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 research aims to study and analysis of concurrent engineering (CE) and cost optimization (CO), and the use of concurrent engineering inputs to outputs to improve the cost, and the statement of the role of concurrent engineering in improving the quality of the product, and achieve savings in the design and manufacturing time and assembly and reduce costs, as well as employing some models to determine how much the savings in time, including the model (Lexmark) model (Pert) to determine the savings in design time for manufacturing and assembly time.
To achieve the search objectives, the General Company for Electrical and Electronic Industries \ Refrigerated Engine
... Show MoreFlourished economic life in the city Asturabaz was the main engine of social and political conditions in the city; In order to provide factors to help the successful cultivation of the city as well as the prosperity of the industry as famous city Asturabaz since ancient times textile industry and won wide acclaim as well as leather and wood industries and the pharmaceutical industry industry in addition to the livestock that have contributed to increased imports of the city, and this led to the prosperity of the evolution of physical movement and intellectual life.
The organization and coordination of any communication is based on the system of turn-taking which refers to the process by which a participant in a conversation takes the role of speaker. The progression of any conversation is achieved by the change of roles between speaker and hearer which, in its turn, represents the heart of the turn-taking system. The turn-taking system is not a random process but it is a highly organized process governed by a set of rules. Thus, this system has certain features and rules which exist in any English communicative process. These rules, if applied by speakers, help to achieve successful exchange of turns in any conversation. This paper attempts to present full exposition of the concepts of conversation
... Show MoreMarriage as a social case began Almighty God created Adam, peace be upon him then created from the rib Eve to be the first couple of human beings on the face of the earth and the formation of the first social family in the land, human and picked up this social reality through the generations, but in different shapes and purposes, but the mating process is one. So I got the divine religions and organized that life, especially in Islam, as explained every aspect of the life of the role and practice of marriage and had a large share in this organization and I got many Quranic verses and the Hadith.
With different civilizations, many of the marriage ceremony appeared in ancient societies take several forms of marriage.
But marriage and
Among the findings of the research are:
1. This type of ambiguity is old in use and was adopted by the Arab poets as a
reaction against hyperbole and as a tendency towards compression of expression that
results in an. amusing suspension through the use of irony. The Andalusian poets
tended to employ this form because it involves interaction and interrogation,
2. Furthermore, it indicates the poet’s insight, talent and skill and it is, therefore,
regarded as a form. Of verse discourse that appeals to the reader, in contrast to
hyperbole.
3. Its presence in Andalusian poetry is evident n eulogy and descriptive poetry and it
held a place of prominence as a poetic form in achieving these purposes.
4. Through i
With a great diversity in the curriculum contemporary monetary and visions, and development that hit the graphic design field, it has become imperative for the workers in the contemporary design research and investigation in accordance with the intellectual treatises and methods of modern criticism, because the work design requires the designer and recipient both know the mechanics of tibographic text analysis in a heavy world of texts and images varied vocabulary and graphics, and designer on before anyone else manages the process of analysis to know what you offer others of shipments visual often of oriented intended from behind, what is meant, in the midst of this world, the curriculum Alsemiae directly overlap with such diverse offer
... Show MoreThe problems of urban historic centers are considered some of the subjects which are widely dealt with in urban studies since the middle of the 20th century. literature of urban development have raised it , beside the fact that large number of urban development projects of the historical centers in many cities of the world ,and emerged from the application of these new problems projects added their original urban problems , because these projects have dealt with the physical structures with the neglect of the social and economic sides, which are the base in sustainable development nResearch problem was elaborated as : The unclearly of knowledge of the potentials of the sustainable development in solving the urban problems of historic cen
... Show MoreMechanism of Arbitration in the Stock Exchange Disputes