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.
This paper studies the demonstratives as deictic expressions in Standard Arabic and English by outlining their phonological, syntactic and semantic properties in the two languages. On the basis of the outcome of this outline, a contrastive study of the linguistic properties of this group of deictic expressions in the two languages is conducted next. The aim is to find out what generalizations could be made from the results of this contrastive study.
Review of multidrug sensitivity and resistance in enterococcus
The definition of the role of any institution in society is achieved through its objectives, The same is true for the military and how to deal with security threats in the humanitarian field ,Terrorism, which has almost replaced the traditional pattern of war, has waged a street war and intimidated individuals, families and society ,On the other hand, he found someone to meet him from a popular crowd of volunteers to defend their homeland from different sects, sects and religions, Thus, our study will be exposed to the role of popular mobilization in human security from a sociological point of view in Samarra, a field study of 100 male and female respondents.
The simulation is the oldest theory in art, since it appeared in the Greek aesthetic thought of the philosopher Plato, as we find in many of the thinkers and philosophers over a wide period of time to reach our world today. Our fascination with art in general and design art in particular is due to the creativity and innovations of the artist through the simulation, as well as the peculiarities in this simulation, which give objects signs and signals that may have an echo that sometimes does not exist in their physical reality.
The real representation of life and design construction, descriptions of the expression of each of them in the form of intellectual construction and the ideas of producti
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The Islamic religion approach Rabbani urges and seeks to bring happiness to people, as Allah says: ((We sent thee not all people glad tidings and a warner, but most people do not know)) Spa: State 28
Islam looks at the concept of educational values through positive behavior derived emerging through formal and informal education. The Islamic approach works on the basis of a systematic and clear rule in the form of an integrated system includes multiple areas. As the lead actor role as the desired position.
Although
How I was eager to research the ruling on three of the most dangerous types to Islam and Muslims (the heretic, the sorcerer, the innovator, and related terms).
Because it is the most dangerous deadly disease that destroys the hearts of Muslims, and may even expel a Muslim from the circle of Islam, and how many Muslims have done or committed such a thing without knowing it. Indeed, how many Muslims have left Islam and whose wife has abandoned him without realizing it, and among them are those who have committed it without knowing it. As well as related words associated with heresy.( )
Because people debated such matters between extremists and lenient ones, most of whom were extremists, and they did not reach a conclusion. So I decid
A Al-Nuaimy, B Fadheel…, IPMJ, 2009 - Cited by 1
Through the study of social work and social policy ( problems of marginalization and empowerment opportunities ) and taken a theoretically descriptive and analytical and highliyhed the role of social work in social policy its achieved only through community intraction and paamong all parties and according to social policies include of material resources and haman and integrated in to the planning and development framework with the aim of providing social services for allsegments of society and become the study in social work that include the introducation / and five chapters each chapter in cludes several detectives and each complements the other .
1 – The absence of social development projects on social policy .
2 – social pol
This study deals with the thems of "in-betweeness" in the modern Afro-American Drama, drawing upon the accumulated literature of the colonial and postcolonial studies. In-betweeness appears in these studies under the canopy of the terms mimicry, hybridity and liminality which refer to a transformative, in-between state of being. It also refers to themutual relations holdingbetween man and his cultural space.
This concept is fitting the Afro-American playwright Amiri Baraka's plays and his violent, revolutionary theatre. In his play Dutchman (1964), Clay, the protagonist, is a good example of the two-ness or in-betweeness. He finds difficulty choosing between the ethnocentric white culture and the black culture.He allows
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