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.
With the growing number of Internet users, public and private arts activities have become increasingly popular. Adolescents have begun to establish aesthetic taste and new cultural values. This category is the most affected one by the published images and ideas especially in the social networking space and specifically the Facebook. It is the most important problem in their cultural composition. This research aims to detect the problems of social networking sites in nurturing the aesthetic taste of adolescents. The researcher used the analytical descriptive approach to obtain accurate information describing the current situation or depicting the social reality of adolescents. The research concluded that the public discourse in social med
... Show MoreHumor is an interesting phenomenon that has been studied widely, yet it is considered a universal trait that cannot be an old subject for a study. This study is conducted to investigate humor from a universal pragmatic lens in a stand-up comedy show, namely, You Wanna Hear Something Crazy?. It aims to study humor as a coin with two sides, the production side and the understanding side. To achieve the aim of the study, the researchers use an eclectic contains Grice’s CP model (1975) and Habermas’s UP model (1979, 1984, 1987, 1998). The study has noted that while using the observance and the non-observance of the cooperative maxims to produce humor, the universal validity claims of truth, sincerity, and normative rightness for rea
... Show MoreThe study aimed to identify the perceptions of social studies teachers in the Governorate of Muscat about the importance of employing the skills of the twenty-first century in teaching. The study employed a qualitative approach. The two researchers used an analytical approach based on the Grounded Theory, the data was gathered through semi-structured interviews with (15) male and female teachers. The results indicated that social studies teachers relate the twenty-first-century skills more to improving students’ achievement level in the subject, while they see that these skills have less influence in developing students’ communication skills and cooperation with their peers. In light of the results of the study, the two researchers r
... Show MoreAbstract The strategic performance of the United States depends on dealing with the Middle East countries and its variants on several bases and motives that enabled them to achieve American hegemony and invest its interests at the expense of the region countries. Within this performance, the administration of the United State President Donald Trump presented the Strategic Document on December 18, 2017, which focused on the principle of "America First", to determine the direction of future US strategic performance in the formulation of means of cooperation and intersections or hostility in addition to interests and threats.The future vision of the Arab region and the Middle East as a whole, this strategy is based on the fact that
... Show MoreThe purpose of the current research is to investigate the impact of cooperative learning elements upon Iraqi EFL Academic learners` Educational outcomes in Syntactic proficiency. The hypothesis of current research is that there are no statistically significant differences between the mean score of experimental groups that used Kagan’s PIES (Positive reliance, Individual Accountability, equivalent cooperation, Simultaneous Interaction) and the control group that followed conventional method. In this study, the sample of the study is (30) university ESP learners were involved at college of Education. The control group (15) students were taught in conventional teaching whereas other (15) learners in experimental groups exposed to Kagan’s P
... Show MoreThe present study aimed to evaluate the concentration of Malon dialdehyde (MDA) in pregnant women during different stages of pregnancy (stage of pregnancy, abortion, contraceptives and parity number).The study included (120) blood samples from normal pregnant women in age of the procreating were subdivided into three trimesters of pregnancy (40/group), and (40) samples from non-pregnant women as a control group. The results showed a significant increase in MDA in three stages of pregnancy compared with the control group. The concentration of MDA increased significantly in pregnant women with multipregnancy when compared with pregnant women for the first time, and in pregnant women whom was using contraceptions compared with p
... Show MoreStudy of determining the optimal future field development has been done in a sector of South Rumaila oil field/ main pay. The aspects of net present value (economic evaluation) as objective function have been adopted in the present study.
Many different future prediction cases have been studied to determine the optimal production future scenario. The first future scenario was without water injection and the second and third with 7500 surface bbls/day and 15000 surface bbls/day water injection per well, respectively. At the beginning, the runs have been made to 2028 years, the results showed that the optimal future scenario is continuing without water in