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.
The rapid growth of cities and their inflation is a big problem, especially in the last years. this growth is accompanied by such problems like population growth, housing need, low level of services, random expansion, traffic congestion as well as pollution of the environment, which leads to a decline in the quality of life in Baghdad, the population are concentration in Baghdad therefore that leads to imbalance of development among cities and productive concentration for service projects in a mega cities, causing migration from other provinces In search of a better life. The main objective of the new cities is to relieve pressure on major cities and guide the growth of cities. Basmaya city it’s a new city project adopted f
... Show MoreThe logistic regression model is an important statistical model showing the relationship between the binary variable and the explanatory variables. The large number of explanations that are usually used to illustrate the response led to the emergence of the problem of linear multiplicity between the explanatory variables that make estimating the parameters of the model not accurate.
... Show Moreيعد التكرار من الظواهر الاسلوبية التي اتخذت دورها في بناء النص الشعري الحديث ويقوم على جملة من الاختيارات الاسلوبية لمادة دون أخرى ولصياغة لغوية دون سواها ، مما يكشف في النهاية عن سرّ ميل هذا النص الشعري أو ذاك لهذا النمط الاسلوبي دون غيره ، وعلى الرغم من ان التكرار يعد مسألة عامة وشائعة في العمل الأدبي ، فأن الاهتمام بهذا الجانب من المنهج الاسلوبي يأتي من جهة كونه مهيمناً له ايحاءاته ودلال
... Show MoreSubjected Find winged bull Assyrian monetary analysis in order to identify the formative relations in terms of percentages, movement and public swab for being aesthetic values upon which the mechanisms of artistic composition, which did not give researchers artistic interest that affects the status of these sculptures and the like of the achievements of the Iraqi civilization in Assyria.
Resulting analysis to a number of the most important results, the percentages approved in the calculation of the parts to do with all when viewed status horizontal with a realistic formulas while in the case of considering frontally clear for Ras stylized proportions and head size larger in length, a ratio confirmed by previous studies, and
... Show MoreWriting plays an effective role in developing one's thinking and
enhancing Learning. It is, in fact, a means of widening one's own views about
the world for the numerous uses that it can serve (Samuel, 1988:28).
In regard to the unquestionable significance of writing in the teaching –
Learning process, the traditional approach seems to be far from being able to
put such significance into practice. Traditionalists give priority to formulating
students' ideas before using prescribed rhetorical framework and then
submitting the written product for grading. Emphasis is, therefore, limited to the
prewriting stage where a certain topic is explored, and the role of the teacher is
confined to assigning the topic and
Class consciousness represents its highest stage in the contemporary Marxist thought of Rosa Luxemburg and Antonio Gramsci, not just a reflection of reality, but rather a dialectical form through the reflection of consciousness on reality and its reproduction. The superiority over the infrastructure (historical materialism) promised the revolutionary class consciousness to be achieved spontaneously, and the seeds of a breakthrough are mass strikes, denying the role of the party to organize this awareness, limiting its role to the interconnection between classes, emphasizing the role of socialist democracy as a conscious vanguard for organizing spontaneity, struggle, and developing awareness during the revolutionary process and the leader
... Show More- S. Eliot is one of the important founders of the modernist movement in literature, a cutting-edge poet of the first order. After his 1927 conversion to Anglicanism, he began calling himself a conservative, royal, and a classicist.
"Ash Wednesday" is the first long poem written by him after his conversion. It deals with the struggle that ensues when one who has lacked faith acquires it. It is richly but ambiguously allusive, and deals with the aspiration to move from spiritual barrenness to hope for human salvation.
"Ash Wednesday" not only struggles with an approach to faith but with an approach to a language capable of expressing it. Eliot's style is different from that that predates his conve
Abstract
Nowadays, the adoption of economic unity on the accuracy of financial reporting is very important. Economic units need accurate financial reporting to be more competitive and to improve the performance. Management can also achieve financial information in real time through the application of ERP systems. This system will facilitate management to access the most up-to-date information such as planning, monitoring and evaluating the business processes of the organization to be more effective.
On the practical side, the Enterprise Resource Planning (ERP) system was applied to the General Company for Vegetable Oils to demonstrate a course in enhancing the accuracy of financial reporting.
... Show MoreThe expressive discourse, in the form of the rural singing, is considered one of the interactive framework and the metaphorical dialogues in creating the aesthetic climate that connects the circles of its basic elements, singing, playing music, expression, costumes, sham movements and so forth.
The rhetorical language in this field includes all those parts and turns them into an integrated idea within the culture of the musical science, specifically the heart of the rural singing. This research dealt with a number of topics of relevance in the expressive discourse for the form of the rural singing. The first chapter consists of the methodological framework of the research, represented by the r
... Show MoreThanks allah and peace be upon our prophet muhammed and upon his family and his
followers……
The name is only called by the Almighty, One of the Names of the Creator Deity
features and slavery. He is the idol who worshiped.
The creator is derived from the creation of a sophisticated and significant from create Aharaz
for crust, and tailor the gown and the end of launch on God's creation of the creature, and this
release was a matter of metaphor One of the names of Allah, God is the creator himself is not
a partner Creator of all things, is the one who created
man from Nothingness began creating Adam peace be upon him and that he has passed the
stages in the process of creation, namely: He created him from du