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.
The present research aims at revealing the advertising image semiotics in the American printed poster by following the image's significance and its transformations through the poster design trends and indicating its nature whether it is an explicit or implicit image. The limits of the research were the American printed poster during 2016-2018 period. The theoretical side was determined by two sections, the first: (the advertising image semiotics) and the second (design trends in the printed poster). The research procedures were represented by the research method adopted in the analysis of the sample models identified in four models taken from the research community which contains (24) models. The selection was made according to the trend
... Show MoreRapid and continuous developments and changes in the modern business environment in all areas of economic, environmental, social, technology and communications push economic units to search for modern methods and methodologies to produce products at low cost as well as produce products that meet the wishes of customers in terms of quality and environment to maintain their market position, and accounting for the costs of the flow of materials is one of the most prominent environmental management accounting techniques capable of providing information to help produce
This study has applied the theoretical framework of conceptual metaphor theory to the analysis of the source and target domains of metaphors that are used in two English nineteenth century sonnets, both written by contemporaneous female poets. The quantitative and qualitative results of the textual analysis have clearly revealed that Elizabeth Barrett Browning’s sonnet 23 centres around the conceptual mapping of the journey of love and life with that of possession. In contrast, Christina Rossetti’s sonnet Remember tackles the central conceptual mapping of death as a journey in relation to its further experiential connections. In addition, the application of conceptual metaphor theory in identifying the frequencies and densities of metap
... Show MoreThe Comedy of patterns dramas that gave Representative possibilities of advanced functionality and wide being dependent on the diversity performance piece , which is intended to provoke laughter at the receiver, through the diversity of genres performing between dancing and singing and Albantomaim and other methods that have made them distinct from the species dramas other being enabled Representative in dealing with all roles across mature and adaptation of his tools of physical and vocal , as the comedy discusses the societal issues many have a factor of psychological and behind their platforms as a tool face is not directly give way to vent citizen injustice and disadvantages of humans and these conditions need to techniques of physic
... Show MoreAsthma is a condition characterized by bronchial spasms, inflammation, and mucous hypersecretion which leads to difficulties in respiration. Asthmatic patients are usually presented with recurrent attacks of coughing, wheezing, and shortness of breath which could be life-threatening. More than three million cases of asthma in the United States are diagnosed annually. Resveratrol, a polyphenolic stilbene, is known to be useful in controlling asthmatic attacks via different molecular mechanisms within the lung epithelium and infiltrating immune cells. However, few studies mentioned the effect of resveratrol on the microbiome in ovalbumin-induced asthma mouse model. In this study, we ind
In spite of the disappearing of a clear uniform textbook for teaching ESP at different departments and different colleges in both scientific and humanistic studies, the practitioners at those departments and colleges have to teach translation as one of the important requirements to pass the English language exam. The lack of defined translation activities is a noticeable problem therefore; the problem of teaching translation is diagnosed in that the students lack the ability to comprehend the text in English language and other translation knowledge and skills.
The study aims to suggest a translation strategy and then find out the effect of the translation strategy on ESP learners’ achievement in translation. A sample of 50 stud
... Show MoreThe research paper aims to highlight the impact of electronic governance in improving the quality of auditing through accounting disclosure and how to make use out of it in resolving many of the problems by economic units in general and in particular the financial problems in particular. It focuses on the most important financial information of the loss of confidence and credibility in the financial information of the economic units, This study has been carried out through the use and application of many of the principles and rules contained in the electronic governance, The most important Which is the accounting disclosure, and hence the dimensions of accounting for electronic governance through the achievement of ac
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