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.
Advancements and modernizations introduced into the educational and pedagogical systems have significantly impacted teaching processes and how subjects are presented and explained to students. The focus has shifted to how learners interact with the material they need to learn, providing sufficient opportunities for learning and granting them freedom and self-confidence to achieve learning objectives. The research problem stems from the researcher's experience as a lecturer in the College of Physical Education and Sports Science, particularly in teaching basketball. She observed that some instructors were deficient in using the most effective teaching methods. The researcher formulated her research question based on these observations: "What
... Show MoreA field study aimed to improve administrative performance of the Heads of Departments in Wasit University in light of the administrative functions, a questionnaire constructed was c of 38 items, as have been applied during the academic year 2014/2015 to a group of experts from the deans and assistants, professors and heads of departments using the Delphi method by two rounds the adoption rate of 90% and an agreement was numbered 30 experts and study reached important results have been analyzed and discussed according to fields of study, a planning, organization and direction.
For more than seven decades, the Palestinian-Israeli conflict has not ended, and every one claims his right to the land, waters, airspace and wealth of Palestine. This conflict was reflected in the political, military, social and cultural aspects, and the cinema had a prominent role in conveying messages to the world about this conflict. On the geopolitical dimensions and their impact on the cinematic image in the films of the Palestinian cause), the researchers divided the research into four frameworks that came as follows: (methodological framework) and included the research problem, its importance, research objectives, research limits and sealing the chapter by defining the terms. And (theoretical framework): it was divided into two s
... Show MoreCoagulation is the most important process in drinking water treatment. Alum coagulant increases the aluminum residuals, which have been linked in many studies to Alzheimer's disease. Therefore, it is very important to use it with the very optimal dose. In this paper, four sets of experiments were done to determine the relationship between raw water characteristics: turbidity, pH, alkalinity, temperature, and optimum doses of alum [ .14 O] to form a mathematical equation that could replace the need for jar test experiments. The experiments were performed under different conditions and under different seasonal circumstances. The optimal dose in every set was determined, and used to build a gene expression model (GEP). The models were co
... Show MoreThe current study is concerned with the analysis of spatial and temporal to death the elderly population in the city of Baghdad and at the level of administrative units Minor (districts and the areas) depending on the general population census of the province of Baghdad, data for 1997 and data from the Ministry of Health Department of Health and Vital Statistics for 2013.
The study showed differing age and quality of mortality rates at the level of administrative units of the study area, and notes the high mortality rates of elderly people of all age groups in 2013 compared to 1997, and this is due to security conditions after the USA occupation, and the accompanying conditions have affected the increase in mortality rates.
The research deals with the subject of «ways to face rumors in the site of social networking Facebook», a research based on a doctoral thesis, as the research dealt with rumors in the most dangerous type of new media, which sites of social communication with the global community as spreading rumors of all kinds and afflicts everyone who has eyes on him Of the audience of these sites, and aims to identify the rumors on Facebook because it is one of the most popular sites in the world and the strategy of combating the rumors published by Facebook users in their personal pages and groups that organize them, as well as identify methods and methods that can be During which the face of the rumors in the said site and eliminate them t
... Show MoreThis research aims to present a proposed model for disclosure and documentation when performing the audit according to the joint audit method by using the questions and principles of the collective intelligence system, which leads to improving and enhancing the efficiency of the joint audit, and thus enhancing the confidence of the parties concerned in the outputs of the audit process. As the research problem can be formulated through the following question: “Does the proposed model for disclosure of the role of the collective intelligence system contribute to improving joint auditing?”
The proposed model is designed for the disclosure of joint auditing and the role
... Show MoreThe rapid reality of events in the information era, and the enormous pressure of forces market, competition, permanent movement of the markets and consumers and the large development unprecedented of technology in all areas make a lot of organizations find it difficult to keep up with this rapid developments .Here was the role of strategic vigilance closer organization to their environment ,and play an active role in providing the necessary information to make decisions and insurance companies are not far from those changes .On this basis the researcher offered studied(Over the awareness of managers of insurance companies for strategic vigilance).Choosing sample of 35 managers in the National Insurance Company to test th
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