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 factors influencing the financial market are rapidly becoming more complex. The impact of non-financial factors on the performance of a company’s common stock can increase in ways that were not previously expected. This study investigated how brand capital affects the risk of stock prices in Iraqi private banks listed on the Iraq Stock Exchange failing by identifying the likelihood of a crash caused by a negative deviation in the distribution of returns on ordinary shares. As a result, the current study’s concept is to review an analytical knowledge framework of the nature of that relationship, its changes, and its impact on the pricing of ordinary shares of the banks of the researched sector for the years 2009 to 2017, as w
... Show MorePersonal intelligence is thinking about an other person , understanding him, have sympathy and differentiation between people, and to appreciate their own point of view, with the sensitivity to their motives, behavior, and goals, so this intelligence involves dealing with a person or group of persons effectively and in normal or logical manner.
Emotions management is to achieve emotional balance by controlling the emotions continuously, self disciplining, keeping away from excitement sources, and dealing with bad situations in constructive way to achieve the psychological stability .
- the study aims
A new distribution, the Epsilon Skew Gamma (ESΓ ) distribution, which was first introduced by Abdulah [1], is used on a near Gamma data. We first redefine the ESΓ distribution, its properties, and characteristics, and then we estimate its parameters using the maximum likelihood and moment estimators. We finally use these estimators to fit the data with the ESΓ distribution
Found through the study of tissues Alnbarh and domestic focus where a direct impact on the development of the larvae mature into pupae and then to adults appeared to clay soils have a negative impact more than sandy soil at different concentrations salt where as it turns out that the percentage of evolution fly larvae worm Lhalzonnih of the ancient worldadult to have reached more than 80%
The aim of the current research is to measure the sense of coherence among individuals with physical disabilities. The researcher adopted a scale of (29) paragraphs spread over three domains designed by Antonovski (1993) to measure the sense of coherence. A sample of (210) disabled individuals was chosen randomly to collect the required data. The data were analyzed using the statistical package for social sciences (SPSS). The result showed a lack of sense of coherence among the sample.
The main objective of this study is to describe the preparation of topographic maps using the Surfer software. A total of 159 regularly distributed Ground Control Points (GCPs) were collected with the use of the Differential Global Positioning System (DGPS). Seven methods (Contour Map, Post Map, 3D Surface Map, 3D Wireframe Maps, Grid Vector-1 Map, Color Relief Map, and Shaded Relief Maps) at the Surfer environment were used to prepare the topographic maps at the Mukhtar Village near the Al-Fallujah City. Contour lines with other features were superimposed on the DEM layer, which refers to the topography of the terrain inside this study area. The accuracy of the database's results was estimated, essential maps were given, and the re
... Show MoreHypercholesterolemia is a predominant risk factor for atherosclerosis and cardiovascular disease (CVD). The World Health Organization (WHO), ) recommended reducing the intake of cholesterol and saturated fats. On the other hand, limited evidence is available on the benefits of vegetables in the diet to reduce these risk factors, so this research was conducted to compare the hypolipidemic effect between the extracts of two different types of Iraqi peppers, the fruit of the genus Capsicum traditionally known as red pepper extract (RPE), and Piper nigrum as black pepper extract (BPE), respectively, in different parameters and histology of the liver of the experimental animals. The red pepper was extracted by ethyl acetate, while the black pepp
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