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.
With a great diversity in the curriculum contemporary monetary and visions, and development that hit the graphic design field, it has become imperative for the workers in the contemporary design research and investigation in accordance with the intellectual treatises and methods of modern criticism, because the work design requires the designer and recipient both know the mechanics of tibographic text analysis in a heavy world of texts and images varied vocabulary and graphics, and designer on before anyone else manages the process of analysis to know what you offer others of shipments visual often of oriented intended from behind, what is meant, in the midst of this world, the curriculum Alsemiae directly overlap with such diverse offer
... 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.
Media 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 MoreIn the period immediately following the end of World War II, American theatre was transformed by the work of playwright Arthur Miller. Miller tapped into a sense of dissatisfaction and unrest within the greater American psyche because he was profoundly influenced by the depression and the war that immediately followed it. His dramas proved to be both the conscience and redemption of the times; allowing people an honest view of the direction the country had taken.1 Miller has his own concept of tragedy as a modern playwright. He believes that tragedy may depict ordinary people in domestic surroundings instead of talking about a character from a high rank, a king or a queen. Miller’s main concern lies in dramatizing the whole man as he i
... Show MoreThis study aims to discuss the projects of poultry in Wasit province in 2013 and geographical distribution according to the type and contrast on the level of administrative units representing Districts and The reasons for this discrepancy, as well as knowledge of the factors affecting the distribution by the analysis and reasoning and description This study divided to the four themes, The first of the statement of nutritional importance and economic Poultry focused on the importance of various poultry products, The second one shows the relative position of the province of Wasit between the provinces of Iraq in poultry and production of eggs and meat farming projects, and then followed by the third one (theme) as it ensures the geographic
... Show MoreNanoparticles are defined as an organic or non-organic structure of matter in at least one of its dimensions less than 100 nm. Nanoparticles proved their effectiveness in different fields because of their unique physicochemical properties. Using nanoparticles in the power field contributes to cleaning and decreasing environmental pollution, which means it is an environmentally friendly material. It could be used in many different parts of batteries, including an anode, cathode, and electrolyte. This study reviews different types of nanoparticles used in Lithium-ion batteries by collecting the advanced techniques for applying nanotechnology in batteries. In addition, this review presents an idea about the advantages and d
... 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 MorePersonification in Arab poetry is not confined to the abstract items in nature: it trespasses them to include more than that. We found after reviewing the anthologies of the poets tens of the personified items are full of human attributes - via personification- such as speaking, moving, feeling human feelings.. Personification formed a remarkable feature in the relationship between poets and war, which was clear in the Pre-Islamic poetry, because it occupied the minds of the ancient Arab mindset. The poets have envisioned war as ugly as a force that brings destruction and devastation. The paper aims at stating the position in which poets personified war with female tributes. Thus, it is impregnated, conceived, and produced birth like a w
... Show MoreThe Sacrament of Marriage in the Christian Religion