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.
Time and space are indispensable basics in cinematic art. They contain the characters, their actions and the nature of events, as well as their expressive abilities to express many ideas and information. However, the process of collecting space and time in one term is space-time, and it is one of Einstein’s theoretical propositions, who sees that Time is an added dimension within the place, so the study here differs from the previous one, and this is what the researcher determined in the topic of his research, which was titled (The Dramatic Function of Space-Time Variables in the Narrative Film), Which included the following: The research problem, which crystallized in the following question: What is the dramatic function of the tempor
... Show MoreThe concept of insurance policy is one of the concepts that expresses a way to face the risks that a person is exposed to in the field of his life. It is a system that involves a prior agreement between two parties through which the risk is transferred from the second party (the insured) to the first party (the insurer) in return for paying an amount Calculated was able to cover the potential loss according to certain percentages agreed upon between the two parties, and that the main goal of any scientific analysis of the risk is to choose the most appropriate policy or method to confront it, by identifying the risks and ways to address them, and the main goal is to reduce losses and limit the possibility of their occurrence.
In
... Show MoreThe structure is considered in its scientific formula one of the concepts which complete the architectural image that seeks to take out an effective and attractive structure in contemporary architectural production, especially that the structure -in general- represents strength in addition to delight and functional benefits according to Vitruvius trinity. So, the role of structure depends on making its aesthetical properties able to give efficiency within architectural product. That has come through adoption of intellectual mechanism of structural means and details –as a whole or parts- and focused on structure with the recipient's needs, aesthetical, and sensory purposes in addition to its fundamental role of stabilit
... Show Moreof the research is one of the poetic purposes that expresses the philosophy of the intellectual poet who experienced life and learned the tendencies and the gulf of the human soul and the fact that an intellectual attitude towards them, intensified within the poems do not need to be frequently narrated and elaborated, but based on the few words in the rich meanings and expressed the point of view he wanted to convey to the recipient without taking the position of disorientation and retreat to himself expressing his rejection of this reality, but faced this reality different manifestations and reflections and the conditions of human beings in it detailed His opinion is constructive criticism, and accurate observations reveal the culture o
... Show MoreThe development in the presentation and presentation of the service in order to distinguish them from the same, was one of the most important reasons to choose the current issue to upgrade the level of service, especially in the Iraqi restaurant sector, which has become today of the important sectors successful. The problem of research was to try to answer a range of questions: to what extent are Iraqi restaurants interested in physical service factors? Do Iraqi restaurants apply physical factors in a way that leads to customer satisfaction? Are Iraqi restaurants interested in the satisfaction of their customers? The objective of the current research is to try to determine the extent to which the
... Show MoreArchitecture forms theoretical summaries and multi systems that have the essence of change, and that what distinguishes Architecture from other sciences and their systems. Architecture means way of life via its expressional products and that appears through its systems. These systems are based on formative and technological properties in form, structure, services and materials as well as
their moral forms. All these are associated with techniques and facilities in order to establish integrated system.
Architectural creation does not come from void but it depends on a conception base to create a new condition for creative architectural product. The general problem of the research concentrated on limited theoretical and practica
A new blind restoration algorithm is presented and shows high quality restoration. This
is done by enforcing Wiener filtering approach in the Fourier domains of the image and the
psf environments
Abstract
The main goal of this study is to showcase the aesthetic values contained in Nahj Al-Balagha by exploring its wide horizons and enriching the subject of rhetoric with new forms and images that did not exist in other books, as they characterized no other book but Nahj Al-Balagha. Imam Ali mastered the use of rhetorical forms in his speech to the fullest extent that such forms raced to his thought one after the other to book their place amongst the topics of religious and earthly life. One of those rhetoric forms is synecdoche, in its various parts. Due to this form great importance and high status, it was used by the Imam at many
... Show MoreFlexible pavement design and analysis were carried out in the past with semi-experimental methods, using elastic characteristics of pavement layers. Due to the complex interferences between various layers and their time consumption, the traditional pavement analysis, and design methods were replaced with fast and powerful methods including the Finite Element Method (FEM) and the Discrete Element Method (DEM). FEM requires less computational power and is more appropriate for continuous environments. In this study, flexible pavement consisting of 5 layers (surface, binder, base, subbase, and subgrade) had been analyzed using FEM. The ABAQUS (6.14-2) software had been utilized to investigate the influence of the base layer depth on ver
... Show MoreDegradation is one of the key processes governing the impact of pharmaceuticals in the aquatic environment. Most studies on the degradation of pharmaceuticals have focused on soil and sludge, with fewer exploring persistence in aquatic sediments. We investigated the dissipation of 6 pharmaceuticals from different therapeutic classes in a range of sediment types. Dissipation of each pharmaceutical was found to follow first‐order exponential decay. Half‐lives in the sediments ranged from 9.5 (atenolol) to 78.8 (amitriptyline) d. Under sterile conditions, the persistence of pharmaceuticals was considerably longer. Stepwise multiple linear regression analysis was performed to