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.
This study seeks to uncover the aesthetics of the internal rhythm and its effectiveness in
enriching the poetic text with the music tone at represented in the art of repetition and the
permit and recycling division and put back on the chest and the naturalization interview and
counterpoint.
And try to stand on the impact of internal rhythm to highlight the meaning of spelling and
irony with poet Ibn Bassam Al-Bagdadi and have a close look at the literary and
psychological motivations that led the poet to employ these colors in his ridicule and the
extent of its contribution to intensify the poetic alphabetic flush.
And deepening the meanings and provide poetic text in different aesthetics, there is no doubt
tha
The researcher of human history finds that the first social relations on earth were represented by the violence of Adam, peace be upon him, Cain and Abel. Violence has been a phenomenon of life and society. The history of history is full of all forms of violence and its forms. It speaks of cruelty, oppression and states. History began, in some of its chapters, written with the blood of the victims. It is a testimony to the cruelty of human beings. His human nature and his sin have played a major role that can not be overlooked in the development of important and fundamental developments in some historical turning points where violence was a necessity for life, and its launching change, renewal and reform, and major revolutions in human h
... Show MoreThe recent escalation in Southeast Asia showed that the region is on the verge of political and economic crises through the United States and its allies imposing economic sanctions against China, and a military escalation that may begin with China’s invasion of Taiwan, especially since two-thirds of the American forces in the world are located in the Taiwan Strait and the South China Sea.
The United States claims that it is ready to defend the island of Taiwan in the event of the start of Chinese military operations, but the reality shows that the United States supports Taiwan militarily by equipping it with modern weapons to defend itself. Supporting Taiwan economically by engaging it in trade agreements with US allies in the r
... Show MoreAbstract:
Under the state scenario, fiscal policy will not be able to use the oil surpluses optimally and economically and society, as long as these surpluses are not directed by public expenditure towards new productive investments and by following the path of fiscal policy after one year 2003 and until 2013 we note that it is based on the method of spending (excessive) consumption, and did not take any action towards the budget deficit planned at the beginning of the fiscal year, and the actual surplus at the end of the fiscal year, which represents the highest expenditure in the budget, Salaries and wages of workers in various government agencies with the expansion of spending on the security side.&n
... Show MoreCOVID-19 is a disease that has abnormal over 170 nations worldwide. The number of infected people (either sick or dead) has been growing at a worrying ratio in virtually all the affected countries. Forecasting procedures can be instructed so helping in scheming well plans and in captivating creative conclusions. These procedures measure the conditions of the previous thus allowing well forecasts around the state to arise in the future. These predictions strength helps to make contradiction of likely pressures and significances. Forecasting procedures production a very main character in elastic precise predictions. In this case study used two models in order to diagnose optimal approach by compared the outputs. This study was introduce
... Show Moreبعد ثورة تموز عام 1958في العراق, لم يكن يسمح للقطاع الخاص بأن تكون له استثمارات كبيرة في القطاعات الاقتصادية. وذلك بسبب الإيديولوجيات التي كانت تؤطر الفكر السياسي. حيث كان النهج الاشتراكي هو الغالب في إدارة الأنشطة الاقتصادية. إذ قامت الدولة بتأميم معظم الاستثمارات الخاصة الكبيرة ،لاس
... Show MoreThe issue of the Circular Economy is not a new issue to several countries, especially the developed ones. Here in Iraq it is considered newly introduced, despite the few attempts to establish projects that concern recycling most of them were doomed to fail, due to two main reasons: the first one is the financial and administrative corruption widespread in all departments of the country, the second one is the priorities of public spending. It is well known that Iraq was subjected to two major attacks, the ISIS entry attack in 2014 to Iraq. ISIS occupied about a third of Iraqi lands which resulted in a collapse in oil prices, as Iraq depends almost entirely on oil revenues in its budget which is the second attack. This made the Iraqi governme
... Show MoreResearch on geopolitical and geopolitical studies relates to a range of sciences that can be called auxiliary sciences, such as political science, international relations in particular, and history, but their focus is rarely on science and ethnography
That the issues and problems of the world today has become so large and complex that does not allow a specific field or knowledge to solve one of the need for the newly known knowledge integration (geopolitics and geopolitics) in particular to move towards cognitive integration to understand many of the problems and global issues that faced The importance of this study comes to clarify the relationship between Darwinism, geopolitics and geopolitics. The geopolitics in modern terms d
... Show MoreAbstract:
Humanitarian intervention has taken different forms included within the
peaceful and military means to stop the human suffering, whether caused by
natural disaster or humanitarian disasters.
Intervention can not be acquitted because it carries with it political cover,
but sometimes it may be legitimate cover for the occupation and the violation
of sovereignty. Therefore, the research worked to capture the legal and
political aspects of international law and the role of international organizations
to intervene and the right to use force.
The research concludes that international law had not been fairly
successful in controlling the behavior of some countries in the use of force,
and that there is