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.
Discourse markers are expressions used to connect sentences to what comes before or after and indicate a speaker's attitude to what he is saying.As linguistic items, they have important functions in discourses of various styles or registers. And being connective elements, discourse markers relate sentences, clauses and paragraphs to each other. "One of the most prominent function of discourse markers, however, is to signal the kinds of relations a speaker perceives between different parts of the discourse". (Lenk 1997: 2) Through political discourse, different types of discourse markers are used. This paper deals with the importance and functions of discourse markers and tries to shed light on the kinds of discourse markers used in polit
... Show MoreThrough the study of social work and social policy ( problems of marginalization and empowerment opportunities ) and taken a theoretically descriptive and analytical and highliyhed the role of social work in social policy its achieved only through community intraction and paamong all parties and according to social policies include of material resources and haman and integrated in to the planning and development framework with the aim of providing social services for allsegments of society and become the study in social work that include the introducation / and five chapters each chapter in cludes several detectives and each complements the other .
1 – The absence of social development projects on social policy .
2 – social pol
This study deals with the thems of "in-betweeness" in the modern Afro-American Drama, drawing upon the accumulated literature of the colonial and postcolonial studies. In-betweeness appears in these studies under the canopy of the terms mimicry, hybridity and liminality which refer to a transformative, in-between state of being. It also refers to themutual relations holdingbetween man and his cultural space.
This concept is fitting the Afro-American playwright Amiri Baraka's plays and his violent, revolutionary theatre. In his play Dutchman (1964), Clay, the protagonist, is a good example of the two-ness or in-betweeness. He finds difficulty choosing between the ethnocentric white culture and the black culture.He allows
... Show More The research aims to (identify the applications of pedagogy in art education), the research community included, art education for the primary stage, so the community consisted of (8) main areas in art education, either the research sample was chosen, two main areas (objectives, and content), and included the research methodology (descriptive and analytical), the researcher built the research tool represented (the validity form of the tool) and presented to a group of experts to indicate its validity as well as to measure its stability, To show the results, the researcher used the percentage, and the researcher recommended - modifying the curriculum every period of time, such as every four years, others
The Civil Rights era has been an era of struggle for the African American in the
Unites states. Thus, many writers devoted their writing to reflect the racism and
discrimination that many have suffered from, among them is Ralph Ellison.
Ralph Ellison is a 20th century African-American writer and scholar best known for
his renowned, award-winning novel Invisible Man. He illustrates the powerful
social and political forces that conspire to keep black Americans in their place,
denying them the right to life, liberty, and the pursuit of happiness guaranteed to all
Americans. Invisible Man is a 1952 novel that addresses many of the social and intellectual
issues facing African-Americans in the twentieth century. It exa
The current research aims to diagnose the extent of interest in knowledge sharing and its role in achieving organizational excellence at the level of the Iraqi environment Primary data through descriptive statistics (arithmetic mean, standard deviation, coefficient of variation, percentages, frequencies) and hypothesis testing using appropriate statistical methods for inferential statistical analysis (Pearson correlation coefficient, simple linear regression, multiple regression, path analysis) and checking the quality of the data from During (normal distribution, confirmatory factor analysis, structural modeling method, and exploratory factor analysis), after collecting data from (358) observations from the company’s leaders, as
... Show MoreCubosomes are nanosized structures self-assembled nanostructured materials used for controlling the release of the entrapped drug molecule. Lornoxicam (LXM) is a potent analgesic nonsteroidal anti-inflammatory (NSAID) drug with a short half-life (3-4) hours. The present study aims to prepare LXM-loaded cubosomes with well-defined morphology, particle size, PDI, high entrapment efficiency, sustained drug release, and high zeta potential value, as a transdermal drug delivery system.
Twelve formulas of LXM-loaded cubosomal dispersions were prepared by a solvent dilution method using Glyceryl monooleate ( GMO) as polar lipid with different stabilizers as Pluronic® F127 or tween 80 and different types o
... Show MorePraise be to God, Lord of the worlds, and the best of prayers. He has completed the delivery of our master Muhammad, his family, and all his companions. O God, bring us out from the darkness of illusion, honor us with the light of understanding, open us with knowledge of knowledge, facilitate our morals with dreams, and make us who listen to the saying and follow their best.
And after ..
Since ancient times, magic was mentioned in many books in the history of the civilizations of ancient peoples, where the first emergence of human civilizations, the oldest of which is the Mesopotamian civilization, the Chinese civilization, and the Pharaonic civilization in Egypt, where concepts prevailed based on the charlatans and sorcery an
... Show MoreObjective: The aim of this study to detect the correlation between trace elements such as zinc, copper and
spermatogenesis, sperm viability and motility.
Methodology: Serum and semen samples were collected from one hundred twenty patients with age ranged (20-
50 years) attending the high institute for Embryo Research and Infertility Treatment/ Baghdad University, in
addition to thirty fertile males their age comparable to that of patients. The period of this study was from June
2004 until the end of October 2004.
Results: The result of routine seminal fluid analysis of all infertile males was divided according to WHO, (1999) limit
into four groups: Asthenospermia(A), Asthenoteratospermia(AT), Oligoasthenoteratospermi