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 Arabic grammatical theory is characterized by the characteristics that distinguish it from other languages. It is based on the following equation: In its entirety a homogeneous linguistic system that blends with the social nature of the Arab, his beliefs, and his culture.
This means that this theory was born naturally, after the labor of maintaining an integrated inheritance, starting with its legal text (the Koran), and ends with its features of multiple attributes.
Saber was carrying the founding crucible of that theory, which takes over from his teacher, Hebron, to be built on what it has reached. It is redundant to point to his location and the status of his book.
So came to my research tagged: (c
In our previous research , we study the method of women by ( al – sakhaawi " died 902
ah/1496a.c"book witch called ( al- dhau, al-lami) .
So in this paper , we will discuss the social life of women in the mamluk period through the
same book ,especially when the sakhaawi devoted a full part for women in the same book
called it (mhagam ,al –nessa)wich it translations a large number of women like wives
,daughters ,sisters ,and maids of mamluk sultans ,so that make my able to know a lot about
the social life of woman which we study it like a social aspects of women, here wealth,
business, professions ,and in the last we study the habits of them marriage .
The ration card system is a kind of support provided by the state to individuals through the provision of essential goods at subsidized prices during the period of war or crisis. For many years, the ration card was an essential source of food supplies to Iraqis, especially under the economic siege of the nineties, But after the events of 2003 and the passage of Iraq's political and economic changes required radical reforms in the ration card system according to the recipes of the International Monetary Fund. It was evident from the estimation of the demand function that the price did not have the greatest impact on this type of goods because the ration card items are subsidized by the government. There is also a
... Show MoreEducation quality evaluation is one of the objectives of education quality. The evaluation includes assessing the education standards and academic program outcomes to develop intellectual, scientific and practical concepts for the educational structure. It considers the determination of the rates of the number of accepted students and graduates. The research focuses on "what are the levels of education quality according to the evaluation mechanisms in the design department" to enhance the quality system and the objectives of theoretical and applied education.
It is identifying the levels of education quality and evaluating it according to the numbers and rates of graduate students of the design department branches for morning and ev
The research aims to identify the reality of the management strategy followed in the treatment of solid waste in the city of Baquba, and what strategies are used to treat solid waste, and the extent of the application of these strategies, through personal interviews with leading cadres in the Directorate of Baquba Municipality, their assistants and heads of departments, they numbered (55) Individuals. The descriptive method was adopted through a questionnaire prepared to measure the extent of the implementation of the strategy of solid waste management in the city of Baquba and using statistical tools including (arithmetic mean, standard deviation, relative importance, the gap). The research reac
... Show MoreExpansive soil is one of the most serious problems that face engineers during the execution of any infrastructure projects. Soil stabilization using chemical admixture is one of the most traditional and widespread methods of soil improvement. Nevertheless, soil improvement on site is one of the most economical solutions for many engineering applications. Using construction and demolishing waste in soil stabilization is still under research., The aim of this study is to identify the effect of using concrete demolishing waste (CDW) in soil stabilization. Serious tests were conducted to investigate the changes in the geotechnical properties of the natural soil stabilized with CDW. From the results, it is concluded that the
... Show MoreHydraulic fracturing is considered to be a vital cornerstone in decision making of unconventional reservoirs. With an increasing level of development of unconventional reservoirs, many questions have arisen regarding enhancing production performance of tight carbonate reservoirs, especially the evaluation of the potential for adapting multistage hydraulic fracturing technology in tight carbonate reservoirs to attain an economic revenue.
In this paper we present a feasibility study of multistage fractured horizontal well in typical tight carbonate reservoirs covering different values of permeability. We show that NPV is the suitable objective function for deciding on the optimum number
An expression for the transition charge density is investigated where the deformation in nuclear collective modes is taken into consideration besides the shell model transition density. The inelastic longitudinal form factors C2 calculated using this transition charge density with excitation of the levels for Cr54,52,50 nuclei. In this work, the core polarization transition density is evaluated by adopting the shape of Tassie model together with the derived form of the ground state two-body charge density distributions (2BCDD's). It is noticed that the core polarization effects which represent the collective modes are essential in obtaining a remarkable agreement between the calculated inelastic longitudinal F(q)'s and those of experimen
... Show More