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.
After the information revolution that occurred in the Western world, and the developments in all fields, especially in the field of education and e-learning, from an integrated system based on the effective employment of information and communication technology in the teaching and learning processes through an environment rich in computer and Internet applications, the community and the learner were able to access information sources and learning at any time and place, in a way that achieves mutual interaction between the elements of the system and the surrounding environment. After the occurrence of the phenomenon of Covid 19, it led to a major interruption in all educational systems that had never happened before, and the disrupt
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The letters of the Al-Safa Brothers contain many tales, in which each story is a literary text that is independent from the other texts, but it constitutes a unified entity in its entirety, because these stories contain recurring structural elements that go into building each one of them. The stories - the subject of the analysis - were not keen on something that was keen on adhering to the Sufi vision and its apparent effect on the tales of the messages, starting with the announcement of the narration to the narrator and his attempt to persuade the recipient of the truth of what is being told and its realism, and made him believe it. The stories correspond to the formal construction of the ideal style defined by th
... Show MoreOne of the most important problems of Iraqi construction projects is the cost variances, so it is important to identify the problems and shortcomings that cause poor cost control. Through the utilization of questionnaires, the study evaluated how project costs were managed and reported. The questionnaire was distributed to 180 professionals working in the Iraqi construction sector, with a response rate of 91%. The results showed that a high percentage of projects are implemented with a difference between real and estimated costs, and the process of documenting cost data needs to be more secure. On the other hand, there is a weakness in providing the necessary work structure information to monitor costs and a lack of proc
... Show MoreThe performance of photovoltaic (PV) panel having staggered metal foam fins was examined experimentally in Baghdad, Iraq. Three staggered metal foam fin configurations attached to the backside of the PV panel were studied. The measured parameters were front and back surfaces temperature, open voltage and current circuits, maximum power, and PV efficiency. It was noted that the maximum electrical efficiency enhancement was 4.7% for staggered metal foam fins (case III) than the reference PV panel. The operating temperature of the cell was increased when the value of solar intensity was high. Thereby, the electrical efficiency was decreased. It was found that the metal foam fins decreased the PV temperature by 2-3 o
... Show MoreBackground: Penetrating neck injuries are common problem in our country due to increasing violence, terrorist bombing and military operations.
These injuries are potentially life threating and need great attention and proper management.
Objective: The aim of this study is to focus on the importance of anatomical zonal classification of the neck in the management of penetrating injuries of the visceral compartment of the Neck.
Methods :70 patients with various injuries who were managed at causality unit and Otolaryngology department in Al-Kindy Teaching Hospital during aperiod from January 1st 2015 to October 31st 2015.
The study carried on those patient depending on proper clinical examination and their urgent management.
In this research, the water quality of the potable water network in
Al-Shuala Baghdad city were evaluated and compare them with the
Iraqi standards (IQS) for drinking water and World Health
Organization standards (WHO), then water quality index (WQI) were
calculator: pH, heavy metals (lead, cadmium and iron), chlorides,
total hardness, turbidity, dissolved oxygen, total dissolved solid and
electrical conductivity. Water samples are collected weekly during
the period from February 2015 to April 2015 from ten sites. Results
show that the chlorides, total dissolved solid and electrical
conductivity less than acceptable limit of standards, but total
hardness and heavy metals in some samples higher than acceptabl
This paper aims to review the intellectual to the most important thought leaders administrative and strategic They both (Henry Fayol and Michelle Porter), who forward a lot of ideas that have helped countries in the advancement and progress their economies , has been drawing literature theoretical common border in Contributions ( Fayol ) philosophical and between applications ( Porter ), which reversed strategies of the three ( the leadership of the cost, differentiation, and focus ), so browse search how to apply and use the principles of Fayol in the implementation of strategies competitiveness of Porter, and stems from a problem ( ( to what extent a reflection of the principles ( Fayol) fourteen strategies (Porter ) competitiv
... Show MoreTo understand what the arts in general, and plastic arts in particular, have to do, it is necessary to know how they perform, not only that, but also to know their history, which we should understand at least in general terms. Which in turn gives an image of the standards of taste prevailing in each age, and some of the social and historical relationship of each era, and the cultural expression of that era, which is shown in the arts. We need to understand that the arts of each stage, although different from each other, yet remain interrelated in what we see through the effects that appear through the succession of times, which creates certain artistic traditions, inherited by one generation after the other. The research in this field de
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