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 aim of this research is to show the importance of the effective use
of the internet in academic libraries; to improve the services and to increase
the competence of librarians.
The research has given some recommendations to improve the quality
of services and the need for cooperative network among academic libraries.
The research aims to apply the activities of the green value chain as one of the modern administrative techniques that economic units resort to develop solutions to the pollution problems that occur due to the activity of economic units and their products that may cause damage to the environment as well as the waste of natural resources and to identify the production of environmentally friendly products and reduce the costs of environmental failure of both types Internal and external that may be borne by economic units such as taxes, fines and compensation due to nonobservance of environmental requirements and the preservation of human health and protection of the environment. To achieve the goal of the research, the researchers rel
... Show MoreEffective decision-making process is the basis for successfully solving any engineering problem. Many decisions taken in the construction projects differ in their nature due to the complex nature of the construction projects. One of the most crucial decisions that might result in numerous issues over the course of a construction project is the selection of the contractor. This study aims to use the ordinal priority approach (OPA) for the contractor selection process in the construction industry. The proposed model involves two computer programs; the first of these will be used to evaluate the decision-makers/experts in the construction projects, while the second will be used to formul
Negotiations are distinguished in that they are an easy and simple means between the conflicting parties, and it is an effective means at the same time as the conflicting parties seek understanding on the most effective way to solve their dispute, but negotiations are not always appropriate to resolve international disputes, especially when there is a disparity in power between the negotiating countries, or when it is missing Goodwill, or even when one of the parties is absent or less flexible, and the internal circumstances of one of the conflicting countries may play a negative or positive role in the success of the negotiations, away from the influence of the role of external variables in that, a
... Show MoreThis research is intended to high light the uses of political content in foreign Arabic / speaking websites, such as “ CNN “ and” Euro News“, The research problem stems from the main question: What is the nature of the use of the websites in the political content provided through them? A set of sub-questions that give the research aspects and aims to achieve a set of objectives , including the identification of topics that included , the political content provided through , the sample sites during the time period for analysis and determine that the study uses descriptive research based on the discovery of the researcher, describing it accurately and defining the relations between the components.
The research conducted the des
The Phenomenon of Euphemism in the Translon Activity Euphemism is the replacement of a harsh word with a less harsh or more acceptable one. Most languages are affected by ideological, cultural, social, or religious perspectives which in turn would reflect different linguistic levels. On such a basis, translation is affected by its medium,i.e. language, and consequently what is acceptably expressed by a nation may not be acceptable by another. In this paper, we try to
... Show MoreThe paper presents the results of precise of the calculations of the diffusion of slow electrons in ionospheric gases, such as, (Argon – Hydrogen mixture, pure Nitrogen and Argon – Helium – Nitrogen) in the presence of a uniform electric field and temperature 300 Kelvin. Such calculations lead to the value Townsend's energy coefficient (KT) as a function of E/P (electric field strength/gas pressure), electric field (E), electric drift velocity (Vd), momentum transfer collision frequency ( ), energy exchange collision frequency ( ) and characteristic energy (D/?). The following physical quantities are deduced as function s E/P: mean free path of the electrons at unit pressure, mean energy lost by an electron per collision, mean velocit
... Show MoreThe educational service one of activities which have great effect in the city life and it's community which considered as an affective instrument for the social and civilized construction and its role in the development of culture and determining the general features of the society. Therefore planning for educational service is considered as a necessary for economical, social and cultural conditions in the Arab community lives in general and the Iraqi community in special. The educational service buildings and distribution forms an insurmountable obstacle in the urban areas. So the balance distribution in Baghdad presents an indication to ensure the equality of educational opportunities besides the correlation of these institutes with th
... Show MoreCurrent research strives to achieve the following aims:
- Develop a scale for dominant values of Tikrit university students.
- Measuring the dominant of Tikrit university students.
- Identifying the significant differences among dominant values of Tikrit university students according to(sex, specialty, time).
- Measuring the dominant values of each one of the six fields of the scale.
- Identifying the differences in dominant values of each field according to the sex variables.
The current research has limi
... Show MoreThe objective of this study is to enable the role of modern and advanced computerized information systems. The model or mechanism should be developed by collecting the necessary information about the taxpayers and the sources of the taxpayers' income, on the basis of which the accuracy of the inventory process will be adopted. In addition to studies related to computerized information systems and showing their importance to the tax institution. To achieve the objectives of the study and to answer its questions, the researcher relied on collecting data and information on the subject on the literature and previous studies The secondary sources, which also formed the theoretical framework of the study, were obtained either as a practical fr
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