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.
In this research, we tackled the idea of absence and what companies it of interpretations and human, textual, philosophical and explanatory concerns. We also tackled the features and drawing them and identifying and lighting them by Ali Abdunnabi Az-Zaidi and how he read them as an Iraqi who writes in order to express a social, intellectual, political and religious reality in some of its aspects. The idea of absence and what accompanies it of pain or heartbreak or human change was a rich subject for all the writers and authors in the Iraqi theatre, and Ali Abdunnabi Az-Zaidi was one of them and the closest and most affected by it, who deserves discussion, explanation and briefing. The research problem was looking for the nature of absenc
... Show MoreBackground: Immediate implant placement in the maxillary anterior region was challenging, especially with the jumping gap and limited primary implant stability. Objective: To assess the autogenous dentin graft biomaterial's ability to improve the esthetic outcomes of an immediately inserted implant. Methods: Twenty patients with non-restorable retained roots in the maxillary non-molar region surrounded by natural sound teeth were included in this study after a complete clinical and radiological examination, including patient health and clinical fitness for the immediate dental implant procedure. A single dental implant was inserted for each patient, and the resulting jump distance was filled with the mineralized dentin graft and co
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The study focused on the application of smart tourism as one of the applications of electronic commerce in the form of (B2C) to attract tourists to Saudi Arabia, where the tourism sector is one of the important sectors on which the Kingdom depends on the diversity of its economy.
The purpose of the research: With the issuance of tourist visas for the first time the study noted a deterioration in the case of Saudi tourist sites over the Internet, which do not live up to this great interest by the Saudi government for this sector, which became vital to them. The study tried to identify the reality of the Saudi tourist sites through the Internet in order to identify the sui
... Show MoreThe study aims to know the nature of the expected relationship between market share management strategies and the variation in the performance of the shares of a number of Iraqi industrial companies listed in the Iraqi Stock Exchange. For the period (2005-2018) in the light of both the monthly closing prices and sales volume during the research period, the (Panel Data) method was relied on through a stylistic test (fixed effects model and random effects model), and the results determined the need to adopt the fixed effects model method for sample data and test Assumptions, the results showed the positive impact of market share according to its strategies on the performance of stocks according to its studied indicators (Treynor index
... Show MoreThe effect of cognitive trips via the Internet (web quest) accompanying practical lessons in learning some basic handball skills for female students
Abstract
The research aims to identify the application of corporate governance requirements according to the international standard (ISO 26000:2010) in the National Insurance Company. Strengths and weaknesses were identified to study the current state of this requirement's application in the company under investigation. The descriptive-analytical approach was utilized through a checklist derived from ISO 26000:2010. Several personal interviews and field visits were conducted to understand the extent of application and documentation based on various statistical methods. The results revealed a level of applic
... Show MoreThis study aimed at some of the criteria used to determine the form of the river basins, and exposed the need to modify some of its limitations. In which, the generalization of the elongation and roundness ratio coefficient criterion was modified, which was set in a range between (0-1). This range goes beyond determining the form of the basin, which gives it an elongated or rounded feature, and the ratio has been modified by making it more detailed and accurate in giving the basin a specific form, not only a general characteristic. So, we reached a standard for each of the basins' forms regarding the results of the elongation and circularity ratios. Thus, circular is (1-0.8), and square is (between 0.8-0.6), the blade or oval form is (0.6-0
... Show MoreThis study aimed at indicators of technical analysis and their impact on a group of trading stock indices related to it, by standing on the methods used in technical analysis and its various models, diagnosing the obstacles and difficulties that the participants face in predicting stock prices, and proposing solutions and recommendations to overcome and overcome them. From a scientific and practical perspective.
Where the research community consisted of (25) Iraqi private commercial banks, while the research sample consisted of (3) banks with a percentage of (12%) of the research community. The study used the analytical approach to the financial statements during the period between (1/2/ 2022-30/4/2022),
... Show MoreGood governance of service quality through the adoption of sustainable energy the study of A1- Karkh historic center of in Baghdad city
The operative system of theatrical performance depends on the construction of the scenographic space, as it constitutes the most aesthetic effect of the recipient, and the body of the theatrical discourse that contains the signs of the show, and it comes as an embodiment of the directing vision of the show director, so most of the world directors resorted to attention to the output treatment to establish the scenographic space, and thus it possesses a contrast in The embodiment of the directing vision according to the stylistic and hermeneutical dimension of the director, so the two researchers found the importance of studying the topic, and the study came under the title (Directing Treatments of the Scenographic Space in the Iraqi Theat
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