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.
This study aimed to identify the attitudes of school teachers and principals at basic government schools in Ajloun governorate towards the inclusion of disabled students at basic schools, and investigate how they will accept the merger. To achieve the purpose of this study, a questionnaire containing 35 items was administered to school teachers and principals to measure their attitudes toward the inclusion of disabled students in regular schools. The sample of this study consisted of 43 male teachers and (74) female teachers and principals. The frequency, normal distribution, arithmetic means and t-test were used to analyze the data of present study. The findings showed that there
... Show MoreWe use of multi-choice Goal Programming (MCGP), which is a developed model of Goal Programming where it is used in circumstances of the multiplicity and difference of goals when choosing between decision alternatives in cases of allocating resources, as it is a model that seeks to find the closest and best solutions to the specific values of the goals within the aspiration levels, as the first goal in the multi-choice goal programming model that is used to reduce the total cost of storage and shortage, while the other goal was to reduce the difference between the real demand that the hospitals need from the blood transfusion center and the units that already achieved. The case Iraqi Center
... Show MoreThis study aimed to show the extent of compliance with the income taxpayer to provide tax returns and increase the speed of collection of these taxes in addition to increasing confidence in Income Tax department and reduce the number of cases transferred to the courts and promote taxpayer awareness in charge of the importance of self-assessment system, and study sought to investigate the effect of the existence of records documents, technical audit, and computational audit and documentary audit on income tax collections in Jordan, from the point of viewof Jordanian income tax auditors ,results shows there's a strong relation between these variables and Income Tax collections.
in this paper copper oxide (cuO thin films were prepared by the method of vacum thermal evaporation a pressure.
Although renewable energy systems have become an interesting global issue, it is not continuous either daily or seasonally. Latent heat energy storage (LHES) is one of the suitable solutions for this problem. LHES becomes a basic element in renewable energy systems. LHES compensate for the energy lack when these systems are at low production conditions. The present work considered a shell and tube LHES for numerical investigation of the tube rotation influence on the melting process. The simulation and calculations were carried out using ANSYS Fluent software. Paraffin wax represents the phase change material (PCM) in this work, while water was selected to be the heat transfer fluid (HTF). The calculations were carried o
... Show MoreThe paper deals with the language of Russian folklore. Folklore is a unique sphere of existence of the language, the most vivid expression of the national mentality. The folklore word embodied the perception and evaluation of the surrounding world. “What did the word in general mean for the life of the people? The word was equated ... with life itself. The word generated and explained life, it was ... the keeper of memory and the guarantee of the infinity of the future. The folklore text is studied by literary critics, ethnographers, historians, culturologists, and art historians. In the twentieth century, a new science emerged - linguo-folkloristics, the goals and objectives of which were formulated by A.T. Khrolenko only in the seven
... Show MoreThis study aims to create spatial balance between two Iraqi writers' novels (Maysaloon
Hadi, Alya Talib) technical and objective illustrates similarity points and difference in the
writers' style. We depended in our research on spatial classification considering the aggressive
and friendly, since the writers focused on them.
The research study concluded to many sides, some of which are similar and some are
different. Firstly, ingenuity description of the writers. Followed by the deep connection they
have. Because of the personal experience it emanated from alienation sensations and nostalgia
to deep roots to homeland.
On the other hand, difference aspects, we see Maysaloon takes symbols and illusions
unlike Aly
Purpose: We report a series of 29 pediatric patients who sustained head injuries due to metallic ceiling fans. They all were admitted to the Emergency Department of Neurosurgery Teaching Hospital in Baghdad, Iraq, during January 2015 to January 2017. Results: Pediatric ceiling fan head injuries are characterized by four traits which distinguish them from other types of head injuries; 1- Most of them were because of climbing on or jumping from furniture between the ages of two and five. 2- Most of them sustained compound depressed skull fracture which associated with intracranial lesions and pneumocephalus. 3- The most common indication for surgical intervention was because of dirty wound which mixed with hairs. 4- These variables were stati
... Show MoreOften times, especially in practical applications, it is difficult to obtain data that is not tainted by a problem that may be related to the inconsistency of the variance of error or any other problem that impedes the use of the usual methods represented by the method of the ordinary least squares (OLS), To find the capabilities of the features of the multiple linear models, This is why many statisticians resort to the use of estimates by immune methods Especially with the presence of outliers, as well as the problem of error Variance instability, Two methods of horsepower were adopted, they are the robust weighted least square(RWLS)& the two-step robust weighted least square method(TSRWLS), and their performance was verifie
... Show More