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.
There are many developments in political, strategic aspects in the middle east either in
international field which represented by U.S.A as first polar in world or territorial field which
represent by Turkey and Iran, as territorial powers in the region, Turkish role is fit with
American position in order to draw new map of middle east, Turkey advocate new policy to
confirm its attitude in Euro peen Union and its relation with U.S.A.
Iran adopted policy of Expansion in Iraq, Yamen, Lebanon and Syria, in addition Iran
enlist all it efforts to develop its Nuclear program and enter Nuclear club which make Iran,
Super power in middle east and the world, each Turkey and Iran have certain attitudes toward
all political c
Perhaps going to watch movies in cinemas today has become different from what it was before. The cinematic film, the clarity of the image and the luster of its colors pulled the rug out from under the most important change that occurred in the structure of the contemporary cinematography, which is the sound. The surround sound environment that immerses viewers in the realism of sound that reaches them from all directions, and for this the researcher found it necessary to shed light on this topic because of its importance, so the research problem was represented in the following question: (How are modern sound systems used in the structure of contemporary feature films?) The theoretical framework included two topics: the first: the dialec
... Show MoreGiving advice refers to an attempt by the speaker to express what the addressee should do in a particular situation or what is good for him/her. It is also a feature of making social relations and communications move smoothly and become stronger. The current study aims to investigate the strategies of the speech act of advice by old females and males for the younger generation in written signs. Comparison is made between old females and males regarding their pragmatic use of advice and the way they are manifested in expressing gender identity differences. The sample of the study consists of (30) written signs of advice divided equally between the two gender groups. Hinkel’s (1997) classification of the strategies for perceiving th
... Show MoreThis study shows impoliteness as a form of face-threatening that can be intentionally caused by verbal threats in a particular setting. It investigates: what strategies and mitigators do Iraqi-Kurdish English as a foreign language (EFL) learners use in situations of threat responses? The present investigation paper aims to examine impoliteness strategies and mitigators by these learners when they respond to threatening situations in their context. Thus, it fills a gap in pragmatics literature by investigating the reactions to threats in an Iraqi-Kurdish EFL context. To this end, 50 participants have participated in this study. An open-ended questionnaire in the form of a Discourse Completion Task (DCT) is used to elicit responses fr
... Show MoreABSTRACTBackground: cochlear implants are electronic devices that convert sound energy into electrical signals to stimulate ganglion cells and cochlear nerve fibers. These devices are indicated for patients with severe to profound sensorineural hearing losses who receive little or no benefit from hearing aids. The implant basically takes over the function of the cochlear hair cells. The implant consists of external components (microphone, speech processor and transmitting coil) and internal components (receiver stimulator and electrode array). The implant is inserted via a trans mastoid facial recess approach to the round window and scala tympani.Objectives: to determine the effectiveness and safety of non fixation method in cochlear imp
... Show MoreThe paper delves into the examination of trauma portrayals in Heather Raffo's “Noura” (2019). Raffo examines the challenges faced by two Iraqi women, Raffo and Maryam, in relation to parenthood following the capture of Iraq by “ISIS”. The paper is concerned with the various depictions of trauma that Raffo accomplishes in the text then delves in the way she cocooned her characters’ identity in order to recover their traumas. Initially, Noura is a trauma tale, illustrating the recurrent and repetitive nature of trauma from mother to daughter. The narrative reflects the interactions and dynamics between the mother and daughter and their function as substitutes for memory and recounting personal narratives. Moreover, examin
... Show MoreI have studied the relationship between blood groups in humans and disease Cutaneous injury for the first time in Iraq study showed the presence of a significant statistical relationship between them leather Bmsoy in hospitals in Baghdad and its suburbs
Although the number of implants has increased gradually and consistently over the years to around one million per year globally, there is still far more potential for advancement in the field of dental implantology which is typically growing quickly. This study investigates the effect of nanofiller reinforcement high-performance polymer matrix to enhance mechanical and physical characteristics. Calcium silicate (CS)/Polyetherketoneketone (PEKK) biomedical composite (G0 as a control group) is reinforced with different weight percentages (G1-G4) of tellurium dioxide nanoparticles (TeO2NPs) ( n = 5). This research uses ethanol as a binder for mixing various weight percentages (wt%) of TeO2NPs w
... Show MoreThe most common cause of death is cardiovascular disease (CVD), with ischemic heart disease being the most notable type. There is a propensity to raise the sensitivity of methods in contemporary laboratory for diagnosing of CVD, and assessing key as CVD bio-indicators. The urgent task is to seek for different indicators as a hopeful tool for early detection and monitoring of myocardial infarction in blood samples only. This study comprised 117 Volunteers, recorded with both genders in the age range of 32-64 years old. The volunteers were categorized into two groups: 67patients of myocardial infarction, other group embraced 50 healthy individuals. The samples of blood were collected and directed for biochemical analysis to evaluate estr
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