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.
Jurisprudential rules, a broad section to lower the legitimacy of the ruling on the developments of politics, which is increasing day by day, and developments of complex judicial issues, provided that the rule derived from the texts of the legitimate or verbal significance.
And the introduction of jurisprudence rules in the provisions concerning the legitimate policy, the first to take from the provisions of the situation; because the rules of jurisprudence is a summary of the provisions reached by the scholars of the nation after study and scrutiny, which is qualified and largely to cover the need of the owners of public mandates.
The current research studies (representations of metaphysics in the works of potter Jason Walker) a concept that refers to To a large extent, by conveying a sense of reality to the recipient by conveying ideas, contents, and connotations. A variety of center hit, dispersion, and rejection of everything that prevails, so our position on the closed text has shifted To the open text, through the role played by cross-pollination in the works of the potter (Jason Walker), which established a clear hypothetical vision of the image represented in the construction of the ceramic work and the thought that was embodied in that image represented by the nature of its unrealistic formations for those ceramic artworks. It is thus considered a logical
... Show MoreThe goal of current research to know the according of scientific values in the curriculum of chemistry sixth - grade science To achieve this goal wasa to build aalistaofa scientifica values toa be included in the curriculum of chemistry sixth - grade science after seeing a group of literature and previous studies, the list presented to a group of arbitrators and specialists in educational and psychological sciences and methods of teaching science, and curricula and teaching methods , Arbitrators and specialists have expressed their views and comments on the tool, and that the list was formed in final form (9) values Head of scientific includes ( 35) sub - value, then the researcher analyzed the chemistry curriculum for sixth grade Scient
... Show MoreA restrictive relative clause (RRC hereafter), which is also known as a defining relative clause, gives essential information about a noun that comes before it: without this clause the sentence wouldn’t make much sense. A RRC can be introduced by that, which, whose, who, or whom. Givon (1993, 1995), Fox (1987), Fox and Thompson (1990) state that a RCC is used for two main functions: grounding and description. When a RRC serves the function of linking the current referent to the preceding utterance in the discourse, it does a grounding function; and when the information coded in a RRC is associated with the prior proposition frame, the RRC does a proposition-linking grounding function. Furthermore, when a RRC is not used to ground a new di
... Show MoreNon-thermal atmospheric pressure plasma has emerged as a
new promising tool in medicine and biology. In this work, A DBD
system was built as a source of atmospheric pressure non-thermal
Plasma suitable for clinical and biological applications. E. coli and
staphylococcus spp bacteria were exposed to the DBD plasma for a
period of time as inactivation (sterilization) process. A series of
experiments were achieved under different operating conditions. The
results showed that the inactivation, of the two kinds of bacteria, was
affected (increasing or decreasing) according to operation conditions
because they affects, as expected, the produced plasma properties
according to those conditions.
This research deals with the color bias and its effect on maids in Mississippi in Kathryn Stockett''s (2003) The Help. The ill-treatment and negligence of Afro-American maids received from the white women who employed them in Mississippi that must have affected directly or indirectly on their personality and may eventually lead to suffering. They live in an atmosphere of struggle to free themselves from the complicated relationships between black and white. Afro-American maids pledged to liberate themselves from social oppression by protesting through writing a book which chronicles their stories in slave masters’ homes to make their presence felt as human being equal to their white masters.
It is no secret to everyone that the Arab individual suffers from poor self-awareness and political awareness, which made the state and the importance of its existence and preserving its institutions not among his interests, which made researchers wonder about the possibility of strengthening it and the extent of its impact on the future of building the contemporary Arab state. So, the study attempts to addressing the issue of community awareness and its impact on building the state through a clear intellectual vision that blended what is social and political to define the concept of community awareness and highlight its importance and role as a basic pillar in shaping and building modern Arab countries in the Arab world and ways to enha
... Show Morethe political changeable is important reflection in areas of life and the designers tried to high light it in the cover of Journal promised time Journal a fertile square to show reflection of political changeable, and triad to search the current path. The first chapter organized according to axes, problem of research formulated according to question:- what are reflections of political changeable in magazine cover?
The importance of research depth of specialized approach on level of technical and stylistic as ago al ago as in: the baring of political changeable in design of journal's cover. The research moves in cognitive border from 2013 to 2017 and selection of t
... Show MoreThe issue of the other in the graphic design and specifically the advertising constitutes a cognitive study of the structure of the intellectual expansion in the cognitive and intellectual creative systems because of the implicit and declared embodiment it provides within the mechanisms of reading in the advertising design that appeared according to the other and through the embodiment of the textualism, the difference and the binary opposites is nothing but a reaction to the design thought and what constitutes of the manifestations of the other in advertising design. Based on the above, we review this study (Manifestations of the Other in Graphic Design) to clarify the topic through four chapters. The first chapter included the research
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