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 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 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 adoption of many mathematical concepts contributes to the construction of models of sports and the population can be interpreted to explain the movement and growth of the population lead to proper planning to manage the requirements of the population and meet their needs of providing education or providing medical services, health and others. In this study, the number of births in the Governorate of Basrah for the period (1998-2050) is estimated to be based on the assumption that the population of the visually impaired is a stable society. If the rate of growth is (0.0492), some demographic indicators are important for maintaining the average age of women at pregnancy (27.817). Each woman will give birth (3.74) female birth d
... Show MoreThe Security Council has an active role in addressing international crises and dealing with their causes. The Libyan crisis is one of the most important real tests of the Security Council and its role in maintaining international peace and security, as the Council has proven so far an ineffective role in resolving the crisis and dealing withtheir causes, which has prolonged its duration and increased its complexities and dangerous repercussions, perhaps the most prominent of which is the threat of the recently achieved cease-fire and the formation of a new transitional government led by Abdel Hamid al-Dabaiba, the growing significant obstacles facing the political process, foremost of which is the continued presence of foreign forces , m
... Show MoreThis study deals with the intellectual representations whose intellectual systems are incarnated in the Jewish personality, which is considered one of the complex intellectual systems that has caused controversy throughout the ages because of the ambiguity due to the religious and psychological factors that were reflected directly and strongly on the intellectual structure of the Jewish community in general and the Jewish - Zionist personality in particular, in an attempt (to create new dimensions embodied by intellectual representations of a human nature embodied by what that - peaceful - religiously oppressed - psychologically and socially isolated character presents, because of the curse of the peoples of the world that was a cause fo
... Show MoreThe research aims to measure the impact of the empowerment strategy on the performance of employees by mediating organizational trust in the organization. The problem of research was the weak ability of most business organizations to employ the strategy of empowerment in maximizing the performance of employees, and the importance of research in practice lies in the results of a guide to managers in how to use the strategy of empowerment in maximizing the performance of employees by mediating organizational trust dimensions of ability, benevolence, integrity. In order to achieve the objectives of the research and to answer the questions of the problem, the researcher has adopted the descriptive analytical approach as the questionnaire was
... Show More
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
... Show MoreThe research aims to identify the role of the dimensions of financial inclusion in achieving the competitive advantage by An exploratory research of the views of a sample of customers of the 20 Algerian commercial banks, And the relationship between its dimensions (Access dimension, Usage dimension, Quality) And competitive advantage. This research is based on the analytical descriptive approach. The questionnaire was adopted as a main tool in collecting data and information on the sample of 377.
The The research showed several results, the most important of which is a strong correlation between the dimensions of the three financial inclusion combined and the competitive advantage of the Algerian commercial banks, and explained t
... Show MoreThe topic of the research dealt with the image of Iraq in the British press based on a sample of the newspapers (The Guardian and the Daily Telegraph), which are among the most important and largest newspapers in the United Kingdom and the world, because of its active role in guiding local and international public opinion towards important issues and events, Since these two newspapers are interested in the accuracy of sensitive political topics, the message aimed at knowing the media image that these two newspapers painted about Iraq in the period that was limited to the first quarter of 2019, and also to know the nature of the contents promoted by these newspapers about the Iraqi reality, The method of content analysis was used as an ap
... Show More