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.
The main purpose of the research is to demonstrate the importance of the insurance sector in the economy through its role in providing security for all economic sectors and thus stimulating the gross domestic product and reducing dependence on the output of the oil sector, which may expose the Iraqi economy to several problems and imbalances, I have found that there is a great weakness in the role of the insurance sector in Iraq at the level of government, companies and individuals, and the reason for this is the lack of policies supporting the insurance sector and the lack of work in the strategy of economic diversity and the decrease of security awareness by individuals so became Developing the sector to ensure the urgent need
... Show MoreThe light-based life in the universe, including the human derived concepts and meanings of the fear of darkness and evil, comfort and goodness of light, became constitute bilateral haunted man to this day in various concepts of life.Therefore reflect the light form artistic aesthetic in visual arts such arts Fine Photography and the other until the emergence of art cinema, as the use of lighting in cinema has produced high-energy in the composition of its values expressive and symbolic, where it became dark and light are the space visually moving the vehicles media kit for many within the work structure artwork. The research is divided into five chapters, the first chapter (the methodological framework) that included an introduction the
... Show MoreThis research aims to study the target costing and value chain with their complimentary relationship in reducing product costs, meeting the needs of customer, and achieving strategic competitive advantage for manufacturing corporations in response to face international competition, technological development and continuous changing expectations of customers. No doubt, the target costing and value chain both currently occupy a great deal of the attention of managers and accountants at the manufacturing corporations due to the significance to insure their continuity, growth and development. This significance has been the main motive to examine the role of target costing and value chain in a sample of public corporations of the
... Show MoreThe child realize that the meals time provide golden opportunities to get the attention the child needs. However, many difficulties that may appear about eating food can be avoided, if the family used the right way in dealing with this problem. The study aims, in this case, at searching for the reasons that lies behind the child's obstinacy in eating his food and the attempt to study some variables that is related to the research topic.
The results are summed up as follows:
- The number of the sample children is 3 of both sexes between the ages of 3 to 6 years
Accurate computation of the roughness coefficient is important in the studies of open channel flow. To measure and identify the hydraulic characteristics of the flow system, the model simulation is necessary to study and get the results of the hydraulic properties to specify Manning coefficient of the Euphrates River. In this study, the reach is extended along the Euphrates River from Haditha Dam to Ramadi Barrage with a distance of 169km. The HEC-RAS model was implemented to simulate the flow within the study reach. The geometry of the river was represented by more than two hundred cross-sections surveyed in 2013 and 2021. The model was calibrated using some observed discharges at the Heet gage station for records of th
... Show MoreThe use of different materials in the art of ceramics is considered a new form of contemporary philosophical trends. That was introduced to art as a result of societal changes and transformations and rapid technological development. And it plays a very essential part in the beauty of the artistic structure. The contrast of using different materials in ceramics is considered a part of the old historical achievements since the art of ceramics used to follow strict standards. Which does not apply to contemporary ceramic, Because recently, it has become free from any religious and social control and created a whole new intellectual context, heading to new horizons in which it works with the newly added materials as a strategy to ensure the a
... Show MoreThe present study investigates the notion of untranslatability where the concept of equivalence is reconsidered since the misconceptions, related to the said concept, inevitably lead to the emergence of untranslatability. Identifying equivalence as relative, approximate and necessary identity makes the notion of untranslatability a mere theorization. The objectives of the present study are (1) to investigate the notion of untranslatability in terms of the misconceptions associated with the concept of equivalence (2) to examine the possibility of translatability from Arabic into English focusing on culture-bound euphemistic expressions in the Quran as an area of challenge in translation. Data on the translation of culture-bound euphemistic e
... Show MoreThe research aims to measure the net nominal protection coefficients for the products table eggs and poultry meat and the extent of its impact on domestic production volume for the period of 1990- 2013 has been the use of mathematical formulas simplified in the calculation of the transaction process with a view to the extent of support and protection offered by the state pricing policy for products Resources Sector Animal in Iraq and reach search Highlights and most important, there are volatile price state policy with regard to eggs and poultry meat, as it ranged net nominal protection coefficients between the larger and less than the right one, which means that values are unstable to support local producers or consumers, and can be The
... Show MoreThe banking system considered as one of the most important intermediate circle between creditor and debtors it is mean the most important funding rings in economic activity, whether finance takes the a consumer or investment form and therefore it is the main base to stimulate economic activity both on the demand side, both consumption and investment and therefore of the main motivating factors for economic growth.
The banking system depends in achieve its goals on the grants and loan recovery, or what is known credit process and according to what the importance referred to the role of the banking system, it is important to ensure the safety and efficiency of the mechanisms of banking device and safety is
... Show MoreThis study analyzes how to make use of the resources in the marshlands of Iraq and how to utilize them, especially after the water returns to these areas and they are revitalized. We take an example of AL- Saheen Marsh and plan an ideal tourist resort there. This example can further expand to include other parts of the marshlands. The resort will utilize the local environment and tourist characteristics as it will have a feel and architectural resemblance to the houses and buildings that are currently built there. In addition the transportation methods will be the same as those used by the locals. Yet the resort will still posses all the facilities required by a modern tourist resort that includes all the services that will make
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