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.
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 MoreWith 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 Moreفي بداية الستينيات ظهرت شبكة الإنترنت لاستعمالها في أغراض غير تجارية ، ثم تطورت بشكل مذهل خلال السنوات الأخيرة، فبعد أن كانت مجرد شبكة صغيرة أصبحت الآن تضم ملايين المستخدمين حول العالم ، وتحولت من مجرد شبكة بحث أكاديمي إلى بيئة متكاملة للاستثمار والعمل والإنتاج والإعلام والحصول على المعلومات .
وفي بداية تأسيس الشبكة لم يكن ثمة اهتمام بمسائل الأمن بقدر ما كان الاهتمام ببنائها وتوسيع نش
... 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 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 MoreThe notion of presupposition has been tackled by many linguists. They have found that the term ―presupposition” is being used in two different senses in the literature: semantic and pragmatic. As for semantic sense, Geurts (1999) has isolated some constrictions as sources of presupposition by making lists of presupposition triggers. Concerning the pragmatic sense Kennan (1971:89) uses the term pragmatic presupposition to refer to a class of pragmatic inferences which are, in fact, the relation between a speaker and the appropriateness of a sentence in the context. In spite of the fact that there are many researches that have been done in the field of presupposition but few of them in the field of short stories up to the researcher's kno
... Show MoreRecent studies have tended to look at Mottagorat texts for seeking more of the information provided by the book for the reader, has been known by several terms Mottagorat texts, including thresholds, including the margins of the text and the parallel texts, and came this difference, according to researchers who ate the subject of research and investigation. Thus, the researchers assert that all these texts must be subjected to provide information even if propaganda of the text. Hence arose the importance of these texts in Informatics scientific material being wrapped body of the text as well as being propaganda material to evoke the recipient to read, and then to the importance of this topic, the search came on five chapters, the first c
... Show MoreDBN Rashid, IMPAT: International Journal of Research in Humanities, Arts, and Literature, 2016 - Cited by 5
The aim of this research is to identify the availability of quality standards for the websites of the Palestinian TV channels and to provide an assessment of the quality standards used by the websites of TV Channels web sites in general and Palestinian TV channels in particular. Through the use of the method of media survey method descriptive methods, and the research has reached the difference in the application of quality standards for TV Channels sites in the web sites of Palestinian TV Channels, and the development of language of visual communication for the design of those sites in exchange for the lack of access to those sites of the technical possibilities that is Provided by the Internet.