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.
Emily Bronte is born in Yorkshire on 30 July 1818. Her father, Rev. Patrick Bronte, is a man of intelligence and determination which enables him to gain an admission as a sizar to 81. John's Cambridge in 1802. He has six children where Emily is the fifth. The mother is a young beautiful girl who belong to an important family. Both Emily's parents try to teach
Their children well, support them all the time and elevate them to
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high levels. This causes an eagerness towards reading and writing, but the happiness of the children is affected by the sickness and later on by the death of their mother in 1821. After that things would
... Show MoreThe current research is concerned with the study of (aesthetic discourse in the significance of commercial advertisement designs), according to a knowledge structure defined by function and creativity, and the main goal is to interpret the reality of forms, their various sources, their essence, meanings, formal relationships, and design ideas in order to achieve the visual goal as a typographic achievement. It arises through the designer’s internal mental intuition to produce shapes based on subjective feelings that refer his preconceptions about those shapes with his feelings to creative formations. Aesthetic discourse is produced from the mind depending on the various symbolic, psychological and social functions, production methods,
... Show MoreAre the actions and rulings of God Almighty justified by intentions and purposes or not? This is a matter of the minutes of the science of theology in which there was a wide difference between the Islamic groups, especially the verbal ones.
This study is an attempt to reach the correct opinion or to avoid it, and to clarify the disagreement that took place in this issue, especially in the Ash'ari school of thought, and it is also an attempt to reconcile opinions as much as possible, and to explain what may appear to be disagreements among some.
Therefore, I divided this research into two topics, and issued it with an introduction in which I defined the terms that are related to the explanation.
This research entitled: "Artistic processing of Emotional Scenes in the Narrative Film" deals with how to process and embody those emotional scenes. As there are certain filmic elements that play an effective role in deepening the viewer's sense of the importance of those scenes, and that their presence in the film is necessary and inevitable, and cannot be dispensed because it forms an interconnected connection with the rest of the film's scenes, in addition to its dramatic and aesthetic value in the film in crystallizing the viewer's feelings and integrating him/her into the scene.
The research was divided into four chapters, the first chapter includes: the methodological framework, which represented the research problem, and brin
The present study aims to show the importance of ESL reading ability in acquiring English as a second language. The study involves 92 college students (males and females) from the Department of English at Nizwa College of Applied Sciences, Sultanate of Oman. They represent two groups, the foundation year students and the first year English majors. A number of tests were used to measure students’ overall proficiency in English as well as their reading ability (i.e., the ability to contribute to the main idea of the text, scanning, skimming, to derive word meanings from context, to use a dictionary to find meanings, definitions, to identify prefixes, antonyms and synonyms). Students’ ability to read was correlated to their proficiency
... Show MoreThe purpose of this research is to study the organic planning in the United Industry Alliance, focusing on an applied model. It takes the concept of good planning, and its importance in the overall picture, well into political, economic, and military policy. It also analyzes how the United States has used this year to address the challenges that nationalism targets. The research draws on typical examples to illustrate the differences between researcher and decision effectiveness. It also discusses the factors that lead to the success or failure of dynamic planning, and draws lessons from it in other countries. Finally, the researcher begins to help in planning the goal as a basic tool in enhancing effectiveness.
Most cities in the world are suffering from the problem of solid waste and the resting adverse impact on the environment and public health, in particular the spread of diseases, insects and rodents, As well as the proliferation of nuisance odors result of provided by the responsible parties, As wall as weak environmental awareness among those who dwell in dealing in environmentally sound disposal of solid waste, this study was bembgesan first intake of solid waste and the kinds of concept and components by land use, As wall as the effects of solid waste on the environment spatial, factors affecting the quality and quantity of solid waste, the second topic was included as a study field presented the historical city of Baghdad
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The idea of this research is the basis of the role exercised by the dimensions of performance management (Performance Planning- performance evaluation- improve the performance and development- feedback - Review and Performance Monitor) In order to achieve the success Organizational Is through the (strategic vision- the operational activity- development of the company- selection of personnel- the company's culture- Leadership and Management- Personal Development - Assessment and Review).And The research aims to identify the extent of the responsibility of performance management in achieving success Organizational through main hypotheses branched out by the sub-hypotheses to knowing out the&nbs
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