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.
Abstract : This research has tackled about the role of Russia in the international policies which concerning with energy , So the most important states in the world that possesses huge energy resources to be more able in the control over the reality and future production programs and the distribution of global energy alike , the latter had effectively influence on the economic and developmental aspects within many countries in the world and its impacts on political decisions and perhaps effected too much in the dimensions of strategic policies . In this context of research , Russia has been developed a high energy policy of strategic planning in order to restoring Russia position and its global role by using its potential powerful streng
... Show MoreThe slums one of the main problem plaguing the city of Baghdad in general and
the unity of municipality of New Baghdad, especially, where the characteristics of the study
area a prominent role in population growth and the emergence of slums where a private,
although the region suffer from the housing crisis is the lack of the number of housing units
compared to the number of families in which, With high land prices and the level of rent
which was accompanied by the absence of the law, which was followed by the year 2003, has
become the study area and one of the most municipalities of the city of Baghdad Contain
slums which took fills abandoned buildings and acquires vacant land agricultural ones and
allocated to d
The problems of modeling the signal and dispersion properties of a second order recursive section in the integer parameter space are considered. The formulation and solution of the section synthesis problem by selective and dispersive criteria using the methods of integer nonlinear mathematical programming are given. The availability of obtaining both positive and negative frequency dispersion of a signal in a recursive section, as well as the possibility of minimizing dispersion distortions in the system, is shown.
Although cinema is moving towards art, it has dealt with the character since the beginning of the discovery of cinematic art in films such as (Doctor Caligari's cabin) and most German expressive films in the third decade of the twentieth century, but the interest of cinema is growing in the estranged human personality, meaning that this character It lives by its alienation from the environment and society that surrounds it, because our present days have witnessed on the material and moral level more social breakdowns such as wars and disasters, and the sharp contradiction in the social and economic level of people themselves or between different societies, or between the individual and his community, and new social relations have increas
... Show MoreIn this research, we attempt to show the extent of harmony in an aspect of the text according to the stylistics for the Knowing of the stylistic value of the title threshold, and the pathways of titles that suggest and support the meaning when the recipient reads the literary text, in addition to the interpretations that reflect the purposes of the poet who contributed to the drawing of his poetic achievement. The research presented a brief about the poet and his most important works, because they are the text which will be studied according to the stylistics. The research also explained the concept of style and the stylistics in the preface , because of the stylistic is the method adopted by the research to study the title thresholds in
... Show MoreThe research aims to build a training program to develop the willpower in the kindergarten children. In order to achieve the objective of the research, the two researchers have developed a Training Program according to the following steps:
- Determining the general objective of the Training Program.
- Determining the behavioral objectives of the Training Program.
- Determining the content of the Training Program.
- Implementing the content of the Training Program sessions.
- Evaluating the Training Program.
The training program consisted of (15) sessions, each session included a set of parts (title, general objective, methods, time and place to implement the sessions, behavioral goals, tool
... Show Moreأثر تنوع الرؤى الاخراجية للاتجاهات والحركات المسرحية المعاصرة في أتساعالاشتراطات الجمالية لبنية الخطاب المسرحي + الامر الذي ادى الى انزياح مكوناتالعرض وعناصره ؛ ومنها المنظومة السردية للنص التي شكلت في بدايات المسرحجغرافية العرض المسرحي والمرتكز النظري والفكري الذي يمد العرض المسرحي أغلبتدفقه الجمالي وعنصر أستعلائي لعناصر العرض الاخرى ؛ وضمن التطورات اللاحقةأنسحب المخرج المسرحي من سطوة البنية النص
... Show MoreAbstract
The Umayyad poets tried to invest all artistic tools in order to achieve a measure of creativity in their texts. The phenomenon of visual composition is breaking the familiar writing system, with the aim of increasing the number of possible connotations. The visual in the Umayyad poetry tries to replace it through expression with the visual image, and its manifestations were manifested by the multiplication of punctuation marks in the body of the poetic text and the tearing of the single poetic line by cutting it into several sentences or repetition.
Keywords: visual formation, poetic writing, Umayyad poetry, recipien
eclaration has become today has an important and active and influential role in the recipient public life، and are concentrated advertising on the creativity component manufacture to attract his attention toward what to be announced from a variety products ، and is dominated by television commercials tempo and imagination، and display them a variety of ways catches the attention and an impressive simulates the their senses of hearing and sight ، to influence in the receiver and the public paid for purchase. Through it crystallization the subject of our research on the importance of creativity in television advertising and effective for attracting the attention of the public towards the receiver advertised products، and in
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