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.
Teresa Fitzpatrick presents a connection between oppressed women and the plant of Wisteria in gothic fiction in her article “Wisteria: A Female Eco-Gothic Metaphor in American Fiction Through the Ages.” The connection between women and nature is common in literature as women are usually compared to the beauty or ferocity of flowers, rivers, or natural phenomena in general. The connection extends to the architecture and sort of plants that appear in gothic literature. Gothic novels have routinely been connected to the secrets and life stories of women who cannot have the liberty to live or share them outside their homes. A fearful house with a prisoned person, ghost, or a secret is mostly normally found in gothic writing. Women have exce
... Show MoreThis study aimed to knowledge of the effects of the Traditional ore upon the structure of sculpture form, as well as to knowledge of new materials that was used for the contemporary sculpture. This study included four chapter: first chapter was specialized for methodical frame. such as problem of research. that it was abstracted by question about the reason that lead the sculptor to search from new raw to carry out his sculpture works? As well as the important of research and its limits was that define between year 1950 up to 2000. The second chapter included the theoretical field and previous studies, that formed from three researches, such as the fist about the materials, as it was considered master element at the sculpture formal. the
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The research addresses the specification table and the extent of its use in developing achievement tests, as well as detects the obstacles to its use through a sample of (120) respondents from the faculty members in some Baghdad schools and colleges. After unpacking and processing the data statistically, the research reached several results: the study sample do not use the test map in the development of their tests, as their percentage reached (82%) and there are no statistically significant differences in the use of the specification table by the sample members according to their place of work or the number of years of experience. The results also revealed the most important reasons that prevent the use
... Show MoreThe internal administrative spaces of the interior designer formed an obsession for their development and for finding solutions and treatments to advance to enhance the state of adaptation for their employees by providing a healthy, appropriate and sound environment for work and production. . The first chapter focuses on laying theoretical foundations to show what health materials are used in the administrative spaces of the training directorates of the Ministry of Education in Baghdad. The second chapter dealt with the knowledge of health materials, their impact and effectiveness in the interior space, and the variables of their functional characteristics and their work in the interior spaces in a way that enhances the development of
... Show MoreIn recent years, the means of communication have achieved a great generality that made them occupy, in a short time, the first ranks among the most widely used social networks in the world, due to the many services and advantages offered by this network to its users. It has led to a leap in the field of visual communication, especially since it relies mainly on the image Its dimensions make it a means of communication and transfer of ideas and meanings between the peoples of the world, and it also allows the inclusion of digital advertising content using multimedia with a degree of professionalism in other social networks, which allowed the various segments of society the opportunity to invest this network in their businesses of differen
... Show MoreThe methodology of the concept of sovereignty in contemporary Islamic thought
Willa Cather (1873-1947) sought to capture the gradation of human emotion through carefully selected descriptive and narrative touches and firmly controlled management of dramatic scenes, situations, dialogue, and point of view. Cather’s novels and stories drew increasingly upon her personal experiences and memories.
The old settlement of Virginia and the new lands of Nebraska formed the bedding ground for Willa Cather’s talents; so did the layers of memory she found across the North American continent, from New Mexico to Canada. She saw the full-blooded European immigrants, Czechs and Swedes, plowing the unbroken land, on the way up from peasants to proprietors.
 
... Show MorePerhaps one of the most pillars in building communities, and to achieve consistency between its members, is the volunteer work, he is a humanitarian exercise been closely associated with all the meanings of goodness and righteousness since ancient times, but it differs in size and shape and motivations and trends from one community to another, and from time to time; while at least in the stages of calm and stability, it increases in disasters and calamities and wars times, and perhaps (the popular crowd) is the best proof of that, they answered a call reference, and volunteered to defend their land and their holy places. In terms of form it may be donating money or effort or profession or otherwise, either in terms of the trend may be di
... Show MoreThis paper studies the effect of contact areas on the transient response of mechanical structures. Precisely, it investigates replacing the ordinary beam of a structure by two beams of half the thickness, which are joined by bolts. The response of these beams is controlled by adjusting the tightening of the connecting bolts and hence changing the magnitude of the induced frictional force between the two beams which affect the beams damping capacity. A cantilever of two beams joined together by bolts has been investigated numerically and experimentally. The numerical analysis was performed using ANSYS-Workbench version 17.2. A good agreement between the numerical and experimental results has been obtained. In general, results s
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