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.
Scenes of love constitute a large space within the orbit of the movies, so that there is almost no film (no matter what kind) void of these scenes, as they are associated with many dimensions and they constitute a major attraction for viewers, and thus the direction solutions and their connection to the director's vision constitute a large part in the process of employing signs to highlight what should be highlighted or to refer to it symbolically on the grounds that the director does not have full freedom in the transfer of scenes of love at all levels as they are in reality. The research included three sections within the theoretical framework:The first section: the concept of image and its rhetorical importance. This section discussed
... Show MoreIn our previous research , we study the method of women by ( al – sakhaawi " died 902
ah/1496a.c"book witch called ( al- dhau, al-lami) .
So in this paper , we will discuss the social life of women in the mamluk period through the
same book ,especially when the sakhaawi devoted a full part for women in the same book
called it (mhagam ,al –nessa)wich it translations a large number of women like wives
,daughters ,sisters ,and maids of mamluk sultans ,so that make my able to know a lot about
the social life of woman which we study it like a social aspects of women, here wealth,
business, professions ,and in the last we study the habits of them marriage .
The current research aims at transforming the concept of implication from the rhetoric into the industrial design in order to have a new term (the design implication) in which the industrial designer takes all or part of another's design to imply his design in it and acknowledge that, and if he did not do so, it would be (design theft) parallel to the literary plagiarism.
In order to show the potentials of the industrial design in the production of new formulations of the industrial products forms, as the design is the carrier of language that addresses the recipients, it is possible to use the implication as a the tool of literature in the design and as a design strategy as it is one of the concepts that takes its course in e
BACKGROUND: Mental health problems are reflected and linked to human behavior in many aspects. Medical students are susceptible to a wide variety of events that compromise their mental well-being, social life as well as their academic achievements. AIM: This study aimed to find the impact of social support on medical students’ behavior in Iraq via assessing their depression, anxiety, and stress status. METHODS: A cross-sectional online survey-based study targeted all medical students in Iraq. The employed questionnaires covered mental health status of participants by evaluating their perceptions of depression, anxiety, and stress using. Data were analyzed using the Statistical Analysis System. RESULTS: The study revealed a signifi
... Show MoreThis article investigates the decline of language loyalty in the age of audiovisual nearness. It is a socio-linguistic review of previous literature related to language disloyalty. It reviews the current theoretical efforts on the impact of audiovisual nearness created by social media and language loyalty. The descriptive design is used. The argument behind this review is that the audiovisual nearness provided by social media negatively affects language loyalty. This article concludes that the current theoretical efforts have paid much attention to the relationship between the audiovisual nearness and language loyalty. Such efforts have highlighted the fact that the social media platforms have provided unprecedented nearness that provoke in
... Show MoreAbstract The aim of this study is to identify the role played by the university in reinforcing the culture of voluntary work in college students and sequencing these roles according to their priority. To achieve this aim, the researcher used the descriptive approach. After being informed of the literature background and of the previous studies related to the core aim of this recent study, the researcher has built up a questionnaire of (20) items investigating the role of university in reinforcing the culture of voluntary work in the college students. The standardized features of the questionnaire have been checked for the purpose of the questionnaire validity (virtual and constructive validity) and stability (reconstruction and Cronbach's A
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