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 importance of the study lies in highlighting the role of smartwatches as a modern tool for analyzing training load based on functional indicators, such as heart rate and calorie consumption. This allows coaches to monitor individual players’ responses during different training periods, helping to improve physical performance efficiency and reduce the risk of overload-induced fatigue. The study aimed to analyze calorie consumption at different heart rate levels between the special preparation and competition periods for youth football players, with the goal of determining the effect of physiological adaptation on energy efficiency. To achieve this objective, the researcher adopted the descriptive method due to its suitability f
... Show MoreStarting from the term (forbidden montage) initiated by the French critic (Andre Bazin) as a method of processing the movies that depend on (mise en scene) achieved by the action of the camera and its ability to photograph and employ the depth of the field, in addition to the possibility of free movement without interruption in the filming environment in order to avoid montage as much as possible (the montage that distorts focus and distracts attention and moves away from realism, which is the most important theoretical pillar of Bazin in photography). The pursuit was behind a cinema that depicts its topics in one integrated snapshot with all its details thus approximating reality without any interference of montage. Our study sta
... Show MoreAbstract The current study is a theoretical study that aims to underline the role of picture books as a serious genre of children's literature in raising children's understanding of English literature and life concepts; especially for non-English speakers. Unfortunately, most Iraqi people have developed a social phobia of learning English since childhood. This phobia is resulted from the heavy traditional reading and writing assignments as well as hard exams. Therefore, this study suggests incorporating more interesting literary material like picture books that would bring pleasure and help in raising children's love and cognition of English Language. More significantly, it calls to replace the old curriculum with a more vital
... Show MoreThe objective of the research is to identify the effect of an instructional design according to the active learning modelsالباحثين in the achievement of the students of the fifth grade, the instructional design was constructed according to the active learning models for the design of education. The research experience was applied for a full academic year (the first & the second term of 2017-2018). The sample consisted of 58 students, 28 students for the experimental group and 30 students for the control group. The experimental design was adopted with partial and post-test, the final achievement test consisted of (50) objectives and essays items on two terms, the validity of the test was verified by the adoption of the Kudoric
... Show MoreBackground: The immunogenetic predisposition
may be considered as an important factor for the
development of Type 1 Diabetes Mellitus (T1DM)
in association with the HLA antigens.
Objective:This study was designed to investigate
the role of HLA-class II antigens in the etiology of
type T1DM and in prediction of this disease in
siblings, and its effect on expression of glutamic
acid decarboxylase autoantibodies (GADA).
methods:Sixty children who were newly diagnosed
type 1 diabetes (diagnosed less than five months)
were selected. Their age ranged from 3-17 years.
Another 50 healthy siblings were available for this
study, their ages range from 3-16 years. Eighty
apparently healthy control subjects,
Standards play a vital role in documenting the values of new test results in the form of tables. They are one of the basic requirements that the standardization process aims for as a complement to standardizing test procedures, and contribute to knowing the current reality of the student. The degree of readiness and level as a result of practicing different exercises for sports activities, in addition to the possibility of adopting it for comparison with his group or similar groups, classification, prediction and selection. Developing the skill of handling the football in the educational field is an important matter for achieving distinguished performance among students. This skill requires a level of accuracy, speed and control, and
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