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.
After word war ll, the United States of America pursued a policy of containment aimed at preventing the Soviet Union from penetrating into the countries of the world, especially the regions of the Middle East, Therefore, it worked to emphasize the establishment of relations that include various political, economic and even cultural aspects, and focused its policy in his aspect on Turkey due to its geopolitical position. At a time when Turkey was undergoing developments at various levels and a change in govemment policy after the Demccratic Party came to power, which focused in its foreign policy on strengthening reltions with the West in general and the United States America in particular. The US government was the supporter of Democrat
... Show MoreThe inflammatory response is a crucial aspect of the tissues’ responses to deleterious inflammogens. This complex response involves leukocytes cells such as macrophages, neutrophils, and lymphocytes, also known as inflammatory cells. In response to the inflammatory process, these cells release specialized substances which include vasoactive amines and peptides, eicosanoids, proinflammatory cytokines, and acute-phase proteins, which mediate the inflammatory process by preventing further tissue damage and ultimately resulting in healing and restoration of tissue function. This review discusses the role of the inflammatory cells as well as their by-products in the mediation of inflammatory process. A brief insight into the role of natural an
... Show MoreThis study aims to know the extent of the impact of Strategic Leadership as an independent variable in Strategic Learning as a dependent variable to help the senior leadership in Anbar University to take the right decisions to develop Strategic Learning programs in light of the circumstances of the Covid-19 and the sudden decisions adopted by the university to switch to E-learning and to blend. The survey was conducted by distributing a questionnaire that was adopted as a primary tool in data collection from the study sample represented by the university's senior leaders, An intentional random sample of (105) was selected from our community of (127), the data were analyzed by (SPSS) Depe
... Show MoreIn this study, active knife and fixed knife of single-row disc silage machine has three different clearance C1, C2 and C3 (1, 3 and 5 mm) and it is tried in three different working speed V1, V2 and V3 (1.8, 2.5 and 3.7 km / h) and PTO speed (540 min-1) and machine's fuel consumption (l/h), average power consumption (kW), field energy consumption (kW/da), product energy consumption (kW/t), field working capacity (da/h), product working capacity (t/h) and Chopping size distribution characteristics of the fragmented material were determined. It has been found that knife-counter knife clearances smaller than 3 mm (1 mm) and larger (5 mm) have a negative effect on machine performance in general. In terms of fuel and power consumptions, the m
... Show MoreInternational relations scholars have increasingly debated the evolving landscape of actors that challenge the traditional state-centric world order. A key element of this transformation is the rise of sub-state actors, which engages in alternative diplomacy parallel to the state, transcending traditional state-centric frameworks. This paper explores the significant shifts in international actorness over the late 20th century, focusing on the emergence and implications of sub-state diplomacy, or "paradiplomacy." First, the study introduces sub-state actors and their role in challenging the dominant state-centric discourse. It then examines the dynamic evolution of paradiplomacy, highlighting how sub-states have expanded their global
... Show MoreThis study examined the problem of identifying the vocabulary of the methodology of teaching Arabic language in the faculties of Media. The researcher noticed the existence of an overlap between the syllabuses of the general specialization of the Arabic language and its Media sections in the universities with the special professional vocabulary that suits the study of the media student. Thus ,this study is regarded as a real attempt to present a methodological model of media language that concerns with fillfuling students ‘linguistic and knowledgeable needs relying on measuring their benefits from the methodological Arabic curriculum . Key words:problem, teaching’ methodology of Arabic language, media language.
... Show MoreAfter the information revolution that occurred in the Western world, and the developments in all fields, especially in the field of education and e-learning, from an integrated system based on the effective employment of information and communication technology in the teaching and learning processes through an environment rich in computer and Internet applications, the community and the learner were able to access information sources and learning at any time and place, in a way that achieves mutual interaction between the elements of the system and the surrounding environment. After the occurrence of the phenomenon of Covid 19, it led to a major interruption in all educational systems that had never happened before, and the disrupt
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