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.
Deontic modality expresses what is necessary or possible according to the norms of morality and laws of community. It is a cover term for those cases where modal auxiliaries used to express notions like ''obligation'', ''prohibition'' and, ''permission''. Deontic modals are basically performatives, having the ''so-be-it'' component of directives in that the speaker directs the behavior of the addressee to get things done. The present study identifies the use of deontic models in international contracts to prove that there are major pragmatic strategies employed in writing them. To achieve the aim of the study, a modified model of Danet’s (1980) and Trosborg’s (1995) in accordance to Searle (1969) is used to analyze 16 texts selected fro
... Show MoreChaotic features of nuclear energy spectrum in 68Ge nucleus are investigated by nuclear shell model. The energies are calculated through doing shell model calculations employing the OXBASH computer code with effective interaction of F5PVH. The 68Ge nucleus is supposed to have an inert core of 56Ni with 12 nucleons (4 protons and 8 neutrons) move in the f5p-model space ( and ). The nuclear level density of considered classes of states is seen to have a Gaussian form, which is in accord with the prediction of other theoretical studies. The statistical fluctuations of the energy spectrum (the level spacing P(s) and the Dyson-Mehta (or statistics) are well described by the Gaussian orthogonal ens
... Show MoreSocial reform is the main pillar of the organization of societies. Therefore, all religions and theories were directed to focus on this aspect as the most important element for the development of economic and cultural development. In addition to the analysis and application of the Islamic Sharia, he did not present a theory, but offered real solutions and remedies to the crises in our Arab and Islamic societies alike, despite the criticism directed at him. Z his opinions.
In The Name of Allah Most Gracious Most Merciful
The characteristics of the doers of good are mentioned in the Holy Book of God, and love for them in five places, and whoever God loves, honors him and gives him victory. As for the love of the righteous, it has to do with loyalty, covenant, and integrity. Committing sins 0 Then after that he mentioned God those who fight in His cause and those who rely on Him and return to Him and turning away from everything else.
This paper aimed at specifying the leading obstacles which faced by Iraqi EFL secondary school teachers in teaching English language. According to studies and observations, lack of adequate materials, overcrowding classrooms, lack of infrastructures, and low job satisfaction are the main barriers to English language teaching in Iraq. Data were collected from 130 EFL teachers from Iraqi schools through a standard questionnaire. The data were analyzed using a descriptive statistic to summarize and present it in a meaningful way. The findings supported previous studies regarding the classroom overcrowding, lack of teaching aids and materials, and dilapidated facilities. Furthermore, regarding job dissatisfaction and salary, interesting and eye
... Show MorePurpose: The main objective of this paper is, to determine the optimal no. of technicians’ men in a workshop crew of an Industrial System. Theoretical framework: The purpose of applying these tools is to explore their ability to reduce costs and improvements that can be obtained in the process of providing services to the end customer. Design/methodology/approach: The literature structure review was built from analyzing 12 of scientific papers and books, from web sciences and the Elsevier database. The papers were analyzed from descriptive, methodologic, and citation characteristics. Finding: By applying the equation model of the paper, the optimal no. of technician men in the crew of the workshop can be determined when
... Show MoreThe research dealt with the issue of strategic information systems and its impact on the global marketing channel. As the research aims to know the strategic information systems used in the cement company. Which support the senior management in supporting decisions taken in the process of global orientation and moving to foreign markets by choosing the marketing channel that will suit the company. Product and competition with it. With other companies' products. The problem of the study focused on how to move to global markets, and any marketing channel that can be followed to move the cement product globally, what are the strategic information systems used in the company and how will it contribute to supporting senior management dec
... Show MoreThis study is conducted to verify the efficienecy of local Ninivite rock when used in the treatment of drinking water in plants operating currently in the country in order to develop the situation of these stations to cope with the increase in population. Also, this will limit the pollutian which are increasing in the country's rivers.
(Euphrates and Tigris). These rivers are the sources to feed all water treatment plants in the country. The idea is the develop or the modify these stations by replacing part of top layer of sand filters used in these stations with Ninivite rock to operate as filters composed of two medium. The efficiency of this rock is compared with other materials used successfully worldwide in this area, such a
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