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.
Despite the vast areas occupied by deserts in the world, it is still far from the civilized development and development of the other regions, so they became semi-neglected areas that extend to the hand of urbanization only in specific places and for special purposes, due to the harsh natural conditions surrounding it and to the accuracy The ecological balance in it became the greatest enemy of human beings in the desert areas is the same person who paved the way for increased intervention in the exploitation of natural resources and increase the demand for them to drain seriously affect the impact and still on the environmental and climatic conditions and thus living for the inhabitants of these Areas. The main potential for deve
... Show MoreThis research deals with the study of types of parallelism in contemporary Arabic poetry and took the hair Mahmoud Darwish, a model for the study has been the goal of research to clarify the term parallelism and the statement of the most important types, said evidence of that in the poetry of Mahmoud Darwish
This paper deals with the description of the system of formation and derivation of words in the Russian language. In this work, we will present recent trends in the study of the Russian language that deal with vocabulary formation. The lexical system of the Russian language is associated with a common (or opposite) meaning; similar (or opposite) in stylistic characteristics; united by a common type of word formation; related to a common descent and belonging to a vocabulary of much or little use, etc. The results of the most prominent linguists and specialists who dealt with this topic will be presented, in addition to presenting their different views on word formation. The words of the Russian language consist of mor vimat that participate
... Show MoreThis study falls within the core of the deliberative theory, as this research seeks to highlight the concept of dialogical imputation that is present in all the discourses received by the recipient, and that this is not limited to dialogues, and that is why it is called (deliberative imperative). This is in agreement with the deliberative and functional approach that sees literary discourse as a dialogical and fulfilling necessity, due to its attachment to artistic connotations and submerged meanings in the saying. The allotted obligation and its impact on determining the purposes: The specific implication represented an important axis of pragmatic research, and a major concern in the work of discourse analysis. Because of its great importa
... Show MoreAmong the issues that preoccupied ancient and modern grammarians is the phenomenon of grammatical disagreement among grammarians and their differences in many grammatical issues that many of them go back to the phenomenon of dialectical difference, so this filled our thinking with a lot of things that led us to look at the side of the reasons for this grammatical difference, and here lies the significance of research to know that it is a linguistic phenomenon dealing with the living language used among the Arabs and linguistic phenomena that reflect linguistic reality as well. Thus our chagrin determination in research and investigation in this issue is the scarcity of dialectical studies at the compositional grammar side, and the lack o
... Show MoreThe aim of the current study is to identify the morphological description of the tongue in mongoose (Herpestes javanicus) and its relation to the feeding pattern. For this purpose the (5) samples of tongues were dissected from the head of mongoosecaught from different areas of Al-Najaf province, cleaned in normal saline and examined under the dissecting microscope. The results showed the absence of the middle groove in the lingual apex area. As well as the absence of lingual prominence in the body area. The dorsal surface is characterized by the presence of four types from lingual papillae (filiform, cylindrical, fungiform, circumvallate), while the ventral surface is free of lingual papillae. The filiform papillae spread throughout the dor
... Show MoreABSTRACT this paper extends the literature on the elements and effect of financial literacy by investigating the elements of financial literacy and the impact of financial literacy on financial inclusion and savings. This research confirms the results of researches of other economies but exposes some dissimilarities as well. The principal factors of financial literacy are discovered to be government efficiency, educational level, income, economic performance and infrastructure. Both education levels and financial literacy are found to be meaningfully and positively linked to financial inclusion and savings in G20 economies
The design of the Graphic has recently taken a great variety in the curricula and design methods that have led to its applications for career advancement and aesthetic quality. This is due to the communicative role that it plays in the movement of human beings and their aspirations. Among these applications are the designs of magazine covers in different variations. The design of the cover is based on a structural system that requires awareness and skill from the designer, especially since the organizational structure in the design of the envelope is limited in both vocabulary and space, and in the neighborhood Many have the image of sovereignty and sometimes the other head line, and can lead color values are other.
In all
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We produced a study in Estimation for Reliability of the Exponential distribution based on the Bayesian approach. These estimates are derived using Bayesian approaches. In the Bayesian approach, the parameter of the Exponential distribution is assumed to be random variable .we derived bayes estimators of reliability under four types when the prior distribution for the scale parameter of the Exponential distribution is: Inverse Chi-squar
... Show MoreThe basic concept of diversity; where two or more inputs at the receiver are used to get uncorrelated signals. The aim of this paper is an attempt to compare some possible combinations of diversity reception and MLSE detection techniques. Various diversity combining techniques can be distinguished: Equal Gain Combining (EGC), Maximal Ratio Combining (MRC), Selection Combining and Selection Switching Combining (SS).The simulation results shows that the MRC give better performance than the other types of combining (about 1 dB compare with EGC and 2.5~3 dB compare with selection and selection switching combining).