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.
من أجل فهم دور سلطنة عُمان في المفاوضات الإقليمية والوساطة وحل النزاعات يجب تقدير سياستها الخارجية، والتي سيتم تقييمها من أجل فهم كيفية نشأتها وتشكلها وأثر ذلك على مواقفها السياسية طوال سنوات حكم السلطان الراحل قابوس بن سعيد. وتقع عُمان في منطقة مضطربة، وقد طُلب منها في عدة مناسبات أن تعمل كمفاوض أو وسيط في الصراعات الإقليمية. سيبحث هذا البحث في كيفية قيام السلطنة بالوساطة الدولية، خاصة في الصراع الأمريكي
... Show MoreLimited importance of research in a stand on the most important difficulties faced by both faculty and parents to communicate with each process to follow up on their children, and the analysis and inventory of the obstacles that hinder the educational process, and work to develop a vision of how to address these constraints and the important role of technology in the treatment of problems of the society so as to develop frameworks future to minimize the errors and the problems they face, and the development outlook for future generations in order to promote the educational level, especially that Iraq is going through a change in conditions in all sectors. Through the questionnaire, which includes questions set that was made on a sample o
... Show MoreThe aim of this research was to evaluate the level of ball control in basketball. There was a great weakness in ball control that affected the mastery of many skills that affect the success of the team. The researcher also found a lack in training programs concerning ball control. The researchers used (9) special tests for ball control out of (41) test applied on young basketball players were (86). The researchers concluded that: 1. Criteria were set for test results of ball control. 2. A level of criteria was set for test results of ball control.
Abstract
The research is presented according to an objective study on the ideological problems, especially the distortions that the divine scriptures have been subjected to under a false pretext that does not pertain to religion, namely that the heavenly books of the Torah and the Bible have been damaged or lost as a result of apostasy and persecution, and the writing of these books has been entrusted by people who have been bestowed Holiness, they have the testimony of the Church, so they distorted and omitted it in a manner suitable for securing their good and worldly gains, and the Holy Qur’an mentioned this explicitly, and they continued later, especially the Jews, in distorting the verses of the Holy Qur’an. This researc
... Show MoreThe research deals with the concept of a New Urbanism as an urban development strategy in the suburbs of cities or in its centers that are affected by pedestrian-oriented design and the possibility of walking, as well as integrating economic classes through the diversity of housing and its costs, and this works to facilitate access to jobs and services while providing more diverse neighborhoods and reducing the use of cars , As designing separate houses in the suburbs and increasing car trips poses a threat to the environment and the quality of urban life, and thus the new urban provides a good strategy for developing
... Show MoreBetween the duality of sound and image, the completeness of the actor’s personality at the director comes to announce the birth of the appropriate theatrical role for that character as the basic and inherent element of the artwork, within his working system in the pattern of vocal behavior as well as motor/signal behavior as he searches for aesthetic and skill proficiency at the same time.
This is done through the viewer’s relationship with the theatrical event, which the director considers as an area of active creative activity in relation to (the work of the actor) through vocal recitation and the signs it broadcasts in order to fulfill the requirements of the dramatic situation and what it requires of a visual vision drawn in t
The concept of environmental debt, which has several dimensions, emerged in the nineties. One of these dimensions is spatial, referring to the debts that southern countries sustain due to the extraction of natural resources and environmental damage inflicted upon northern countries. Another dimension, the temporal dimension, concerns the environmental debts that current generations owe to their predecessors. That means past generations are culpable for overuse of natural resources and mismanagement. The debt issue is complex, despite many mechanisms to resolve it. Most important are the recently introduced environmental bonds, an important step forward in the field of sustainable financing of environmental debts.
The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the internal environment of the organization in addressing this behavior, being the variables belong to the field of organizational behavior to see the results of those variables on the Iraqi organizations, since the specificities of it differ from the rest of the Arab and foreign environments. Therefore, this study focused on testing the relationship of the internal environment of the organization and its role in addressing the negative behavior of the workers.
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... Show MoreAbstract:
Witness the current business environment changes rapidly reflected on the performance of the facility wishing to stay , which is no longer style reaction enough to handle installations with their environment , and quickly began to lose its luster with the emergence of a message and the vision of contemporary business environment from a set of parts interacting with each other and the concept of behavioral includes all dimensions of performance, it is imperative to adopt a system installations influence variables and positive interaction through the development of strategic plans and the use of implementation and follow-up strategies to ensure the effectiveness of the method for meas
... Show MoreIn this work, the precursor [2-(1,5-dimethyl-3-oxo-2-phenyl-2,3-dihydro-1H-pyrazol-4-ylimino)acetic acid] was synthesised from 4-aminoantipyrine and glyoxylic acid, this precursor has been used in the synthesis of new multidentate ligand [2-((E)-3-(2-hydroxyphenylimino)-1,5-dimethyl-2-phenyl-2,3-dihydro-1H-pyrazol-4-ylimino)acetic acid][H2L] type (N2O2). The ligand was refluxed in ethanol with metal ions [VO(II), Mn(II), Co(II) and Ni(II)] salts to give complexes of general molecular formula:[M(H2L)2(X)(Y)].B, where: M=VO(II), X=0, Y=OSO3-2, B=2H2O; M=Mn(II),Co(II) ,X=Cl, Y=Cl, B=0; M=Ni(II), X=H2O, Y=Cl, B=Cl. These complexes were characterised by atomic absorpition(A.A), F.T-I.R., (U.V-Vis)spectroscopies (1H,13C NMR for ligand only), alon
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