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.
bjective researcher through this research to Put a theoretical framework to strategic orientation the center on the market in the business and the diagnosis and interpretation of the nature of the link between relationships and influencing strategic orientation dimensions Almtmthelh organizations (Entrepreneurial Orientation, market Orientation, Interaction Orientation) and the performance of the Iraqi Private Banks The research community and the level of dimensional and through the use of scale (Balanced Scorecard) Bmnzawradtha the four, the test of this research in the Iraqi banking sector (Gulf Commercial Bank
... Show MoreThis takes research idea representations body in the works of artist Lisa Fattah al -Turk, and the qualities that represent them in the configuration and method of performance in order to achieve an important element in the development of the concepts of knowledge and cultural rights within the surface of the artwork including the body shape of his presence authority dominant in the history of art so it was for this audience motives Self , cultural , and part of the confirmation of the human side, and serves as a conveyor of ideas and diagnostic her.Search theme is determined to attend the address of the body in the works of artist Lisa Fattah al -Turk , a comparison in how the audience and what it will be , so Researcher seeks drilling
... Show MoreThe degree of the woman’s satisfaction on clothing depends, to a large extent, on the body measurements. If clothing is very wide, it shows her enormous and if it is too tight it may draw attention to the defects of the body. It may also lead to the compatibility or incompatibility of clothing with fashion. Whatever the quality of the garment in terms of sewing and design, the costume which is not suitable for body size may affect the physical style negatively and may give the wearer an improper look. Clothing was carried out without measurements and did not use models (templates). The method of preparation affected the overall appearance because it often did not fit the shape of the body completely. Therefore, people thought in many w
... Show MoreThe aim of the current research to determine the extent of logical intelligence in the book of chemistry for the fifth grade of science and to achieve the goal the researcher has prepared a special criterion in the areas of logical intelligence main and sub-to be included in the book after reviewing the previous literature and studies in this regard may be the final form after presentation to experts and arbitrators in the field of Educational and psychological sciences, curricula and teaching methods from (3) main areas and (21) sub-fields, then the researcher analyzed the book Bibih and applied branches and adopted the idea of both explicit and implicit as a unit of registration and repet
... Show MoreThe study aimed to exposure young university students and students talk programs offered by satellite TV exposure, as it represents these programs great importance Information Public Knowledge in general And the youth in private Including Posed From Opinions And ideas About Different Issues Raised Which Charges Opinion, And that Through Application Study Survey To Sample From Students of Diyala University, the Researcher display Public Accrediting Theory To Information Which Provided Means Media To achieve Objectives And satisfy Needs And hypotheses . The Problem Search was Determined Through Study of students of Diyala University exposure Programs Talk And measured&
... Show MoreThe present paper aims at investigating the linguistic image portrayed by UNICEF reports on the Iraqi child from a critical discourse analysis perspective during Covid19 pandemic (2020). The paper attempts to fill a gap in research literature concerning the linguistic construction of the Iraqi child by the UNICEF reports during the critical health crisis of Covid19. Van Leeuwen’s (2008) approach of social actor representation has been adopted for this purpose. From Van Leeuwen’s approach, the category of determination (single determination and overdetermination) has been selected to be the main analytical tool for its high compatibility with the set of objectives put forward to figure out how such a globally effective and
... Show MoreThe sports field is one of the fields that are concerned with the various methods and methods because of their positive impact on the development of actual training, the investment of the exerted effort in time, and through the follow-up of the researcher in the field and academic field, I noticed that there is a weakness in explosive ability, which affects performance and skill level during training and competition Therefore, the researcher decided to prepare maximum physical exertion exercises according to the anaerobic threshold as a principle of development in many physical and skill variables because good physical performance leads to reaching the best achievements and since the skill of shooting by jumping high - either constitutes a
... Show MoreThis research deals with the role that the media can play in spreading awareness, culture and sound behavior among members of society, due to its ability to reach the largest number of individuals; its wide spread within society; and the moral responsibility of the media in consolidating the components of civil peace. The media works on forming intellectual convictions and behavioral attitudes by publishing opinions and ideas, introducing them to people's awareness and enhancing them in the practice of their daily lives, he was its media medium. Sociologists and psychologists confirm that the media. The significance of the research comes due to the broadening of violence and sectarian fighting; the absence of a culture of civil social pe
... Show MoreWhen searching for an answer to the following question: What are the reasons for the reluctance of female physical education teachers in secondary schools to referee sports competitions according to the variable of years of service? It was found that the research aimed to reveal the differences between the opinions of the research sample of physical education teachers in secondary schools (girls) about refereeing sports competitions according to the variable of years of service. To achieve the research goal, it is assumed that there are significant differences between the average opinions of the research sample of female teachers and their reluctance and the reasons for the differences in the practice of refereeing sports competitions accor
... Show More
The aim of the research is to identify the effect of instructional design according to Kagan structure among the first intermediate school student’s, and how skills could help in generating information in mathematics. In accordance with the research objectives, the researcher has followed the experimental research method by adopting an experimental design with two equivalent groups of post-test to measure skills in generating information. Accordingly, the researcher raised two main null hypotheses: there were no statistically significant differences at the level of significance (0.05) between the average scores of the experimental group who studied the material according to Kagan structure and th
... Show More