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 present study aims at answering the following questions:.
1-Which is more effective in enriching students. Vocabulary ,the use of short stories or the traditional way?
2-What extent has the use of short stories an effect upon the students. achievement in vocabulary test?
3- Is there any significant difference between the male and female student of the experimental group in vocabulary achievement test?
 
... Show MoreConflict is a common but complicated phenomenon. It has been extensively researched in many domains, including philosophy, sociology, psychology, and linguistics. Using the Critical Discourse Approach, this study examines the issue of self-society conflict in The Handmaid’s Tale. The significance of this work lies in the identification and explanation of the discursive strategies that force the ideological polarization of the positively portrayed self versus the negatively portrayed other. The purpose of this study is to answer two questions: what are the discursive strategies used in The Handmaid’s Tale to create a positive or negative representation, and how are these strategies implemented? Five extracts from The Handmaid’s
... Show MoreThis research aimed at studying the role of calculated knowledge an its efficiency in improving the performance especially most of the organizations are living within knowledge era which concentrate on new technology investment in different fields of modern live . Under the scientific trends towards the economy of calculated knowledge which depend basically on new computer program in order to utilize the knowledge to raise the level of work performance exploiting different resources in the best way that helps the organizations to achieve their objectives because the information technology and computer programs became a means of survival and indispensible instrument within the developed world which depend on prosperity . progress
... Show MoreIn this study, some attenuation parameters of gamma shields were studied. This shields consisting of composite materials of Unsaturated polyester as a base material and Nano iron oxide (Fe2O3) and, micro iron (Fe) as reinforcement materials at different percentages (1, 3,5,7and 9)wt%, and with different thickness (1, 1.5, 2, 2.5, 3, 3.5and 4) cm. The results showed that the use of nanoparticles is better than the microparticales in the field of radiation shielding. It has been shown that the values of attenuation parameters of gamma it bitter in the case of nanoparticles than case of the use of micro material.
- S. Eliot is one of the important founders of the modernist movement in literature, a cutting-edge poet of the first order. After his 1927 conversion to Anglicanism, he began calling himself a conservative, royal, and a classicist.
"Ash Wednesday" is the first long poem written by him after his conversion. It deals with the struggle that ensues when one who has lacked faith acquires it. It is richly but ambiguously allusive, and deals with the aspiration to move from spiritual barrenness to hope for human salvation.
"Ash Wednesday" not only struggles with an approach to faith but with an approach to a language capable of expressing it. Eliot's style is different from that that predates his conve
This study investigates successive carriage, a distinct legal and commercial form of international transport, arising from the absence or irregularity of direct transport routes. Under this system, multiple carriers perform consecutive stages of transport under a single document, with the first carrier fully liable to the consignor or passenger, including breaches in subsequent stages. The research examines the role of direct and indirect transport documents and the concept of recourse, allowing a carrier who has compensated an injured party to seek reimbursement from other carriers. It highlights carriers’ duties to inspect goods, document their condition, and collect freight, and critically analyzes maritime carrier liability under Iraq
... Show MoreWriting plays an effective role in developing one's thinking and
enhancing Learning. It is, in fact, a means of widening one's own views about
the world for the numerous uses that it can serve (Samuel, 1988:28).
In regard to the unquestionable significance of writing in the teaching –
Learning process, the traditional approach seems to be far from being able to
put such significance into practice. Traditionalists give priority to formulating
students' ideas before using prescribed rhetorical framework and then
submitting the written product for grading. Emphasis is, therefore, limited to the
prewriting stage where a certain topic is explored, and the role of the teacher is
confined to assigning the topic and
The research aims to test the impact of servant leadership in management information systems, as well as to identify the level of servant leadership practice and management information systems in the Directorate of Communications and Information Systems in the Iraqi Ministry of Interior, in terms of the importance of the research variables to the directorate and the sample community, as the research adopted the exploratory analytical descriptive approach In his achievement, through a survey of the opinions of an intended quota sample of (266) individuals, By adopting the questionnaire as a main tool for data collection that includes (44) items divided into the two research variables, As well as conducting open interviews to identify the pro
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