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.
Through an experimental program of eighteen specimens presented in this paper, the bond strength between reinforcing bar and rubberized concrete was produced by adding waste tire rubber instead of natural aggregate. The fine and coarse aggregate was replaced in 0%, 25%, and 50% with the small pieces of a waste tire. Natural aggregate replacement ratio, rebar size, embedded rebar length, the rebar yield stress of rebar, cover, and concrete compressive strength were studied in this investigation. Ultimate bond stress, bond stress-slip response, and failure modes were presented. The experimental results reported that a reduction of 19% in bond strength was noticed in 50% replaced rubberized concrete compared with convention
... Show MoreThe Legend between reality and its future Treatment in threatre analytics study
The security environment for Northeast Asia is extremely important, as it includes most of the international actors (United States of America, China, Russian Federation and Japan), which gives the nature of the interactions of these forces a special importance for the region.
Because of the multiplicity of policies and interests of the active forces in the region, the result has been an unstable regional environment where the interests of the major powers often clash repeatedly on many related issues, which is coupled with the growing efforts of many powers to adopt policies that differ from what they did in the past This resulted in different patterns of relations, which were mainly characterized by competition over regional lea
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This research deals with the technical of opening text during the critical
study about the poem of Al- ssiyab which is named ( city with out rain)
We chose this poem also to make connection with the western critical
theories.
Our study aims to explain the act of opening texts and critics and its
methods and directions in modern Arabic poetry.
It also aims to show the differences in the point of view between critics
and poetries.
The research depends on dimension vision of selective, and descriptive.
The study aimed to show the concept and importance of accounting Conservatism, Persistence and volatility of earnings of companies listed in the Iraqi market for securities have been selected 35 companies for the period between 2013 to 2107 used the scale of book value to market value to measure the Conservatism while the current profit regression model was used to measure future profits Eviews 9 was used for the purpose of testing the two hypotheses. The results of the study found that there is a statistically significant relationship between accounting Conservatism and Persistence of earnings. The relationship is inverse with no statistically significant relationship between Conservatism and earnings volatility.
Forecasting is one of the important topics in the analysis of time series, as the importance of forecasting in the economic field has emerged in order to achieve economic growth. Therefore, accurate forecasting of time series is one of the most important challenges that we seek to make the best decision, the aim of the research is to suggest employing hybrid models to predict daily crude oil prices. The hybrid model consists of integrating the linear component, which represents Box Jenkins models, and the non-linear component, which represents one of the methods of artificial intelligence, which is the artificial neural network (ANN), support vector regression (SVR) algorithm and it was shown that the proposed hybrid models in the predicti
... Show MoreThe importance of forecasting has emerged in the economic field in order to achieve economic growth, as forecasting is one of the important topics in the analysis of time series, and accurate forecasting of time series is one of the most important challenges in which we seek to make the best decision. The aim of the research is to suggest the use of hybrid models for forecasting the daily crude oil prices as the hybrid model consists of integrating the linear component, which represents Box Jenkins models and the non-linear component, which represents one of the methods of artificial intelligence, which is long short term memory (LSTM) and the gated recurrent unit (GRU) which represents deep learning models. It was found that the proposed h
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