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.
This research deals with the formalities of the mortgage contract according to American law, We have given an overview of the provisions of this law related to the subject, We have also taken into consideration the role of American jurisprudence and the judiciary in finding legal solutions to the aforementioned formality, We have discussed the formality of mortgage in American law in two sections, In the first section we showed the formalism in immovable mortgage, and the second section specified to studying the formalism in movable mortgage.
The world is moving towards greening business in general and production systems in particular. At the same time, economic units seek to enhance their productivity and find any variables that can contribute to improving their elements. Economic units should not ignore the green dimension of cost management techniques because of its role in containing the green dimension of the production system and the product. However the few researches dealt with the subject of the green kaizen showed its role in reducing costs and improving the environment. Those researches did not address its contribution to raising the level of productivity. Productivity is an important indicator of economic units that expresses their level of success and progre
... Show MoreNanoparticles are defined as an organic or non-organic structure of matter in at least one of its dimensions less than 100 nm. Nanoparticles proved their effectiveness in different fields because of their unique physicochemical properties. Using nanoparticles in the power field contributes to cleaning and decreasing environmental pollution, which means it is an environmentally friendly material. It could be used in many different parts of batteries, including an anode, cathode, and electrolyte. This study reviews different types of nanoparticles used in Lithium-ion batteries by collecting the advanced techniques for applying nanotechnology in batteries. In addition, this review presents an idea about the advantages and d
... Show MoreGreenhouses are provide that produce of vegetable in non times seasons production by controlling the various environmental factors that appropriate atmosphere in temperature and humidity for the growth of plants in the plastic houses and owner plastic.
The objective of this research is to study of the most important natural and human factors affecting the Greenhouses in the province of Baghdad and study geographic distribution for the Greenhouses in the province.
Some properties on curriculum geographical descriptive analytical that used in describe and analysis of data and information that could be available from Directorate of agriculture in Baghdad to 2014. As it turns out that district of Mahmudiya acquired (45.3%) of the total
In the period immediately following the end of World War II, American theatre was transformed by the work of playwright Arthur Miller. Miller tapped into a sense of dissatisfaction and unrest within the greater American psyche because he was profoundly influenced by the depression and the war that immediately followed it. His dramas proved to be both the conscience and redemption of the times; allowing people an honest view of the direction the country had taken.1 Miller has his own concept of tragedy as a modern playwright. He believes that tragedy may depict ordinary people in domestic surroundings instead of talking about a character from a high rank, a king or a queen. Miller’s main concern lies in dramatizing the whole man as he i
... Show MoreAbstract: In accordance with contemporary Western thinking, power is an organized force with a high ability to achieve stability and social security because it possesses tools based on rational organization, which helps it to control the behavior of the individual and society and prevent them from practicing the processes of exclusion and discrimination against others in pursuit of their interests and needs. Vision The philosophers and thinkers of the theory of social contract can consolidate it, which changed the form and nature of power from the traditional heritage to the constructionWhich has contributed to the development and development of civil society - Western political, and despite the success of this experiment, especially aft
... Show MoreThis research tackles the play of Synge "Rider to the Sea" to find out whether the theories of Leech (1983) and Brown and Levinson (1987) can be applied or not to this study. The model of Leech (1983) consists of seven principles and for Brown and Levinson (1987),it consists of two principles of politeness where one of them is positive and the other is negative politeness. It is hypothesed that: 1. There is a relation between the two theories. 2. Synge deals with these theories in such a way to depict his characters. 3. It is also hypothesed that every character deals with these principles in such a way to show the events of the play. The study concludes that there is a relation between the two theories in depicting the characters then it s
... Show MoreThe loss of dental hard tissue as a result of odontoclastic activity is known as root resorption. It is unwanted and pathological in permanent teeth. Root resorption may happen within the root canal called internal root resorption or on the outer surface of the root called external root resorption. Regardless of where it occurs, root resorption is irreparable, can cause pain for the patient, necessitates treatment, and in some circumstances, resulting in the early loss of the affected tooth. It might be challenging to precisely diagnose and treat root resorption. There is limited information within literatures on root resorption therefore this review aims to understand the radiological and clinical characteristics of r
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