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 research focused on clarifying the relationship strategic decisions for operations management & performance excellence organizational, The research emerges from a problem which explained by many application questions. Special questionnaire has been prepared for this purpose distributed (72) to sample of management levels (Top, middle) in the General company for mining industries and aquatic Insullation & the General company of batteries industry, The research has tried to test a number hypotheses related to the relation and regression among the variables of the research, and the differences among the <
... Show MoreThe present paper sheds light on irony as one of the most important and most common linguistic phenomena in modern linguistics, in general ,and in discourse in particular, whether it is (political, literary, journalistic, etc.). When irony is used correctly or positively, it paves the way for the speaker to gain the approval of other parties participating in the dialogue and dissolve barriers between them. It is a simple multi-functional linguistic style and an expression of one’s meaning by using language that normally signifies the opposite according to the context and the situation. Therefore, it is necessary to study its characteristics, define its functions and traces the extent of
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One of the important things provided by fuzzy model is to identify the membership functions. In the fuzzy reliability applications with failure functions of the kind who cares that deals with positive variables .There are many types of membership functions studied by many researchers, including triangular membership function, trapezoidal membership function and bell-shaped membership function. In I research we used beta function. Based on this paper study classical method to obtain estimation fuzzy reliability function for both series and parallel systems.
Many risks have adverse consequences for construction projects’ objectives such as quality, schedule, and cost. As engineering procurement construction (EPC) contracts gradually become one of the most common types used in implementing major large-scale construction projects, identifying common risk types and analyzing their root causes is important for developing measures to decrease and eliminate future risks in these types of contracts. The information about the main causes of risks was collected
Racism changes its meaning, shape, purpose or function according to various factors such as time, place, motives, and backgrounds; among others. It seems, however, to have deep roots back in the history of mankind. Such a concept stems from a perceived difference with the other. It is fed by the feeling of being hierarchically superior in opposition to another party that is depicted as inferior. Since ancient times, racism is disguised in different forms and manifests itself on various levels. It is a truism that this ideology can be best presented via language.
Due to its negative implication, racism lends itself to a critical kind of research. As such, this paper is a critical pragmatic investigation for this phenomenon a
... Show Moreيتناول البحث شخصية شعرية وأدبية فذة هو محمد صالح بحر العلوم الشاعر العراقي المعروف والمولود في بيت ثوري من بيوتات النجف المعادية للاستعمار البريطاني في مطلع القرن العشرين، وينحدر من أسرة عريقة مشهورة بالعلم والأدب، عاش بحر العلوم شاعراً ينقل بصوره الجمالية كل ما يقع في حواسه، وتجربته تثري من اتصاله ببيئته فنجد الشاعر اشبه بالمصور يستمد صوره من واقع بيئته المتنوع. ونحن في بحثنا هذا نحاول أن نرصد أهم المصادر
... Show MoreNovel has recently received the attention of readers and writers greatly, because of the role they play, and this indicates an important rule, which is whenever there is an art or creativity, there must be a respective criticism, and this criticism is certainly not less important than the author. So there are critics who have a prestigious literary position in the follow-up story development, and trying to describe the transformation of its elements. One of these critics is professor Fadhel Thamer, and who wants to approach one of the elements of the novel exploring, must stop on the visions of this critic about it , and that’s why we take the (character) element following the most important opinions of this critic about
... Show MoreThe adoption of the concept of preventive war in any country especially in a country like the United States result in a lot of serious consequences, so that pre-emptive military action may alter certain regional arrangements based on the basis of political and security balance, and reduce the incidence of tensions that may worsen a sudden during the application of preventive war, so the concept is applicable to be a risk much more when you face the reality and that because the issues more importantly, it should prepare a detailed and careful study of the post –stage of the use of preventive military action and this requires realy no papers insist or documents discuss this but accurate this field study of the situation thereafter.
The concept of meaning is one of the most important topics that have occupied the mind of the recipient and critic in all the arts, especially the plastic arts, where we find that the art of contemporary plastic art, in particular sculpture has multiple readings and many critics differed in terms of different reading and views of the same artistic achievement.
This research will identify the different works of contemporary Iraqi sculptors while presenting and studying their works, as well as (studying the problem of meaning) of the artistic achievements of the sculptors in particular. The various parties interested in Iraqi sculpture did not seize the problem of the objective and subjective meaning of contemporary Iraqi sculpture
... Show MoreIn this research, that been focused on the most important economic benefits expected when applying the three standards of sustainability in construction projects (economic, environmental and social). Fuzzy AHP, a multi-decision decision-making technique for evaluating construction projects. Which when used we get the speed and accuracy in the results. Using this technique will reduce uncertainties decisions significantly (fuzzy environment), that found in most projects .The results of the data analysis showed that the economic standards take the greatest relative importance (60%) among the three sustainability standards. Therefore, the implementation of any standards need a cost so the economic benefit of any proje
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