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 modern teaching methods, and their importance in achieving the desired learning goals for the individual and the society, have been addressed, as it is necessary to develop the methods, ways and strategies used in the process of teaching the intermediate stages in the various fields in general and the field of physical education in particular, the importance of research is the effect of using the strategy of similarities in teaching some basic skills of basketball for students of the second intermediate. As for the problem of research, the researcher mentioned the lack of use of teachers’ strategy method similarities in the educational units because of its importance, and after study and analysis the researcher found it necessary to i
... Show MoreIn this research study the effect of fish on the properties optical films thickness 1200-1800 and calculated energy gap Basra direct transport permitted and forbidden to membranes and urged decreasing values ??of Optical Energy Gap increase fish included accounts optical also calculate the constants visual as factories winding down and the refractive index and reflectivity membranes also by real part and imaginarythe dielectric constant
Kurdish language multifunctional morphemes indicate the different functional morphological, syntactical, and semantic tasks of the morphemes. The present study discusses the multifunctional task of the Morpheme Le in Kurdish Language. The Morpheme Le has marginally been included in other studies, yet up to the present times, there has not been a research inclusively dedicated to thoroughly discuss and clarify its multifunctional aspects. The present study is divided into two chapters:
Chapter one discusses the theoretical aspect of chapter two that is entirely concerned with the practical aspect of the morpheme Le. The first part of chapte
... Show MoreThis study aimed to determine the level of spiritual intelligence among students of educational psychology course at the Jerash University. and whether this level of varies depend on the gender of the student as well as the college type. The study sample consisted of (180) male and female students of bachelor students at the University Jerash, in the second semester of academic year2014-2015. The main results of the study were that the level of spiritual
Intelligence of Jerash University students was high. More over There were no statistically significant differences at the level of significance (0.05) due to the effect of gender, college type or academic achievement
The purpose of the research is to investigate the response of stock prices of companies that issued debt instruments (bonds) listed on the Abu Dhabi Securities Exchange for information content from the Moody's first credit rating announcements for the period 1 January 2005 - 30 May 2017. The study methodology was used to verify the existence of this response by the market and the Market efficiency of the Semi-strong shape. The research focused on testing the impact of the initial announcement.The research showed that there is an influential information content to announce credit ratings in stock prices, with different responses between negative and positive. It was also found that the industrial sectors sample research separately d
... Show MoreFrom the responses of Imam Abi Zakaria al-Nawawi 676 AH on the grammarians in his commentary on Sahel Muslim
In this research, we find the Bayesian formulas and the estimation of Bayesian expectation for product system of Atlas Company. The units of the system have been examined by helping the technical staff at the company and by providing a real data the company which manufacturer the system. This real data include the failed units for each drawn sample, which represents the total number of the manufacturer units by the company system. We calculate the range for each estimator by using the Maximum Likelihood estimator. We obtain that the expectation-Bayesian estimation is better than the Bayesian estimator of the different partially samples which were drawn from the product system after it checked by the
... Show MoreThe research aims at determining the main reason for the deterioration of the services and determining the correct method of distributing the funds to the administrative and administrative units. The discrepancy between the size of the financial allocations and the municipal services was the main research problem. Therefore, the researcher identified the gaps in municipal services by the concerned departments and compared them with The percentage of funds obtained through the work of a checklist for each of the directorates concerned. The researcher studied the specific criteria for these services, which were approved by the Ministry of Construction, Housing, Municipalities, and Public Works, and compared them wi
... Show MoreThe researcher seeks to get scientific facts through knowing the relationship between the priorities of Yemeni audience in follow-up paper daily newspapers compared to surfing publics the online journalism sites and the nature of information obtained from online journalism sites and printed paper newspapers and the impact of the daily newspapers in the priority of issues and political events among a sample of a group of Yemeni readers in order to identify the extent to keep up the paper daily newspapers of the development in the field of online journalism and the extent of reading paper newspapers under the intense competition by online journalism sites, and are paper newspapers able to keep pace with the actual developments provided by
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