaluated by measure the water consumption in Michigan State to find its variation with time as the plant growth. Crop coefficients value (Kc) for cherries were predicated by Michigan State University (MSU) and also by Food and Agriculture Organization (FAO) according to consume of water through the season. In this paper crop coefficients for cherries are modified accordingly to the actual measurements of soil moisture content. Actual evapotranspiration (consumptive use) were measured by the soil moisture readings using Time Domain Reflectometers (TDR), and compared with the actual potential evapotranspiration that calculated by using modified Penman-Monteith equation which depends on metrological statio
... Show MoreThe majority of Arab EFL (English as a Foreign Language) learners struggle with speaking English fluency. Iraqi students struggle to speak English confidently due to mispronunciation, grammatical errors, short and long pauses while speaking or feeling confused in normal conversations. Collaborative learning is crucial to enhance student’s speaking skills in the long run. This study aims to state the importance of collaborative learning as a teaching method to EFL learners in the meantime. In this quantitative and qualitative study, specific focus is taken on some of Barros’s views of collaborative learning as a teamwork and some of Pattanpichet’s speaking achievements under four categories: academic benefits, social benefits,
... Show MoreThe doctrine of naturalism appeared in the sixties of the nineteenth century as a continuation of the realism tendency and an expression of feeling in historical and social conditions in the language known to societies in Western Europe. Naturalism is a literary doctrine with an artistic style derived from realism, but it carries with it a philosophical character. Thus, we can understand that naturalism is those external and social forces that impede human freedom, as opposed to the subconscious internal genetic forces that determine moral responsibility and human rationality, far from displaying aesthetic images, as it is closer to reality than imagination. Naturalism looks at several axes, the most important of which are mental and psycho
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