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.
Background: Mother-infant bonding is an important psychological step postpartum and disturbed relationship may carry dramatic consequences as a psychological disorder which may affect the periodontal health of the mother. The aim of the present study was to assess the effect of the postpartum Mother-infant bonding on their periodontal condition. Materials and Methods: Mothers in the postpartum period with age range 20-35 years were subjected to postpartum Bonding Questionnaire (PBQ). Periodontal health status was assessed by measuring probing pocket depth and clinical attachment level. Results: The mean values of both probing pocket depth (PPD) and clinical attachment loss (CAL) were higher among disordered mothers than mothers with normal
... Show MoreTime represented a significant element in building any film story, despite its inability to express itself, but by employing the rest of the elements of the cinematic mediator language to express it. Time factor is present and manifested in all the details of the picture, and the more important is its presence in the event narration process. The narration totally depends on temporal structure in which it appears, which makes time a dominating element in the development of the narrative shapes and patterns. The narrative propositions have come to take new workings that time streams appeared that manipulate the time structure, reversing it, stopping it or making it fluctuate between the three levels of time, or repeating it or make
... Show MoreThis paper aims at discovering the real implication of deduction in the Arabic culture
with concentration on its applications in Arabic grammar, logic, and fundamentals of Islamic
legislations. Some light has been shed on deduction in the Arabic culture but most of recent
works did not analyze deduction according to the pragmatic analysis. This paper will answer
the following questions:
to what extent deduction in Arabic grammar could comprehend with deduction l logic and
fundamentals of thinking in Islamic thought?
how can we find the deduction thinking in the Qur’anic surah if Ghafir?
Can we find parts of deduction in the surah?
The methodology in this paper is descriptive analytical. This metho
The aim of the research is to identify the suitability of a patrol model in evaluating the financial performance of Iraqi banks. The financial reports of five Iraqi commercial banks were approved as a sample for research for the period from 2015 to 2020. The most common financial ratios were adopted for the purpose of measuring the five elements of the model, which are capital adequacy, profitability, credit risk, bankal efficiency and liquidity. The results showed the possibility of using the PATROL model in evaluating the performance of Iraqi banks, as it gave a realistic image of the reality of Iraqi banks in terms of high capital adequacy index and high liquidity, as well as fluctuation in profitability index, not to mention the prob
... Show MoreAbstract:
The aim of the research is to highlight the role of electronic human resources management practices in the sustainability of knowledge capital as one of its success factors, as well as the diagnosis and interpretation of the relationship between research variables and their dimensions. The research problem is that the University of Babil implements some electronic human resources management practices not in a complete way, The level of its application and the problems it faces, as well as the extent to which these practices reflect the knowledge capital and sustainability in the university, and highlights the importance of research as it is concerned with the electronic aspects and achieve the competitive advant
... Show MoreSummary Search Alachtgalat process semantic encoding carried out by the actor inside the theater to deliver the intellectual sense, and social, as well as the aesthetic to the recipient, the fact that the code is the function is operated relationship in accordance with the prior intent to deliver the implications of a particular intent, too, and the fact that encryption is the best way to transfer messages in system theater, where should the actor that has the ability to create images (sensory) or intellectual new in human consciousness on the basis of conversion of impressions collected from reality and re technically formed inside the theater, allowing the recipient to arrange these marks to obtain the meaning that lies in them. So he
... Show MoreNative speakers of English from different parts of the world have different accents,but the differences of accents are mainly the result of differences in the sound of vowels and consonants . The actual use of all these sounds in combination leads the speaker to produce a number of segments which only appear on the production level and realized on the perceptual one . RP pronunciation represents the teachable variety in all Iraqi universities because it is the most acceptable and understandable accent all over the world and not only in South East London ..The structure of the English syllable in RP pronunciation is influenced by the appearance of certain allophones especially aspiration and glottalization which ch
... Show MoreAs is known that the consumer price index (CPI) is one of the most important price indices because of its direct effect on the welfare of the individual and his living.
We have been address the problem of Strongly seasonal commodities in calculating (CPI) and identifying some of the solution.
We have used an actual data for a set of commodities (including strongly seasonal commodities) to calculate the index price by using (Annual Basket With Carry Forward Prices method) . Although this method can be successfully used in the context of seasonal&nbs
... Show MoreThe article examines the definition of the verb in the form of the imperative mood (imperative) _ general information about the verb in Russian .
A verb in Russian is one of the parts of speech that unify all parts of speech, expressing the meaning of action, movement, process in grammatical forms of time, type, mood, face and voice. The imperative mood is a grammatical feature of the verb expressed through several forms of the verb that urges someone to do things. In other words, imperative mood or (imperative) : - one of the single meaning of the form . The form of the imperative expresses a supplicatio
... Show MoreRole of public relations (PR) and from one community to another, depending on the different cultures of these societies in General, and different ethical values established by their practitioners in these communities organizations , public relations in developed societies, and in some developing countries have taken great strides to contribute to the strategic planning and decision-making, in the framework of their commitment to the values and ethical standards for practitioners, In contrast, we find that applied in Iraq still skips phase coordinate with different communication means with the aim of advertising and publicity for the organization. As a result of the limited recognition of the strategic and vital
... Show More