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.
This paper deals with the role of the clergy in the Church and artists in the emergence of this art, which is represented by an atmosphere of spiritual, aesthetic, artistic, technical and engineering very magnificence and is located in two Find.Chapter One: the stages of stained glass in the Middle AgesThe Architects Goths to get rid of the walls gradually, based Baloctav plane, columns and beams strengthened with the vehicle, as previously mentioned, making the building looks like a glass of excessive use of colored windows building, this art has been known to the art of stained glass And the second chapter: the stages of stained glass in the Middle Ages Department of Winston (Winston) works of stained glass since its inception in the t
... Show MoreThe article considers the language of the mass media as a synthesis of the language means of all other styles of language. It is alleged that the newspaper and journalistic language actively uses foreign words and elements of words, replenishing the vocabulary of the language. It is noted that the lexical-semantic system of language is sensitive to socio-economic, political, cultural and scientific-technical changes. Attention is focused on the fact that one of the reasons that affect the change in the lexical composition of the language are the mass media. Thus, the language of the media is characterized by the use of a variety of neutral vocabulary, which, in conjunction with other words in atypical combinations for it, can acquire additi
... Show MoreIn the present study, the aim was made to identify the relationship between thyroid autoimmunity (TAI) and female infertility. The study was performed on 30 infertile women and 22 age-matched healthy fertile control age (33 ± 5 years). Overall, serum prolactin (PRL), thyroid stimulating hormone (TSH) assay is the key test for the diagnosis and management of hypo and hyperthyroidism. Anti-TPO Ab and anti-TG Ab were measured. The mean ± SE of serum PRL (31.080 ± 3.06) ng/ml was significantly (P<0.05) higher in infertile group compared with control (16.191±1.36) ng/ml. Serum TSH was significantly (P<0.05) higher in infertile group (5.689 ± 1.12) µIU/ml compared to control group (2.282 ± 0.18) µIU/ml. The prevalence of positive
... Show MoreA field study aimed at identifying the reality of the application of strategic management in the colleges of education/ University of Baghdad. The research adopted the descriptive analytical approach. The research community, consisting of 801 faculty teachers, has been identified. The research sample was selected in a simple random way and represented 15% of the research community, totalling 124 teaching members. A questionnaire was constructed that included (46) items divided between areas (strategic objectives, strategy planning and formulation, implementation of the strategy, and evaluation of the strategy). The honesty and consistency of the tool was verified. The researcher analyzed the research data using SPSS. The most important resu
... Show MoreThe multisystem inflammatory syndrome in children (MIS-C) considers a post-infectious immunological response to coronavirus illness (COVID-19) that was originally identified in the United Kingdom and later identified in other countries. A previously healthy 3-month-old boy was admitted to hospital context with -5-day history of fever, gastrointestinal symptoms [diarrhea, vomiting of normal gastric contents], hypoactivity, and poor oral intake, but so far no history of covid-19 active disease. The infant was dehydrated, with macular non-blanching skin rash everywhere over his body and widespread non-pitting edema. With supportive measures, methylprednisolone and IV immunoglobulin, the child improved, with his fever, skin rash, and labor
... Show MorePlanning of cities show great attention on streets planning as one of the most structural component foundations for cities, that providing many functional needs and connect parts of the city each other, and work as a commercial and services activities centers. Instead of this highly focused on distributing streets with different streets types such as economical and trading and housing streets. This concerned was only on the dimensions and scales of different types of vehicles and their movement. When scale and dimension and movement of mans were as a second priority in designing and planning streets. Which came's first for traditional streets. The research try to submit some designs guides for planners that contribute in re conce
... Show MoreIn the last decades, using mineral admixture in concrete became very necessary to improve concrete properties and reduce CO2 emissions associated with the cement production process. Subsequently, more sustainable concrete can be obtained. Ternary blended cement containing two different types of mineral admixture can achieve ambitious steps in this trend. In this research, the synergic effects of mineral admixtures in ternary blended cement and its effects on concrete fresh properties, strength, durability, and efficiency factors of mineral admixture in ternary blended cement, were reviewed. The main conclusion reached after reviewing many literature pieces is that the concrete with ternary blended cement
... Show MoreRisk identification and assessment can be analysed using many risk management tools. Fishbone diagram is one of these techniques which can be employed, for the identification of the causes behind the construction failure, which has become a phenomenon that often gets repeated in several projects. If these failures are not understood and handled scientifically, it may lead to disputes between the project parties. Additionally, the construction failure also leads to an increase in the project budget, which in turn causes a delay in the completion of the projects. Punching shear in reinforcement slab may be one of the reasons for construction failures. However, there are many doubts about other causes that lead to this failure as w
... Show MoreThe present study is a qualitative study that aims to investigate the way the Iraqi caricaturist,Dheaa Al-Hajjar uses caricatures to produce a satirical meaning humorously.Producing satire while at the same maintaining humor requires a creative thinking on the part of the caricaturist. Thus, the study examines the production of humorous satire in terms of creativity. The analysis is done from the cognitive linguistic point of view using Arthur Koestler's theory of bisociation as presented in his book The Act of Creation in 1964. The main principle on which the theory is based is that humor is created via linking (or bisociating in Koestler's terms) two habitually incompatible trains of thought in order to come up with a novel me
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