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.
Patients are very concerned about the lengthy nature of orthodontic treatment. It is necessary to find a non-invasive way to quicken physiologic tooth movement. This study's objective was to assess the effectiveness of low-intensity laser therapy in shortening the time and discomfort of orthodontic treatment. Experimental work: Using a split-mouth study to compare tooth movement with conventional treatment and laser-accelerated orthodontic tooth movement. A patient presenting with a class II division I malocclusion characterized by the misalignment of the upper and lower teeth as classified by Angle’s molar classification system was indicated to undergo fixed orthodontic appliance orthodontic treatment. The treatment plan involved bila
... Show MoreThe printing designer's creative thinking is a deliberate mental process based on specific skills that stimulate the motivation of the student to learn and call for new information for the investigation and research to discover the problems and attitudes and through reformulating the experience in new patterns depending on the active imagination and the flexible scientific thinking through providing the largest number possible of various unfamiliar printing design models, and testing their suitability and then readjusting the results with the availability of suitable educational, learning and academic atmosphere.
The designer's creative thinking depends on main skills. Fluency skill is to put t
... Show MoreThe research is exposed to an important issue, related to communication obstacles that prevent the media message contained in cultural topics published in local newspapers to reach the hands of the readers; or related to lack of awareness of aspects of that media message, Because it contains immersed vocabulary in elitism where, sometime, the average reader of the newspaper of medium-sized educated, and even the academic reader are unable to decode it and understand its significance.
After determining the problem of the study and the tools that the researcher wants to use to accomplish his research, a sample of students of college of Arts at the University of Baghdad was selected. As they are clo
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This research aims to know the effect of job burnout in the worker’s performance. The researcher presented a theoretical basis for job burnout and the worker's performance. In order to achieve the objectives of the research, a hypothesis was drawn up that determines the nature of the relationship between the independent variable of job burnout and its dimensions (reduced personal accomplishment, depersonalization, Emotional Exhaustion) and variable dependent performance of workers dimensions (productivity, job satisfaction, organizational commitment, creativity), And to represent the volume of this community according to (de Morgan, D. Morgan) glo
... Show MoreThis research is based on interaction of two most important variables to the business organizations in the current era , these two variables are (marketing orientation and quality of service), this research is trying to urge the service organizations to reconsider the mechanisms adopted in the formulation of its plans, It was the application of research in Korek Telecom and Asia Cell Telecom as a sector of service active and important in the business sector in Iraq, the information was obtained through the design of the Likert questionnaire , it was distributed (92) questionnaire , (50) for the company Korek Telecom and (42) of the Asia-Cell and represent research population sample
... Show MoreA character is one of the most important pillars of narrative production. Most critics believe that a character is the focus of events.
Jacob Steinberg, a Jewish writer who is Ukrainian by origin, wrote many stories, most of which spoke about the lives of Jews in the diaspora, especially in Ukraine. The environment there has been reflected in his stories.
Steinberg focused on the role of characters in shaping these productions.
In this study, we discuss the conflict of characters in Steinberg's stories. This conflict is characterized by different trends and goals. There is a conflict with the environment, a conflict with society, a conflict with the self,
... Show MoreObjectives: the study aims to findout the effectiveness of educational program concerning infection control guideline on nurses, and to find out the relationship between effectiveness of program and types of hospital unit, age, level of education, and years of experience of nurses. Methodology: A quasi-experimental design study was carried out in Baghdad teaching hospital in the wards, for the period of December, 20th 2013 to September, 30th of July 2014, The study samples is composed of (60) nurses who have been actually working in the medical ward, blood disease, psychiatric ward, and neurological war
In this work, a single pile is physically modeled and embedded in an upper liquefiable loose sand layer overlying a non-liquefiable dense layer. A laminar soil container is adopted to simulate the coupled static-dynamic loading pile response during earthquake motions: Ali Algharbi, Halabjah, El-Centro, and Kobe earthquakes. During seismic events with combined loading, the rotation along the pile, the lateral and vertical displacements at the pile head as well as the pore pressure ratio in loose sandy soil were assessed. According to the experimental findings, combined loading that ranged from 50 to 100% of axial load would alter the pile reaction by reducing the pile head peak ground acceleration, rotation of the pile, and lateral displacem
... Show MoreIn this work Different weight of pure Zinc powder suspended particles in 4ml base engine Oil were used.
Intensity of Kα Line was measured for the suspended particles ,also for mixture which consist from Zinc particle blended with Engine base Oil. Calibration Curve was drawn between Ikα line Intensity and Zinc concentration at different operation condition. The Lower Limit detection (LLD) and Sensitivity (m) of Spectrometer were determined for different Zinc Concentration (Wt%). The results of LLD and m for Samples were analyzed at Operation Condition of 30KV,17mA is best from Samples were analyzed at Operation Condition of 25KV,15mA