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.
Background: Acute appendicitis is the most common abdominal surgical emergency. The diagnosis of this condition is still essentially clinical and there is difficulty in the clinical diagnosis, especially among elderly, children and patients with a typical presentation, so early and accurate diagnosis of acute appendicitis is important to avoid its complications.Objectives: To evaluate the degree of accuracy of Alvarado scoring system in the diagnosis of acute appendicitis.Method: Two hundred patients were admitted to the Alkindy Teaching Hospital from January 2011 to april 2014- presented with symptoms and signs suggestive of acute appendicitis. After examination and investigations all patients were given a score according to Alvarado sc
... Show MorePlace is considered one of the important artistic elements in the movie through which the events occur in different arts and literatures and with its absence there isn’t any that can initiate events. Place is important for the things that we recognize, and the first fact in cinema is the place which can't be dispensed with on the level of the film or scene or cinematic shot that can't be emptied from its spatial content. The characters are always there in a place occupying some space of it, despite that it is not merely a container for the event cinematically. The researcher views the importance of discovering and observing them in this research which is divided into four chapters as follows: (theoretical framework) which includes the
... Show MoreThe problem of the research is indicated by answering the following questions: 1) what are the attitudes of the Arabic language teachers towards homework?
2) Do the Arabic language teachers differ in their attitudes towards homework according to their specialization? 3) Do the Arabic language teachers differ in their attitudes towards homework according to their gender (male and female)? According to the three questions asked above, we may state the following hypotheses. There is no statistically significant difference between the average of the marks of Arabic language teachers in the real practice of the scale of the attitudes towards their homework and their average in the hypothetical practice of the
... Show MoreVitamin D receptor (VDR) is a nuclear transcription factor that controls gene expression. Its impaired expression was found to be related to different diseases. VDR also acts as a regulator of different pathways including differentiation, inflammation, calcium and phosphate absorption, etc. but there is no sufficient knowledge about the regulation of the gene itself. Therefore, a better understanding of the genetic and epigenetic factors regulating the VDR may facilitate the improvement of strategies for the prevention and treatment of diseases associated with dysregulation of VDR. In the present investigation, a set of databases and methods were used to identify putative functional elements in the VDR locus. Histone modifications, CpG I
... Show MoreDisplacement is a problem that worries the human conscience and has received the attention of the international community. Furthermore, it has become one of the most urgent issues nowadays, especially when the number of displaced people in different countries are increased because of the causes of displacement and their political, economic, environmental, social and psychological effects. Iraq is one of the countries where displacement has taken place in several governorates, according to United Nations and International Organization for Migration (IOM), Iraq is considered the second largest country in the world after Syria in terms of the number of displaced people in 2015. Gratitude, a positive emotional response to benevolence, is a m
... Show Morekinetic studies were carried out the uterine homogenate time course of the association of with LH in benign and malignant uterine
The current research aims to: 1- Identify the emotional sensitivity of children from the parents' point of view. 2- Identifying the differences in the emotional sensitivity of children from the parents ’point of view, according to the parents’ gender variable (father - mother). The basic research sample consisted of (285) male and female students from the sixth grade (primary school), chosen in a randomized stratified method from the districts (Al-Karkh and AlRasafa). While the sample of statistical analysis amounted to (200) father and (200) mothers of male and female students who were randomly selected from the sixth grade of the education directorates (Al-Karkh and Al-Rasafa). The two researchers also used a number of sta
... Show MoreThe research dealt with the study of the element of time in the cinematic language and the role it plays in creating the aesthetic meanings in the documentary film by means of the various structural constructions with which time is constructed. The research included the introduction and the problem of research, which was represented by the following question: (Did the documentary film adopt the values of time formats in the fiction film or it created for itself special linguistic formulations and models which achieve the aesthetic concept?). It also included the importance of research, the need for it and its goal in addition to clarifying the limits of research.The theoretical framework included three sections the first of which is the
... Show MoreThe present study analyzes the violation of the strategies of conversation in two English plays namely Richard II and King Lear. The present study tries to achieve the following goals: 1. showing how the strategies of real conversation can be applied to conversation in plays. 2. analyzing how the characters communicate with each other to discover how Shakespeare violates the strategies of conversation in depicting his characters. The study has been conducted on the bases of the following hypotheses:
- The strategies of conversation which are derived from the study of natural conversation can be applied to conversation in drama with some modification for dramatic purposes.
This study focuses on the modeling of manufactured damper when used in steel buildings. The main aim of the manufactured dampers is to protect the steel buildings from the damaging effects that may result due to earthquakes by introducing an extra damping in addition to the traditional damping.
Only Pure Manufactured Dampers, has been considered in this study. Viscous modeling of damping is generally preferred in structural engineering as it leads to a linear model then it has been used during this study to simulate the behavior of the Pure Manufactured Damper.
After definition of structural parameters of a manufactured damper (its stiffness and its damping) it can be used as a structural element that can be added to a mathematica