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.
ABSTRACT this paper extends the literature on the elements and effect of financial literacy by investigating the elements of financial literacy and the impact of financial literacy on financial inclusion and savings. This research confirms the results of researches of other economies but exposes some dissimilarities as well. The principal factors of financial literacy are discovered to be government efficiency, educational level, income, economic performance and infrastructure. Both education levels and financial literacy are found to be meaningfully and positively linked to financial inclusion and savings in G20 economies
Witnessing human societies with the turn of the century atheist twenty huge revolution in information , the result of scientific and technological developments rapidly in space science and communications , and that made the whole world is like a small village not linked by road as it was in ancient times, through the rapid transportation as was the case a few years ago , thanks to the remote sensing devices that roam in space observant everything on the ground , that the information networks that overflowed the world a tremendous amount of information provided for each inhabitants of the earth , which made this information requirement for human life and human survival and well-being , as it has allowed that information to humans opportun
... Show MoreThe aim of the research to measure the correlation relationship between modern manufacturing systems and process design and measure the effect by adopting the regression; the research consists of two main variables, which are modern manufacturing systems and process design; it was applied in the production lines of the General Company for Construction Industries, There is a sample of managers, engineers, technicians, administrators, and some workers were selected to fill the special questionnaire with (70) forms which distributed and (65) were approved suitable for use, For data analysis the correlation coefficient was adopted to measure the relationship and regression analysis to find out the effect, Using (SPSS), So the first h
... Show MoreMarriage is a holly secret in Christian religion .So it id natural that its ceremonies acquired religious form .In general the marriage is contracted by minister of religion in presence of the two parties or by a proxy or presence of parents if it is necessary . And to make the condition of publicity for the marriage ,its procedures must be made before witnesses .Also the minister of religionhave to confirm the agreement of the two parties before beginning the procedures.The marriage ceremonies are made.These procedures are religious traditions that includes praying and make blessings and putting the rings in fingers by thepriest . The marriage is a holly secret performed by the crown pray according to the church religious traditions
A Forensic Accounting is represent science that deals with the application of knowledge in the areas of accounting, finance, tax and audit for the analysis, investigation, inquiry, inspection and testing issues in the civil law and criminal law in an attempt to reach the truth through which enable the Forensic Accountant to provide his Expert opinion , forensic accounting plays a major role by providing a range of important services in the field of investigation for fraud and litigation support, As one of the most important legal and accounting functions is to investigate allegations of alleged by the related parties, especially those allegations related to the existence of fraud, since the goal of judicial accountant will depend
... 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.
In the name of God, praise be to God, and prayers and peace be upon the best of God’s creation, Muhammad bin Abdullah, and upon his family and companions, and from his family:
And after:
He saw from verbs that transcend one effect if it is visual and to two effects if it is heart and this action has several strokes and it is an awareness of the sense and illusion and imagination and reason and in addition to that it has many meanings dealt with in the glossary books and as for what the verb included in the audio studies it is the explanation and deletion and slurring The heart of my place. As for what the grammatical studies included, it focuses on one or two effects according to its l
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 Era of Henry VII is the king who established the Tudor as they ruled England for
(24) years .He made drasfic changes in British Economy and the state of the country was
stable and secure.
Thes economic achievement of make him Qualified to be called The founder of the
modern English History .
On the basis of that significance to study one of the development stages of one of the
developed societies presently, i.e. the English society, this thesis came under the title (The
Internal Policy in England 1509-1547) to examine the overall political, economic and social
positions England passed through. The thesis also indicated the intensive labor state suffered
by the English society with all its sections, especial
In this work, Soda Lime Glass (S.L.G.) powder was used ,as
fluxe in traditional porcelain instead of feldspar. Two ceramics
porcelain were compared; commercial or traditional porcelain that
content of 50wt % kaolin, 25wt % quartz, and 25wt % feldspar.
Feldspar mass was substituted by scraps soda lime glass yielding a
new porcelain composition, to determine the softening points and
then the effect of glass addition on porcelain firing process.
Eight samples, for each patch, were prepared and 8wt % water
was added. The resulting composite blends were then die pressed at
2N, to produce disk specimens with diameter of 1.5 cm, and then
they were sintered at (1000, 1100, 1200, 1250,1300,1350,1400 and
1450) ˚C,