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 cities are not yet a temporal status in the process of the human and civilization development. The cities consider as a life pattern, this mean that people cannot live without cities, which surround us. Several phenomena like globalization, revolution of information, technical development, increased of consumption, do not confirmed without the living in cities. The urbanization – in its simple meaning – means transferring from rural community to city community. In other word, it means that socioeconomic changes happened subject to the patterns and conditions of the urban life. Each government depend a certain policy, this policy contains set of plans and programs, that targeting to affect the population factors and the st
... Show MoreThe specialist researcher fined the relations between economic ideas with economic facts in his theory which called humanity building it is appeared clearly ( in Ibn Khalduons’ Muqaddimah) in a clothe of economic social phenomenon's as a systematical analysis in all fifty chapters of al Muqaddimah ,therefore this paper deal with Ibn Khalduon economic thoughts as important says which describe the society building in its economic subjective and examine the relationship between The dissert and the city within economic says which are cover the social analysis ,and determinate the analysis objects which clearly in this dualism model ,between the state and economic bas
... Show MoreThe inner wasteland can be observed in Samuel Beckett’s early and later plays. His characters suffer from loss of identity, emotions, and sense of time. They lead a life of failure, repetition, inaction, loneliness, doubt, suffering, and nothingness. The inner wasteland includes many aspects, such as the multi and split identity, the habitual repetitive element of life, the dark sorrowful life the characters lead, lack of communication and relations among them, their unfree, inactive condition, their foggy terrible recollections, loneliness, dryness of love, and uncertainty. The analysis and the illustration of each aspect will show how the inner wasteland is intensified in the selected later plays of Beckett.
The research aims to demonstrate the impact of internal audit in Iraqi economic units on enhancing social performance reports, through the statistical models used, as a survey list (for the independent variant) of the search, which contains five axes of each axis, contains a set of The questions were prepared on the basis of the standards issued by the Institute of Internal Auditors (IIA) and were distributed to a sample of internal auditors, as for (for the approved variable) the researcher obtained numerical data represented by the financial statements of the research sample and used statistical models such as model (Kolmakrov-Smirnov) is a good match (goodness of fit) which assumes that the data is distributed naturally as wel
... Show MoreSubjected Find winged bull Assyrian monetary analysis in order to identify the formative relations in terms of percentages, movement and public swab for being aesthetic values upon which the mechanisms of artistic composition, which did not give researchers artistic interest that affects the status of these sculptures and the like of the achievements of the Iraqi civilization in Assyria.
Resulting analysis to a number of the most important results, the percentages approved in the calculation of the parts to do with all when viewed status horizontal with a realistic formulas while in the case of considering frontally clear for Ras stylized proportions and head size larger in length, a ratio confirmed by previous studies, and
... Show Morefashion designers who have benefited greatly from the mobilization of ancient aesthetic ideas in the heritage of the people and guaranteed in their productions so that there is no change In the aesthetic value created by the designers of the research in the ancient heritage to find new signs that reflect the connection of man to the present as the aesthetic value of all the man created by the designs of fabrics and fashion through the ages The problem of research was determined in the absence of a precise understanding of the nature of classical thought in fashion and the absence of a clear perception of the sustainability of this thought in contemporary fashion. He
... Show MoreThe theory of Pilgrims in the Magra is based on Dekru's view that the mgha is considered a pilgrim, and that the pilgrims are pilgrims
Tujia purely exposes the abstract temptation structure, and that the discharge of the Mfezouz Mfarouz is through factors
This theory tends to highlight the role of pilgrim function as a language
There is no preservation unless directed towards a particular outcome. Gemma can include morphine blindness
Or formulas that allow for the presentation of a pilgrimage to a writer in addition to the content of the news, and the guidance of the recipient
In one direction or another.
The orbital masses are one of these morphines and functional components that achieve function
The Togolese
