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 researcher has studied in his research (International Public Relations methods in building the state's image through Cyberspace)
, analytical study of the Facebook and twitter pages for British foreign office , the role was played by the International Public Relations in building the mental image of British , especially after the new media and internet have became influential role in political life . and became an important tools used by political institutions as ministries of foreign affairs in the twenty: one century .
The researcher identified the problem of this study with the following question:
(what is the role of the International Public Relations in building the mental image of state through Cyberspace)
To answer
The purpose of this study is testing the effect of orgnizational learning in orgnizational Effectivness an applied study in Al-hiqma Jordinan Medecine Company . study sosiety 88 manegers sleect 80 of them .study used SPSS to test the hypothesis.study reachs to significant conculctions
This paper addresses some of the morphological views of Al-Seraphy in the matter of "altasqeer" (reduction) in his book, "shareh ketab Sibawayh" (the explanation of Sibawayh's book) linking between them (views of Al-Seraphy) and the data of the morphological theme, in ancient times, and recently. Through balancing between what we have learned from the views of Al-Seraphy and the views of other former linguists and grammarians and latecomers of him. In this research we have linguistically and idiomatically explained the definition of "altasqeer" (reduction), and it's standard morphological balancing and what has deviated from it, by the examples in both cases; then we has produced the views of the grammarians of that "the definition of "a
... Show MoreA dose of ten grams of the roots and leaves of Nettle (Urtica dioica) dissolved in (200)ml of boiled water then covered for (10)min. was given to a sample of (15) patients attending to the herbal department of ministry of health complaining of malnutrition and low Hb(hemoglobin) concentration and PCV(packed cell volume) levels with absence of any other predisposing factors disease inorder to find the effects of these roots and leaves on Hb and PCV levels for different periods of time in relation to age and sex variations . The study have shown that this mixture has a high significant effect (p<0.001) in elevating (Hb) concentration and PCV levels on those patients according to the differences recorded from the start of the basic period unt
... Show MoreABSTRACT: BACKGROUND: Infantile haemangioma one of the most common tumour of new borns , a safe and effective treatment options are under ongoing research . OBJECTIVE: The authors show the effectiveness and safety of low dose propranolol as a method for infantile haemangioma treatment . METHOD: In this study twenty- four patients with infantile haemangioma in different anatomical locations were treated with oral propranolol and the result were assessed in a retrospective analysis of the results patients were kept on 0.25 mg/kg/day for one month , then on 0.5mg/kg/day in 2 divided doses for another one month , in the third month the dose will be increased to 1 mg/kg/day in 2 divided doses , then the propranolol were given in a maintenance do
... Show MorePun concept the design discourse for the cover of magazines the researcher chose the German magazine Der Spiegel as a model for that, as the research problem was manifested by the following question: What are the representations of puns in the covers of the German magazine (Der Spiegel)? The researcher has identified four chapters for this study as follows: The first chapter is devoted to research procedures, and the theoretical framework, which is like the second chapter, included the literature related to the topic of research according to the two interlocutors. A review of the concept of pun in the field of typographic design and the functions that puns achieve in that field, leading to the third chapter, which included the analysis
... Show MoreThe research aims to demonstrate the impact of TDABC as a strategic technology compatible with the rapid developments and changes in the contemporary business environment) on pricing decisions. As TDABC provides a new philosophy in the process of allocating indirect costs through time directives of resources and activities to the goal of cost, identifying unused energy and associated costs, which provides the management of economic units with financial and non-financial information that helps them in the complex and dangerous decision-making process. Of pricing decisions. To achieve better pricing decisions in light of the endeavor to maintain customers in a highly competitive environment and a variety of alternatives, the resear
... Show MoreThe research aims at clarifying the role of green human resource management practices in achieving sustainable development. The research problem is that the health sector is less concerned with environmental aspects, specifically green human resource management practices, Which are reflected on sustainable development with their economic, environmental and social dimensions as well as reducing costs, waste minimization and recycling, And the research started from two main hypotheses to explore the correlation and influence between the variables of the research by analyzing the answers of the research sample, which included (136) employees of the Al-Imamein Al-kadhemein medical city, Data and information were collected using quest
... Show MoreMany cinematic adaptations were produced for the Grimms’ “Little Snow-White” (1812) including Mirror Mirror movie (2012), the contemporary version adapted by Taresm Singh. Singh’s version was able to depict the modern reality of women and went against patriarchy by embracing feminist ideologies of the fourth-wave feminism. Therefore, he challenged the ideologies of the mainstream cinema dominated by the patriarchal élite’s capitalist mode of production that still adhere to the stereotyped patriarchal image of women’s ‘victimization,’ ‘objectification’ and ‘marginalization,’ which did not represent women’s modern reality anymore. This paper, however, is a qualitative study aimed to prove that the femini
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