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.
Harold Pinter often portrays the dilemma of obliterated figures that are incapable of feeling of their own existences. These figures feel exhausted and frustrated in a world that deprives them their humanity. They retreat into a limited world where they look for security and protection. The characters' feeling of security is threatened by outside forces represented by intruding persons who stand for the mysterious powers that are indefinable. The conflict between these intruders and the characters finally ends with the characters’ defeat. The reason for the intruders' attack on the victims remains ambiguous and is not explained. The element of mystery pervades Pinter's plays and represents one of
... Show MoreIn 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,
The road networks is considered to be one of the determinants that controls to specify the areas of human activities, which it depend on to specify the arrival cost , in addition it is useful to achieve the connectivity for interaction and human activities , and shorten the distance and time between the population and places of service. The density of the road network in any space directly affected by the density of population and the type of economic activities and administrative functions performed by the space. On this basis, the subject of this study is reflected in the quantitative analysis of the roads network in the Governorate of Karbala. The study consists the quantitative analysis for the roads network and the Urban Nodes in th
... Show MoreIsmailism is of great importance in Islamic history and Islamic political thought. In different countries of the Muslim world today their presence exists and is active but is confused with mystery and secrecy. The most important characteristic of their political ideology is their dependence on the esoteric exegesis, which they have made an intellectual basis for which their most ideas relate, when they make for everything visible and exposed a hidden matter, not only aware of the esoteric exegesis, which only God knows and entrenched in science, and they mean imams or whoever They are called "(esoteric)" as a result of the Ismaili belief in esoteric interpretation and that everything is apparent inward, as well as they called the ((seven
... Show MoreThe research addresses smart city concept as it is the latest urban design trends, by the investment of the capabilities of human, and artificial intelligence for the sake of the advancement of the city. The concept of a smart city is described as one of the most important manifestations of the information revolution, with the end of the twentieth, and the beginning of twenty – first century, The research attributes the emergence of the concept to: deficiencies of means, and traditional methods in building and development of cities, as well as The significant increase in the number of city and global metropolises dwellers. So, smart city approach has been adopted, along with innovative principles and methods which cons
... Show MoreThe first chapter included the frame approach on research in which we discuss instigation in Iraqi drama as it as an active sign to enrich the structure of the speech so the researcher limits the problem of his research which is to follow the important of instigation in the Iraqi theatrical discourse. this chapter also contains the important of the research and its aim and limits. And reflected the importance of research in approaching the concept of instigation and effectiveness within the paths of the Iraqi, theatrical discourse.The 2nd chapter included the two sections and reviewed in the first section manifestations of incitement in the global theatrical discourse. the 2rd studied instigation in the Arab theatrical discourse. The 3rd
... Show MoreThe research aims to measure the impact of knowledge management processes individually and in total in the innovative marketing.
We depart search of a problem expressed in a number of intellectual and practical questions, the application of this research in the General Company for Vegetable Oil Industry, represented composed a sample of (63) (Director General and Deputy Director General and Director of the Department and the Division) in the company researched, it has been designed measuring instrument to collect the necessary data either statistical means they are the percentage and the arithmetic mean and standard deviation and coefficient of variation and the coefficient of simple correlation and model
... Show MoreAbstract :
The present study aims at identifying the status of the two research variables in the organization under study and specifying the relationship and impact of the authentic leadership with all its four branch dimensions of (self-awareness, transparent relations, balanced processing of information and the moral perspective) on business process reengineering.
The basic problem of the study lies in the attempt to present a new leadership style that is more responsive to the dynamic changes surrounding it based on the authentic leadership behaviors. This is because this pattern has an impact on the nature of the organization's work and its progress.
The research
... Show MoreSustainability is a concept embodied in traditional architecture around the world since ancient times through spontaneous experimental compatibility with the environment and efficient exploitation of the natural resources of the environment according to a rapid development of trial and error over the years . Architecture was the basic means that man devised to protect him from the harsh conditions of the external environment by exploiting natural energy sources such as the sun, wind, and soil capabilitie, Many of the principles of sustainability overlapped with the social organization and human behavior of the community as it was reflected in the urban production at the level of standards of city planning and urban agglomerations as well
... Show MoreA new blind restoration algorithm is presented and shows high quality restoration. This
is done by enforcing Wiener filtering approach in the Fourier domains of the image and the
psf environments