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 mechanical function of the heart is governed by the contractile properties of the cells, the mechanical stiffness of the muscle and connective tissue, and pressure and volume loading conditions on the organ. Although ventricular pressures and volumes are available for assessing the global pumping performance of the heart, the distribution of stress and strain that characterize regional ventricular function and change in cell biology must be known. The mechanics of the equatorial region of the left, ventricle was modeled by a thick-walled cylinder. The tangential (circumferential) stress, radial stress and longitudinal stress in the wall of the heart have been calculated. There are also significant torsional shear in the wall during b
... Show MoreThis research deals with the color bias and its effect on maids in Mississippi in Kathryn Stockett''s (2003) The Help. The ill-treatment and negligence of Afro-American maids received from the white women who employed them in Mississippi that must have affected directly or indirectly on their personality and may eventually lead to suffering. They live in an atmosphere of struggle to free themselves from the complicated relationships between black and white. Afro-American maids pledged to liberate themselves from social oppression by protesting through writing a book which chronicles their stories in slave masters’ homes to make their presence felt as human being equal to their white masters.
A restrictive relative clause (RRC hereafter), which is also known as a defining relative clause, gives essential information about a noun that comes before it: without this clause the sentence wouldn’t make much sense. A RRC can be introduced by that, which, whose, who, or whom. Givon (1993, 1995), Fox (1987), Fox and Thompson (1990) state that a RCC is used for two main functions: grounding and description. When a RRC serves the function of linking the current referent to the preceding utterance in the discourse, it does a grounding function; and when the information coded in a RRC is associated with the prior proposition frame, the RRC does a proposition-linking grounding function. Furthermore, when a RRC is not used to ground a new di
... Show MoreThe research tagged (eloquence of the Qur’anic verses in the resurrection verses) deals with study and analysis of the aesthetics of miracles in the Qur’anic poems centered on the horrors of the Day of Resurrection, and aims to clarify the role of the Qur’anic unique and its impact the miraculousness of the Qur’anic style systems, the accuracy of the unique selection and its wonderful harmony in form and content, voice and meaning, composition And a picture with its context and denomination; based on that, the research was based on the analytical method to reach its goal, and the research plan imposed its division into two preamble and two topics, the first topic dealt with: the rhetoric of the nominal Qur’anic verses in
... Show MoreThe aim of this research is to study the factors affecting drag coefficient (C d ) in
non-Newtonian fluids which are the rheological properties ,concentrations of non-
Newtonian fluids, particle shape, size and the density difference between particle and
fluid .Also this study shows drag coefficient (C d ) and particle Reynolds' number (Re
P ) relationship and the effect of rheological properties on this relationship.
An experimental apparatus was designed and built, which consists of Perspex pipe
of length of 160 cm. and inside diameter of 7.8 cm. to calculate the settling velocity,
also electronic circuit was designed to calculate the falling time of particles through
fluid.
Two types of solid particles were
The American-European dispute is one of the important issues that dominated international relations during the nineteenth century in particular, although the previous period witnessed the emergence of a dispute over the right to control these colonies, which the United States of America, especially after the proclamation of the Monroe Doctrine in 1823, is a natural right and that It has the ability to prevent European countries from interfering in the affairs of the American continent, so the United States of America entered into continuous disputes with European countries, which were constantly directing their eyes towards the Spanish colonies in the American continent. But the American government had priority in controlling those colonies
... Show MoreThis research aims to address the most recent international standard in the field of insurance contracts, the International Financial Reporting Standard (IFRS17) and the theoretical framework of the standard in addition to the most important characteristics of the standard (IFRS17), as well as to identify the paragraphs of the modern standard, with the challenges its application in general and the use of the approach (inputs - operations - outputs) to present the challenges of its application in the Iraqi environment and specifically in the environment of Iraqi insurance sector companies (government), the research is based on the main premise that the identification of the requirements for the application of the International Fin
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This research sheds light on how press advertising affects consumer behavior and draws attention to it by identifying the factors that influence the intellectual perception process or attention to it. The aim of the research was to identify the factors that help achieve the objectives of the press announcement. The aim of the research was to identify the factors that help to achieve the objectives of the press announcement. The research problem was identified in four questions that were answered through a questionnaire distributed to a sample of students of College of Mass Communication, University of Baghdad. Do newspaper advertisements meet the readers’ need to search for the req |
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
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