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 contribute to the consolidation of scientific knowledge of compliance control and its role in verifying the proper disposal of funds to manage the wheel of the economy towards achieving targeted development and preserving public money, as well as clarifying the role of tax revenues in strengthening the public treasury and achieving social justice. The analytical descriptive approach was adopted in the process of analyzing The quantitative data collected through personal interviews, and the research reached a set of conclusions, the most important of which is the contribution of compliance control according to its three principles. (Transparency, accountability, and inclusiveness) on the availability
... Show MoreThe researcher chose her research which is imprinted ( the mechanism of employing the numbered personality in structuring scientific imaginary movies) because it’s found in modern employing of the numbered personalities of the movies that are designed by computers which made the directors and the producers to exploit these numbered development technologies in designing numbered personalities, in order to make them heroes instead of the actual actors in the cinema scene, it’s divided the research to five chapters, the first chapter, the methodical fine which includes, the problem of the research, the aim of the research includes, the importance of the research and it’s details, and the chapter concludes limiting the important terms,
... Show MoreThis research studies the effectiveness of the symbol in the Iraqi monodrama texts. The methodological framework is devoted to the research problem and the need for conducting it, its importance, the purpose of research, and the definition of the most important terms. The research problem dealt with the concept of the effectiveness of the symbol, the monodrama, and the working levels of the symbol in the monodrama texts of the author, in addition to the disclosure of the artistic vision embodied by the playwright in the use of the symbol within the literary product, as well as the development of the creative process. The research problem was defined by the following question: How effective is the symbol in the Iraqi Monodrama texts?
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The objective of this study is to enable the role of modern and advanced computerized information systems. The model or mechanism should be developed by collecting the necessary information about the taxpayers and the sources of the taxpayers' income, on the basis of which the accuracy of the inventory process will be adopted. In addition to studies related to computerized information systems and showing their importance to the tax institution. To achieve the objectives of the study and to answer its questions, the researcher relied on collecting data and information on the subject on the literature and previous studies The secondary sources, which also formed the theoretical framework of the study, were obtained either as a practical fr
... Show MoreNegotiations are distinguished in that they are an easy and simple means between the conflicting parties, and it is an effective means at the same time as the conflicting parties seek understanding on the most effective way to solve their dispute, but negotiations are not always appropriate to resolve international disputes, especially when there is a disparity in power between the negotiating countries, or when it is missing Goodwill, or even when one of the parties is absent or less flexible, and the internal circumstances of one of the conflicting countries may play a negative or positive role in the success of the negotiations, away from the influence of the role of external variables in that, a
... Show MoreThe purpose of this research is to highlight the nature of the relationship between the mental abilities of decision makers and strategic orientation . The intellectual capacity of decision-makers is the cornerstone for the implementation of all the tasks and duties of the Organization and constitutes the most important of its capabilities. As a result of the sharp changes in the environment in which it operates, this organization must accurately define its strategic directions to ensure its
survival and continuity. The problem of field research was to answer a fundamental question: Is the Iraqi director aware of how to employ mental abilities in strategic direc
... Show MoreThis research is intended to high light the uses of political content in foreign Arabic / speaking websites, such as “ CNN “ and” Euro News“, The research problem stems from the main question: What is the nature of the use of the websites in the political content provided through them? A set of sub-questions that give the research aspects and aims to achieve a set of objectives , including the identification of topics that included , the political content provided through , the sample sites during the time period for analysis and determine that the study uses descriptive research based on the discovery of the researcher, describing it accurately and defining the relations between the components.
The research conducted the des
The Phenomenon of Euphemism in the Translon Activity Euphemism is the replacement of a harsh word with a less harsh or more acceptable one. Most languages are affected by ideological, cultural, social, or religious perspectives which in turn would reflect different linguistic levels. On such a basis, translation is affected by its medium,i.e. language, and consequently what is acceptably expressed by a nation may not be acceptable by another. In this paper, we try to
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The aim of the research is to explain the role of quality costs their importance and their classification, and to clarify the most important tools that help to reduce costs.
In order to achieve the objective of the research and test hypotheses adopted the descriptive approach, as well as the adoption of the analytical approach in the study of applied data has been relied upon in providing data on the financial and production reports of the research sample company, the data were used to study and analyze financial and productivity reports . A number of conclusions have been reached the most important being the following
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