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.
Each school of Islamic jurisprudence has principles and rules upon which the diligent work in these schools is based. This is due to the view of sanctification of these rulings, as they are divine rulings. Therefore, the goal is to reach a ruling that represents the intent of the legislator as much as possible.
Hence, these schools of thought established rules for issuing fatwas with the intention of restricting the performance of a fatwa to the hands of those who are qualified for it and have met its conditions, so they gave priority to the most knowledgeable person over others to perform the fatwa. In the Hanafi school of thought, for example, the saying of Imam Abu Hanifa (may God have mercy on him) is given precedence over others,
In this research, we attempt to show the extent of harmony in an aspect of the text according to the stylistics for the Knowing of the stylistic value of the title threshold, and the pathways of titles that suggest and support the meaning when the recipient reads the literary text, in addition to the interpretations that reflect the purposes of the poet who contributed to the drawing of his poetic achievement. The research presented a brief about the poet and his most important works, because they are the text which will be studied according to the stylistics. The research also explained the concept of style and the stylistics in the preface , because of the stylistic is the method adopted by the research to study the title thresholds in
... Show MoreThis study aimed to identify the role of digital transformation in improving the quality of the internal audit process. The researchers used the descriptive analytical approach, and the questionnaire was relied on as a study tool that was applied to the study population consisting of internal auditors working in banks listed on the Palestine Stock Exchange, and their number was (85). A checker and a comprehensive inventory method was used due to the small size of the community, where the response data of the questionnaire was analyzed and interpreted using the Statistical Packages Program (SPSS).
The results of the study showed that the use of digital transformation contributes to ensuring the quality of
... Show MoreThe problems of modeling the signal and dispersion properties of a second order recursive section in the integer parameter space are considered. The formulation and solution of the section synthesis problem by selective and dispersive criteria using the methods of integer nonlinear mathematical programming are given. The availability of obtaining both positive and negative frequency dispersion of a signal in a recursive section, as well as the possibility of minimizing dispersion distortions in the system, is shown.
أثر تنوع الرؤى الاخراجية للاتجاهات والحركات المسرحية المعاصرة في أتساعالاشتراطات الجمالية لبنية الخطاب المسرحي + الامر الذي ادى الى انزياح مكوناتالعرض وعناصره ؛ ومنها المنظومة السردية للنص التي شكلت في بدايات المسرحجغرافية العرض المسرحي والمرتكز النظري والفكري الذي يمد العرض المسرحي أغلبتدفقه الجمالي وعنصر أستعلائي لعناصر العرض الاخرى ؛ وضمن التطورات اللاحقةأنسحب المخرج المسرحي من سطوة البنية النص
... Show MoreAbstract : This research has tackled about the role of Russia in the international policies which concerning with energy , So the most important states in the world that possesses huge energy resources to be more able in the control over the reality and future production programs and the distribution of global energy alike , the latter had effectively influence on the economic and developmental aspects within many countries in the world and its impacts on political decisions and perhaps effected too much in the dimensions of strategic policies . In this context of research , Russia has been developed a high energy policy of strategic planning in order to restoring Russia position and its global role by using its potential powerful streng
... Show MoreDiscourse is a form of communication, and It carries with it an Intellectual framework, and It is a form of expression to communicate Ideas to people through an interactive process.The interest and analysis of discourse Is one of the most important fields of linguistic studies, and It has a basis In ancient studies, and It has become one of the most Important topics of the study, and (Sayyid al-Sadr) often uses guidance In his sermons.
By extrapolating and analyzing a set of examples received, from the perspective of the deliberative approach and the theory of speech acts, and the statement of the extent to whichh (Sayyid al-Sadr) relied on linguistic elements, and the use of the rank of the speaker In issuing directives, and the
... Show MoreBackground: Dietary intakes are critical during pregnancy, because inadequate amounts of key nutrients may compromise fetal development or maternal health. In addition to that maternal diet could be one of the methods to select the gender of the baby. The aim of the study is to correlate the level of the minerals in the mother’s blood with the gender and wellbeing of the baby after delivery.Patients and Methods: Fifty women were involved in this study with a mean age (23.92 ± 4.75), collected from the labor room during labor in the period between December 2013 and May 2014, in Baghdad teaching hospital. After taking a full history from the women, 10 ml of blood was withdrawn from them, 2ml in EDTA tubes for lead estimation and 8 ml in pl
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