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.
A mathematical model is developed which predicates the performance of cylindrical ion exchange bed involving comparing of axial dispersion model for cation exchange column with different assumption, this model permits the performance to predicate the residence time within the bed with the variance, axial dispersion and Pecklet No. to indicated deviation from plug flow model.
Two type of systems are chosen for positive ions first with divalent ions (Ca+2) to exchange with resin of Na+1form used as application in water softener units and second with monovalent ions (Na+1) to exchange with resin of H+1 form used as application in deionize water units &n
... Show MoreDomestic violence, or as sometimes known as family abuse, is usually related to a domestic or local setting as in cohabitation or in marriage. It can take the forms of being physical, verbal, economic or emotional. Globally, most of the domestic violence is overwhelmingly directed to females as they tend to experience and receive severe forms of violence, most likely because they do not involve their intimate, or sometimes even non-intimate partners, in the process of mental and physical self-defense. Sometimes countries justify domestic violence directed to females, they may be legally permitted when the reasons behind it are related to issues of women's infidelity. Usually, the permission to violent acts is related to
... Show MoreThe purpose of this research its study of Natural Consideration that contributed in turning of Dairy products in Baghdad Governorate , this subject deal with centered geographical location in the midlle of Iraq ,it’s also main market in discharge and marketing to rest of Iraqi’s governorate pointed to it’s an active role in localized of it’s factory(milk ,cheese,cream ,butter, yoghurte)and it’s constant ,thus distributedin all district of Baghdad ,flat governorate surface encourage this industry ,also climate (temperature, wind, (it’s speed and it’s direction) ,rainfull and relative wet) also water resources and it’s influenced that nessacity of production process with important inculclusion that researcher came out throu
... Show MoreGod has honored the man with life and decent living and warned against attacking anything that violates his sanctity without a legitimate right. Our Islamic Shari'ah has the rights to preserve the right of a Muslim in the event of any harm.
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
... Show MoreTime 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.
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... Show MoreThe cinematic medium consists of a group of elements that overlap with each other in balance, giving it its high influential capabilities, and the character is one of the most important of these elements, as it performs a set of important functions, foremost of which is the transmission of the main ideas to the recipient, and since cinema is an art closely related to the intellectual data of the worlds outside it, it is influenced by them and then reproduces them intellectually more deeply and with a higher vitality through its intermediate elements, including the character, to re-broadcast them to society with a retrograde movement, and the character of the prisoner is one of the cinematic characters that achieved this goal, as we can infe
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