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.
Abstract
The human mind knew the philosophy and logic in the ancient times, and the history afterwards, while the semiotics concept appeared in the modern time, and became a new knowledge field like the other knowledge fields. It deals, in its different concepts and references, with the processes that lead to and reveals the meaning through what is hidden in addition to what is disclosed. It is the result of human activity in its pragmatic and cognitive dimensions together. The semiotic token concept became a knowledge key to access all the study, research, and investigation fields, due to its ability of description, explanation, and dismantling. The paper is divided into two sections preceded by a the
... Show MoreThis work evaluates the economic feasibility of various production scenarios for the Zubair reservoir in the Kifl oil field using cash flow and net present value (NPV) calculations. The Kifl field is an exploratory field that has not yet been developed or assessed economically. The first well was drilled in 1960, and three other wells were later drilled to assess the oil accumulation, so in this research, Different production scenarios were evaluated economically. These scenarios were proposed based on the reservoir model of the Zubair formation in the field. The research methodology used QUE$TOR software to estimate capital expenditures (CapEx) and operating expenditures (OpEx) based on field-level data, production prof
... Show MoreArchitecture has evolved through the ages as forms, relationships, materials and mechanisms according to the data of each era and up to the era of digital technology, where the change in proportions and aesthetic dimensions of contemporary architectural formation due to the capabilities of digitization has created innovative plastic properties using the void formation in the facades and the introduction of void as a formative and aesthetic element, which led to The emergence of new creative concepts and ideas that contradict traditional ideas and are consistent with the spirit of the times, led to a revolution in the world of architectural form at the level of (architectural ideas and the generation of shapes, materials and construction
... Show MoreThe Iraqi market for securities in light of financial globalization faces real challenges at the local and international levels, which were reflected in their shadows on the overall economic reality, which imposed the necessity of making fundamental changes in terms of form and content, and from here stems the research problem in the ability of the Iraqi stock market to adapt to the transformations Financial imposed by financial globalization in light of the weakness of the economic structure and its position in the global economy. The research starts from the hypothesis that the Iraqi market for securities in light of financial globalization has an important and significant role in the economic field, through its role in stimula
... Show MoreThe present research aims at identifying the impact of S.N.I.P.S strategy on the achievement of fifth grade students in natural geography
For the purpose of verifying the objective of the research, the researcher put the following zero hypothesis: There is no statistically significant difference at the level of (0.05) between the mean score of experimental group who study according to the (S.N.I.P.S) strategy, and the mean score of control group who study according to the traditional method in the achievement test.
In order to verify the validity of this null hypothesis, the researcher adopted the experimental method. Two groups of (60) fifth grade literary students were collecte
... Show MoreThe present study is concerned with the concept of ethics academically. It aims to investigate the major problems that contemporary Iraqi society suffers from; on top of which is the problem of sectarian and religious intolerance. Such a problem has a major role in the emergence of extremism and terrorism. It further destabilizes the security and stability of the country, exposing, as a result, the lives of citizens to the danger of genocide, disintegrating the social structure, stopping the wheel of development, rampant corruption, and deteriorating the political, social, moral and economic situation. Here comes the role of social work as governmental institutions and civil society organizations in curbing this reprehensible phenomenon
... Show MoreObjective: Assessment of health problems and identify demographical information to elderly. Methodology:
it is a descriptive study, data were collected by the researchers depended on the direct interview with the
elderly by using the study instrument (questionnaire) as well as review the records of the geriatric.
Results: The majority of study sample (66%) were males and (24.3%) were within age group (70-74) years,
(44.7%) were widows, and (41.7%) did not read and write. This study applied the international classification
of diseases(short-table) in (11) items, which stated that most of the elderly were complaining from
health problems: debility of hearing (80.65%), eczema or allergies (69.35%), debility of vision (66.9
This paper presents a numerical simulation of the flow around elliptic groynes by using CFD software. The flow was simulated in a flume with 4m long, 0.4m wide, and 0.175m high with a constant bed slope. Moreover, the first Groyne placed at 1m from the flow inlet with a constant the Groyne height of 10cm and a 1cm thickness, and the width of Groynes equals 7cm. A submergence ratio of the elliptic Groynes of 75% was assumed, corresponding to a discharge of 0.0057m3/sec. The CFD model showed a good ability to simulate the flow around Groynes with good accuracy. The results of CFD software showed that when using double elliptic Groy
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