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 Glass Manegerie is a metaphor, which is one of the greatest plays of great writer Williams. The play talks about the poor people in society and how try to escape this group of people from the real world to get rid of the hardness of this tuff reality and live in a fantasy world that is much like the glass where the world is very weak this world is acting by Laura, she is owner of these animals breakable glass where it's weak and unable to defend itself as well as the mother Amanda is a very selfish never think about her children but only herself.
The design of the Graphic has recently taken a great variety in the curricula and design methods that have led to its applications for career advancement and aesthetic quality. This is due to the communicative role that it plays in the movement of human beings and their aspirations. Among these applications are the designs of magazine covers in different variations. The design of the cover is based on a structural system that requires awareness and skill from the designer, especially since the organizational structure in the design of the envelope is limited in both vocabulary and space, and in the neighborhood Many have the image of sovereignty and sometimes the other head line, and can lead color values are other.
In all
... Show MoreMe researcher in this research study and discover the symbolic indications in the work of the Iraqi sculptor Morteza Haddad, has corrupted search of four chapters first chapter contains research problem and its significance and objectives of the research, which was to detect signs symbolism in works of contemporary Iraqi sculptor Morteza Haddad and terminology, which included significant the GTA and idiomatically and Velsfatta and conduct,
It also included the symbol for GTA and idiomatically and Velsfatta and hold, while the second chapter includes three sections are straight, semantics and icon, a brief on Iraqi contemporary sculpture, About the lives of contemporary Iraqi sculptor Then choose the terms of the research sample,
... Show MoreThis research entitled: "Artistic processing of Emotional Scenes in the Narrative Film" deals with how to process and embody those emotional scenes. As there are certain filmic elements that play an effective role in deepening the viewer's sense of the importance of those scenes, and that their presence in the film is necessary and inevitable, and cannot be dispensed because it forms an interconnected connection with the rest of the film's scenes, in addition to its dramatic and aesthetic value in the film in crystallizing the viewer's feelings and integrating him/her into the scene.
The research was divided into four chapters, the first chapter includes: the methodological framework, which represented the research problem, and brin
The current research is concerned with the study of (aesthetic discourse in the significance of commercial advertisement designs), according to a knowledge structure defined by function and creativity, and the main goal is to interpret the reality of forms, their various sources, their essence, meanings, formal relationships, and design ideas in order to achieve the visual goal as a typographic achievement. It arises through the designer’s internal mental intuition to produce shapes based on subjective feelings that refer his preconceptions about those shapes with his feelings to creative formations. Aesthetic discourse is produced from the mind depending on the various symbolic, psychological and social functions, production methods,
... Show MoreThe tagged research problem (the outputs of the written text in conceptual art) dealt with a comparative analytical study in the concept of conceptual art trends (land art - body art - art - language).
The study consisted of four chapters. The first chapter dealt with the theoretical framework, which was represented in presenting (the research problem), which raised the following question: What is the role of the written text in the transformations of the conceptual arts?
The first chapter included (the importance of research) and (research objectives) seeking to conduct comparative research in the written text within the trends of conceptual art as a moving phenomenon in art, and to reveal the variable written text in the
... Show MoreDespite the vast areas occupied by deserts in the world, it is still far from the civilized development and development of the other regions, so they became semi-neglected areas that extend to the hand of urbanization only in specific places and for special purposes, due to the harsh natural conditions surrounding it and to the accuracy The ecological balance in it became the greatest enemy of human beings in the desert areas is the same person who paved the way for increased intervention in the exploitation of natural resources and increase the demand for them to drain seriously affect the impact and still on the environmental and climatic conditions and thus living for the inhabitants of these Areas. The main potential for deve
... 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