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.
Joseph Curtis wrote in his book (Introduction to Semiotics narrative and rhetoric) on the development of a semiotic project in exploring the meaning of communion. The book is rich in theoretical and analytical benefits both in the approach of texts and in the pursuit of letters in search of mechanisms of scriptural and scriptural generation and mechanics in narrative production, especially as the book offers exercises that help to assess the distance separating the narrative spread from the sin of the text, for the semiotics, Refers to the theoretical developments of the science of relations, through the combination of conventional definitions and the representative and comparative limitations, to provide an approach to the application o
... Show MoreThis paper offers a critical examination of Canadian news guidelines and policies
on user-generated content (UGC) posted on news-related comment sections and
social media.
The outline of how news-related UGC is moderated within Canadian news is achieved
by looking at the online comment policies of major Canadian news organizations like .
the CBC, CityNews (Halifax), CTV News, Glacier Media, Global News, The Globe
and Mail, Narcity Media, Postmedia, QUB (Québecor), and Torstar.The policies highlight how Canadian news organizations have practical strategies
to manage news-related UGC but also call upon positive and negative social
principles, to flag ill practices, foster democracy, and fight against online hate sp
Baker's Yeast is an important additive among the substances, which improves bred quality, thus, a consideration has been made to study the conditions and parameters that affecting the production of the yeast in a batch fermenter experimentally and theoretically. Experimental runs were implemented in a 12-liter pilot-scale fermenter to predict the rate of growth and other parameters such as amount of additive consumed and the amount of heat generated. The process is modeled and performed using a computer programming prepped for this purpose, the model gave a good agreement comparing to the experimental work specially in the log phase.
The concept of clarity and readability of the written texts is an important goal in order to convey the communication idea to the receiver easily; the written texts have special significance because it is the most effective way to fulfill this idea as well as to achieve the aesthetic dimension of the written material, and clarity in the written texts is a prerequisite for reading, and readability is the speed of the optical reading of the written form, as the letters design plays a key role in facilitating the readability of the texts, and thus, it is necessitated to take care of these texts and studied them thoroughly in terms of shape for easy to read, and thus to understand the implications of the texts.
For that reason, the resear
The achievements of the art that we know today are questioned in motives that differ from what art knew before, including dramatic artistic transformations, which he called modern art.
In view of the enormity of such a topic, its ramifications and its complexity, it was necessary to confine its subject to the origin of the motives of the transformations of its first pioneers, and then to stand on what resulted from that of the data of vision in composition and drawing exclusively, and through exploration in that, we got to know the vitality of change from the art of its time.
And by examining the ruling contemporary philosophical concepts and their new standards and their epistemological role in contemporary life, since they includ
studied, and its important properties and relationship with both closed and open Nano sets were investigated. The new Nano sets were linked to the concept of Nano ideal, the development of nano ideal mildly closed set and it has been studied its properties. In addition to the applied aspect of the research, a sample was taken from patients infected with viral hepatitis, and by examining the infected people and using closed and open (nano mildly. and nano ideal mildly) sets, the important symptoms that constitute the core of this dangerous examining the infected people and using closed and open (nano mildly. and nano ideal mildly) sets, the important symptoms that constitute the core of this dangerous disease.
