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.
Abstract
This paper tackles the theme of alienation as being a concurrent state of human being from birth to death; so extensive is the description of this state by writers. Alienation has been a product of their hard experiences and miserable lives. One such writer is Jean-Marie Gustave le Clézio who was so perfect in describing alienation in his works. Upon so many occasions, he imagined one or more of his characters as living in a chaotic world and so lived safely in alienation. The novel "Le Procès-Verbal" is one of the most important of his works. This paper deals with e the narrative structure of novel while shedding light on the hero's alienation: its essence and causes.
... Show MoreLegislative language is characterized by its complexity, specifically in the process of translating statutory terms from two quite different languages, and from totally two different legal systems as from Spanish into Arabic. The present study stresses the process of translating legislative terms used in Spanish wills into Arabic through high lightening the polysemy of such mentioned terms and explaining their use in other legislative grounds. Additionally, the present study elucidates, analyzes, underlines the difficulty and looks for the most appropriate procedures and techniques of translating some of the prominent inheritance expressions taking in account the legislative dif
... Show MoreJean-Paul Sartre and Badr Shakir al-Sayyabe are among the most prominent writers that critiqued the destructive role of capitalism and the patriarchal power system in the period of the Post-World War II crisis. Divided into three chapters, the present study examines two of the most eminent literary works in the history of the Western and Eastern societies in the fifties of the last decade: Jean Paul Sartre’s play : The Respectful Prostitute and Badr Shaker al-Sayyabe’s poem: The Blind Prostitute.
Chapter one discusses the position of the prostitute in a patriarchal societies. Chapter two linguistically analy
... Show MoreBecause asceticism has a great impact on educating the human soul properly, according to what was mentioned in the Book and the Sunnah of the Prophet, and keeping it away from vices and what is devolving into it, and this world and its adornments keep the Muslim away from virtues and work with them in order to reach the Hereafter in which is the eternal bliss that God, peace be upon him, has prepared for the obedient. The two pious obedient ones. And because of the impact of this topic on the Islamic community and adorn it with good qualities. Likewise, I saw many Muslims who do not prefer the life of this world over the hereafter, and they began to fight over the world and enjoy its adornments, and they took pride in money, building, an
... Show MoreExtemporization is the ability of the actor to reflect his internal being. It gives a sort of confidence and an ability to show the personal countenance of the role away from tension and rigidity. By extemporization, it is possible to deal with and criticize the real living life so it is an intellectual, emotional, sensual, and perceptive process connected with the psychological energy and the emotional memory and all this goes under the control of the director and his instigations and instructions depending on what the text involves of intellectual, social and psychological motivators so it primarily depends on talent, chance and discussion. The research involves four chapters; the first contains the problem
... Show MoreThe research aims to identify the impact of using the electronic participatory learning strategy according to internet programs in learning some basic basketball skills for middle first graders according to the curricular course, and the sample of research was selected in the deliberate way of students The first stage of intermediate school.As for the problem of research, the researchers said that there is a weakness in the levels of school students in terms of teaching basketball skills, which prompted the researchers to create appropriate solutions by using a participatory learning strategy.The researchers imposed statistically significant differences between pre and post-test tests, in favor of the post tests individually and in favor of
... Show MoreThis study includes applying chemical tests on cow, sheep and chicken bones including both hallow and flat. The results of chemical tests on bones mentioned the moisture percentage which was between 4.95-7.32 %, and it was noticed the difference in protein percentage among different kinds of bones, The highest protien percentage was 39.62 % in hallow chicken bones and the lowest was in hallow sheep bones 20.31%, at the same time, the highest Ash percentage was in hallow sheep bones48.11% , whereas the highest percentage of fat was in hallow cow bones 30%. The chemical and physical tests were conducted for extracted fat from hallow and flat bones for cows, sheeps and chicken. It was found that peroxide values (PV), and free fatty acids (F
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The current research aims to examine the effect of the Adi and Shayer model on the achievement of fifth-grade students and their attitudes toward history. To achieve the research objective, the researcher has adopted two null hypotheses. 1) there is no statistically significant difference at the level of (0.05) between the average score of students of the experimental group who study the history of Europe and modern American history according to the model of Addie and Shayer, and the average scores of the students of the control group who study the same subjects according to the traditional method in the test of post-achievement. 2) There was no statistically significant difference at the level (
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This study aims to identify the repercussions of the Corona pandemic (Covid 19) and its impact on the educational and psychological functions of the Omani family from the point of view of a number of fathers and mothers. Drive for a group of fathers and mothers, some of whom work in the government sector and others are mothers enrolled in graduate studies programs at the university, their ages range between (30-50 years) totally (28) mothers and fathers: 22 mothers and 6 fathers. The results showed that the repercussions of the transformation of e-learning, home quarantine, social distancing, and the challenges associated with them were among the most frequent responses that posed a real challenge to the
... Show MoreThe research aims to understand the psychological status of and the feeling of loneliness of the trainees (recently released detainees) participating in the training and rehabilitation courses held in the Technical College - Baghdad. The study was conducted on a specimen of (23) trainees. An open questionnaire was adopted which included one question that was ( What was your feeling psychologically and socially before taking part in the training course?) , also the feeling of loneliness Scale , designed by ( Russel,Peplau, Cutrona /University of California Los Angeles ) was implemented after the courses .
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