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.
يهدف البحث الى صياغة استراتيجية اعلامية لمواجهة اعلام التنظيمات الارهابية
Urban land price is the primary indicator of land development in urban areas. Land prices in holly cities have rapidly increased due to tourism and religious activities. Public agencies are usually facing challenges in managing land prices in religious areas. Therefore, they require developed models or tools to understand land prices within religious cities. Predicting land prices can efficiently retain future management and develop urban lands within religious cities. This study proposed a new methodology to predict urban land prices within holy cities. The methodology is based on two models, Linear Regression (LR) and Support Vector Regression (SVR), and nine variables (land price, land area,
... Show MoreIn this paper will be applied to a probability model of inventories periods of multiple stores of raw materials used in the cement industry, cement factory in Samawah and basic materials are limestone, soil normal, iron soil, fuel oil and gypsum. It was built of this model after the test and determine the distribution of demand during the supply period (waiting period) for each subject and independently of the rest of the material as it is not affected by any of the materials above interrelated in the process of supply, this test has been using the Statistical Package of (SPSS) and then was determining the amount of request optimum seeking in each batch and each substance known volume of economic optimization of
... Show MoreBACKGROUND: In pregnancy, several physiological changes occur that lead to decrease in the level of hemoglobin. Anemia during pregnancy is a major public health concern in underdeveloped nations, with a high rate of morbidity and death among pregnant women. Inadequate prenatal care, a lack of information about the nutritional requirements of pregnant women, and general low socioeconomic circumstances all contribute to these high rates of morbidity and death. As pregnant women’s and husbands’ education levels increased, the frequency and severity of anemia decreased in the investigated community of pregnant women. AIM: This study aims to find out the level of knowledge about anemia in pregnancy among adult females attending pr
... Show MoreSeptember 11th attacks held the biggest tragedy in American history. It was a day of grief, and it proved that America was not immune to attacks and threat. Afterwards life has changed not only for the American Muslims but also American Christians and Jews and to people from other religions. The cruelty of that day has left its shed particularly on the Muslims’ life in America who in reality had nothing to do with the attacks. Arab American Muslim writer Laila Halaby’s novel, Once in a Promised Land, intensely displays the problems that Arab Muslims went through after September 11th attacks. This paper discusses this issue through analysing Halaby’s novel, where she deals with the issues such as discrimination, stereotype, and prejudi
... Show MoreThe study aims to indicate the role of the agricultural initiative in building agricultural development, mediated by activation of the role of internal and external audit on agricultural initiative projects, for the purpose of meeting the challenges of abuses on agricultural land and lack of water used in agriculture and proportions of high poverty, which led to the rural people of the migration to the city and leave agriculture and livestock, and that of the main conclusions reached by the researcher. When comparing the work of the external auditing agencies (the Federal Office of Financial Supervision) on the initiative of agricultural projects with internal audit services in the Directorate of Agriculture and branches of the Agricultu
... Show MoreThis study was designed to know the effect of Diclofenac sodium (voltaren) drug on the histological composition of kidney in domestic rabbits . Twelve adult males with (1.4) kg weight . The first group of animals administrated orally by 1 ml of Voltaren with 6 mg/kg , while the second group with (1) ml of distal water (as control group ) . the administrated continue for (60) days sequentially. The treatment with voltaren showed pathological cases in tissues and cells of kidney including necrosis, infilteration ,congestion in blood vessels edema.Also epithelial separation in kidney tubules in comparison with control group Conclusion from the above results, revealed that voltaren had negative effects on the kidn
... Show MoreBACKGROUND: In pregnancy, several physiological changes occur that lead to decrease in the level of hemoglobin. Anemia during pregnancy is a major public health concern in underdeveloped nations, with a high rate of morbidity and death among pregnant women. Inadequate prenatal care, a lack of information about the nutritional requirements of pregnant women, and general low socioeconomic circumstances all contribute to these high rates of morbidity and death. As pregnant women’s and husbands’ education levels increased, the frequency and severity of anemia decreased in the investigated community of pregnant women. AIM: This study aims to find out the level of knowledge about anemia in pregnancy among adult females attending pr
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This paper deals with the concept of electronic reference services in academic
libraries , showing forms of communications , training needs for reference librarians
and the role of the librarian in the new technological environment.
The need to create the optimal water quality management process has motivated researchers to pursue prediction modeling development. One of the widely important forecasting models is the sessional autoregressive integrated moving average (SARIMA) model. In the present study, a SARIMA model was developed in R software to fit a time series data of monthly fluoride content collected from six stations on Tigris River for the period from 2004 to 2014. The adequate SARIMA model that has the least Akaike's information criterion (AIC) and mean squared error (MSE) was found to be SARIMA (2,0,0) (0,1,1). The model parameters were identified and diagnosed to derive the forecasting equations at each selected location. The correlation coefficien
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