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.
Understanding of in-situ stress profiles and orientations plays a vital role in designing a successful hydraulic fracturing treatment. This paper is an attempet to examine the effect of lithology and in situ stress on geometery of hydraulic fractures. A hydraulic fracturing design simulator software called FracproPT with various capabilities for designing most of hydraulic fracture was used for simulate and optimize the hydraulic fracturing. For studying purpose, three different cases of stress gradient contrast between different formations are considered in this study (0.4, 0.5 and 0.75 psi/ft). The results obtained from the simulator showed that lithologies surrounding the pay zone have an effect on the fracture
... Show MoreThe graphic privacy feature is one of the most important specifications for the existence of any type of design achievements alike, which is one of the graphic products with its multiple data, and from here the current research investigates the graphic privacy of vector graphics design with all its technical descriptions and concepts associated with it and the possibility of achieving it to the best that it should be from Where its formal structure in children's publications, where the structural structure of the current research came from the first chapter, which contained the research problem, which came according to the following question: What is the graphic privacy in the design of vector graphics in children's publ
... Show MoreIn the name of God the Merciful
Praise be to God and the Hall and Peace Uncle Prophet Muhammad and blindness Alo and companions
Money is the lifeblood and a reason for living. An individual cannot live without money to make it
It is only through the necessities of life and the state that it can perform its duties and functions only
As money is so important, the state must regulate the balance of revenues
And expenses in order to avoid failure in Mizanitia, but perhaps the country may be exposed to crises
An exception that leads to misappropriation in the general Mizanitia and the Islamic Shari'ah is valid for Makkah
Time and place for all circumstances has created several ways to address the budget defici
Social interaction is the platform that enables people to connect and practice language. Active listening stimulates them to understand the language they are speaking. The problem of the study highlights that less attention to listening among speaking, reading, and writing skills causes the weakness of collaborative learning. This paper contributes to characterizing the effectiveness of collaborative learning in developing learner’s listening skills. It aims to underscore the role of target language learners as members of the learning groups and of the teacher in the collaborative learning process. 130 Iraqi EFL teachers from different colleges at the University of Baghdad participated in this study. The scores in the statistical data wer
... Show MoreIn our current era, women need to practice sports activities in order to compensate for the lack of movement. The development of life and the introduction of technology in all fields contributed to reducing body movements to the maximum. Many movements were also shortened, and some parts of the body became almost static. All machines became available in homes. Necessary to help women clean and cook. The presence of transportation also restricted women, so the walking sport that women used to practice when they went shopping in nearby places or to visit friends disappeared. As a result, many health problems emerged, prompting some developed countries to allocate financial aid with the help of insurance companies to these patients.The researc
... Show MoreCloud computing represents the most important shift in computing and information technology (IT). However, security and privacy remain the main obstacles to its widespread adoption. In this research we will review the security and privacy challenges that affect critical data in cloud computing and identify solutions that are used to address these challenges. Some questions that need answers are: (a) User access management, (b) Protect privacy of sensitive data, (c) Identity anonymity to protect the Identity of user and data file. To answer these questions, a systematic literature review was conducted and structured interview with several security experts working on cloud computing security to investigate the main objectives of propo
... Show MoreThis article discusses some of the metaphorical use of language units. Here we will define the basic concepts and underline the causes of this phenomenon. Through research it is proven that through the application of names of some body parts achieves the variety of metaphorical meanings.
The 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 MoreAlthough severe epistaxis is uncommon, it is serious. The systematic endoscopic nasal examination is an essential step in identifying the bleeding point and aiding electrocauterization. Currently, the S-point, which is located in the superior part of the nasal septum behind the septal body and corresponding to the axilla of the middle concha, is identified in about 30% of cases with severe epistaxis. Cauterization of this point has an excellent rate of controlling the bleeding and preventing its recurrence. We aimed to highlight the significance of the S-point in the management of severe cases of epistaxis.
