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.
Native speakers of English from different parts of the world have different accents,but the differences of accents are mainly the result of differences in the sound of vowels and consonants . The actual use of all these sounds in combination leads the speaker to produce a number of segments which only appear on the production level and realized on the perceptual one . RP pronunciation represents the teachable variety in all Iraqi universities because it is the most acceptable and understandable accent all over the world and not only in South East London ..The structure of the English syllable in RP pronunciation is influenced by the appearance of certain allophones especially aspiration and glottalization which ch
... Show MoreThe impacts of harvested cropland in the double cropping region (DCR) of the northern China plains (NCP) on the regional climate are examined using surface meteorological data and the satellite-derived normalized difference vegetation index (NDVI) and land surface temperature (LST). The NDVI data are used to distinguish the DCR from the single cropping region (SCR) in the NCP. Notable increases in LST in the period May–June are found in the area identified as the DCR on the basis of the NDVI data. The difference between the mean daily maximum temperature averaged over the DCR and SCR stations peaks at 1.27°C in June. The specific humidity in the DCR is significantly smaller than in
In this paper we have dealt with the word " בַּיִת" in the Book of Joshua because it makes one of those that highly employed the word בַּיִת" " in the Old Testament. The Book of Joshua comes sixth in the order of tanakh wich was written by Joshua son of Noon in Palestine during the fifteenth century B.C. and it covers a three-decade era extending from the death of Moses til the death of Joshua son of Noon.
The word " בַּיִת " in this paper refers to the place, where expressions are made by a noun modified by a noun . The modifier is"" בַּיִת , and the modified is another noun. Herein, we
... Show MoreThe phenomenon of advertising In the poetry of Ali bin Abdul Rahman Balnopi Sicilian
The space constitutes a cornerstone of the creativity process since the emergence of arts and literature. Gaston Bachelard has a significant role in highlighting the importance of the place in his book entitled (Poetics of Space). Since then, the space, especially in the TV drama, is no longer a mere background indicating the location or the date of the event. Space inside these series has become an inseparable part of the artistic or dramatic fabric, that the visual scene started to formulate alongside the movement of the individuals in their language or accents that are specified inside the space as an incubator for the décor, clothes, makeup, accessories and lights in addition to the sound and musical effects. The lens angles
... Show MoreThe primary objective of this study was to identify the obstacles and problems encountered in the work of sports clubs according to the reality of the application of administrative automation. The present study was conducted in the sports club headquarters of Baghdad within the timeframe of October 2021 to December 2021. In the present study, a descriptive approach was used by the researchers in an analytical style according to the nature of the problem to be studied. The research community of the current study was composed of 100 sports clubs in the governorate of Baghdad. A total of 80 questionnaires were filled by the sample participants, who represented a percentage of 80% of the research community. After processin
... Show MoreThis study presents the effect of laser energy on burning loss of magnesium from the holes' drilled in aluminum alloy 5052. High energy free running pulsed Nd:Glass laser of 300 µs pulse duration has been used to perform the experiments. The laser energy was varied from 1.0 to 8.0 Joules, The drilling processes have been carried out under atmospheric pressure and vacuum inside a specially designed chamber. Microhardness of the blind drilled holes has been investigated .The results indicated that the magnesium loss could be manipulated by adjusting the focusing conditions of the laser beam. Almost, the obtained holes were free of cracks with low taper and low sputter deposition. .The holes performed under atmospheric conditions have high
... Show MoreThe investigative film is part of the documentary films and is considered one of the important films that have a high viewership by the recipient, which is of great importance in transmitting information and contributing to creating awareness of the community through the advertising function performed by the cinematic image, as the researcher addresses the concept of advertising and its development through the time stages. And advertising functions. Then the researcher dealt in his research with the cinematic technical elements that contribute to the success of the investigative advertising work, such as camera movements, music, sound effects, dialogue ... etc., which enrich the investigative picture with realism and the flow of informat
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