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 article discusses the most beloved and creative dialect of the Arabs - the Iraqi dialect, despite its complexity, but it has a lot of beautiful foreign vocabulary. We followed a descriptive and historical approach, also tracked phonetic changes in this dialect, and then gave phonological explanations for these phenomena, trying to connect most of the phenomena with their historical roots in the standard Arabic "al-Fussha" and in ancient Arabic dialects. Most modern linguists have realized the need to study these dialects, since many of the modern dialect characteristics are only extensions of some ancient Arabic dialects, and do not refer them to the classical language. The study of modern Arabic dialects may be faced with a nu
... Show MoreThe aim of the research is to clarify the role of service quality through its dimensions represented by (tangibility, reliability, safety, response, empathy) in tax compliance with taxpayers, i.e. performance of the duties and obligations of the taxpayer through its dimensions (registration, accounting, payment of the amount of tax), and to know For this role, a sample was taken from the taxpayers of the branches of the General Authority for Taxes spread in the governorate of Baghdad and its affiliated districts, which amount to (15) tax branches, as (215) questionnaires were distributed to know the impressions and reactions of the taxpayers regarding the level of service quality through the aforementioned dimensions. Using the statistic
... Show MoreMedia theories and studies have provided many diligences on the concept of social media and the circle of influence, including the theory of social marketing which deals with how to promote ideas espoused by the elite in a society to become a recognized social value. The emergence of social networks provided a revolutionary breakthrough, taking the media to unprecedented horizons; and giving its users great opportunities to influence and move across borders without restrictions and censorship, except in a relatively limited manner.
So, the emergence of social media has created channels of live broadcasting from its audience in a method of development that changes the essence of the known communication theories; a
... Show MoreThis research deals with the role of Qur’anic intents in facilitating and facilitating the understanding of the reader and the seeker of knowledge of the verses of the Holy Qur’an, particularly in the doctrinal investigations (prophecies), and the feature that distinguishes reference to the books of the intentions or the intentional interpretations is that it sings from referring to the books of speakers and delving into their differences in contractual issues and facilitating access To the meanings, purposes and wisdom that the wise street wanted directly from the rulings and orders contained in the verses of the wise Qur’an.
حضيت القيادة باهتمام كبير من قبل الباحثين ودورها الإيجابي في التأثير على الموظفين ونجاح المنظمات، في الآونة الأخير بدأت الدراسات تركز على الجانب المظلم للقيادة وتأثيرها على التابعين وبيئة العمل، وقد تم تحديد القيادة السامة بأنها أخطر الأساليب القيادية التي تتسبب بتكاليف مادية ومعنوية على المنظمات بمختلف جوانبها، ان القيادة السامة تأثر على دوافع المرؤوسين وقدرتهم على انجاز المهام، ورغبتهم في الاستمرار في
... Show MoreBackground: This study aimed to determine the gender of a sample of Iraqi adults utilizing the mesio-distal width of maxillary canines, inter-canine width and standard maxillary canine index, and to determine the percentage of dimorphism as an aid in forensic odontology. Materials and methods: The sample included 200 sets of study models belong to 200 subjects (100 males and 100 females) with an age ranged between 17-23 years. The mesio-distal crown dimension was measured manually, from the contact points for the maxillary canines (both sides), in addition to the inter-canine width using digital vernier. Descriptive statistics were obtained for the measurements for both genders; independent samples t-test was performed to evaluate the gende
... Show MoreDrama "The Condamned of Altona" shows many different aspects of the 20th century. It contrasts strong, self-assured characters with weak, unsure ones to address absurdism and existentialism. Also, this piece shows the misery of the decade by showing Frantz, one of the play's heroes, taking his own life. Through suicide, disillusionment, and worry, the play depicts the upheaval of the 20th century, which was marred by numerous crises. The play's depiction of the jail and its inmates exemplifies the regret that accompanied the two world wars . Not only does guilt serve as a metaphor for the wrongs done by the Germans, but it also serves as a metaphor for the French inactivity during the occupation. And also the writers who did not devote thei
... Show MoreAbstract : The concept of moderation is one of the important concepts that have been discussed in political thought in general and in Islamic political thought in particular. It concerns the status of moderation and balance and the need of Islamic societies to apply them in contemporary times. The Islamic societies faced challenges facing Islamic advancement. And the right, which is the middle between the excessive and the excessive -and the exaggeration and cost-, and between negligence and default, moderation and integritybetween both two sides are: excessive and negligent". In addition, the concept of moderation and its intellectual roots have been sought in the Holy Quran and the noble prophetic, and the search for its charac
... Show MoreAbstract: The term extremism refers to the distance from moderation, excess and hyperbole, and it is a relative term that varies from one society to another, according to the prevailing traditions, values and culture, as the problem of extremism is one of the main issues that contemporary societies are concerned with is a phenomenon that has its roots in the intellectual formation of societies. By knowing the concept of extremism, we can identify the reasons that contributed to the existence of extremism as a phenomenon, on the one hand; on the other hand, to clarify the role of women in combating extremism and developing effective solutions to reduce this phenomenon. As women play a major role in society, starting from the family to educa
... Show MoreABSTRACT Studying the positive and negative effects resulted from the industrial projects and laying down the comprehensive planning bases to the urban development projects which insure retaining the social, economic and environmental development, taking in to consternation the time factor within the planning process which is considered the most important factor that determine the extent of the efficient selection to the site and not interpenetrate in the industrial activities and efficiency and calculating its future expansions away from the residential areas. It is more favorable to plan the industrial areas of apparent pollution outside the bounds of the basic plan to limit the negative effects on the environment and providing
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