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.
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 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.
Discourse 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 MoreAbstract
The Umayyad poets tried to invest all artistic tools in order to achieve a measure of creativity in their texts. The phenomenon of visual composition is breaking the familiar writing system, with the aim of increasing the number of possible connotations. The visual in the Umayyad poetry tries to replace it through expression with the visual image, and its manifestations were manifested by the multiplication of punctuation marks in the body of the poetic text and the tearing of the single poetic line by cutting it into several sentences or repetition.
Keywords: visual formation, poetic writing, Umayyad poetry, recipien
This 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 Moreأثر 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 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
... Show More The researcher was interested in studying a crucial aspect of the systematic world music culture. He highlights the analysis of the harmonic construction in the musical compositions of the artist Khalil Ismail, where harmony is a significant Western musical science, a pillar of the structure of instrumental and vocal music.
It depends on the compositions of vertical sounds performed simultaneously, as tones coincide and are sometimes dissonant to give sound resonance that enriches musical work and attracts recipients. Hence, the researcher has many questions, including: Can the composition of the writings of the artist Khalil Ismail determine in an objective research framework? Is there a study on this subject in some detail? whic
The images and drawings reduce the intellectual, symbolic and cognitive dimensions inside them that make them an intermediary that imposes itself on the educational method, as they have become responsive to all the needs of the student in the modern era unlike the previous periods. The artistic direction of the illustrations in the scientific books meets the educational and pedagogical needs of the learner and their frame in an illustrative educational method that contributes in developing the student's abilities to benefit from the scientific curricula in the age of scientific and cognitive development.
Here, the researcher finds that the artistic direction of the illustrations lacks the achievement of scientific and technical p
... Show More