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 aim of the research is to identify the level of both organizational trust and decentralized performance of those in charge of managing local championships for the Iraqi Athletics Federation, and to identify the effect of organizational trust in decentralized performance from their point of view. The descriptive approach was based on the method of relational relations on a sample of those in charge of managing local championships for the Iraqi Federation In athletics, represented by each of (coaches, referees, members, president and members of the administrative body of the central federation, and the president of members of sub-federations) for the sports season (2020/2021) of 260 individuals, all of them were intentionally chosen by (1
... Show MoreThe issue of measurement of operational efficiency and productivity plays a major role in determining the weakness of the company, especially in relation to the productive processes, and thus starting to address these points and improve their performance. Hence the problem of research on how to determine the constraints in the production process, to identify weaknesses in the company. The research aims to clarify the role of throughput accounting in measuring the operational efficiency of the company in addition to clarify some of the constraints and causes behind them. The study concluded a set of conclusions, the most important of which is the availability of throughput accounting indicators that help in measuring operational efficienc
... Show MoreThe efficiency of Nd:YAG laser radiation in removing debris and smear layer from prepared root
canal walls was studied. Fifty-seven human extracted single rooted anterior teeth were divided into three
groups. A group that was not lased is considered as a control group. The remaining teeth were exposed to
different laser parameters regarding laser energy, repetition rate and exposure time. For the case of the set of
parameters of 7 mJ laser energy, the cleaning was maximum at 3 p.p.s. repetition rate for 3 seconds exposure
time for, the coronal, middle and apical thirds. Above and below this energy level, there was an overdose
(melting) or under dose (no effect). Nevertheless for 10mJ laser energy case, the cleaning effi
We have provided in this research model multi assignment with fuzzy function goal has been to build programming model is correct Integer Programming fogging after removing the case from the objective function data and convert it to real data .Pascal triangular graded mean using Pascal way to the center of the triangular.
The data processing to get rid of the case fogging which is surrounded by using an Excel 2007 either model multi assignment has been used program LNDO to reach the optimal solution, which represents less than what can be from time to accomplish a number of tasks by the number of employees on the specific amount of the Internet, also included a search on some of the
... Show MoreTwelve pends were selected and distributed on three verticals transects paths on the Tigers river in Al Rasheed county.Passing through land covers, that classified and covers the whole region. Based on the 8 Landsat of the year 2015. It was oriental classified by using Erdas 10.2 . The pedons were distributed on the area of each varicty of these classes. the series of soil according of the transect series (DW74,MMg,DMu6 , Df96) respectively were represented P1 , P2 , P3 , P4 .
The second transits series(DM97,MM5,DM96,DF115) respectively were represented P5 , P6 , P7 , P8 .The third transits series(DM46,MMg,MF12,MM11) re
... Show MoreBackground: The fracture of instruments within root canal during endodontic treatment is a common incidence, fracture because of fatigue through flexure occurs due to metal fatigue, this study aimed to assess the effect of curvature angle and rotational speed on the cyclic fatigue of different type of Endodontic NiTi Rotary Instruments and compare among them. Materials and method: Three types of rotary instruments with tip size 0.25: ProTaPer F2 (Densply, Malifier) Revo-S SU( 0.06 taper, MicroMega) and RaCe system (0.06 taper, FKG, Dentaire), Forty file of each instrument were used within two canals with angle of curvature (40 &60 )at two speed (250&400)RPM, twelve group were formed for all instruments(total number=120),ten file fo
... Show MoreThe research aims at identify the role of the electronic trading system used in the Iraq stock exchange to promote trading activity for the stocks of listed companies in this market.
To prove the hypothesis of research, it was selected the main trading indicators for the market to be a main field in test the research hypothesis.it was selected as the period of time for (9)years span between the years (2005-2013) because they represent the first two articles of equal time periods represent aperiod that preceded the introduction of electronic trading system while the second represents the period of time that followed
The research found a number of conclusions but the mo
... Show MoreThe objective of this study was to investigate the effect of Royal jelly RJ on morphology and motility of mice sperms. Sperms were collected from the cauda region of the epididymis of each 10 mice from the treatment and control groups. Direct activation techniques and evaluation of sperm morphology were carried out. Dhino microscope was used for sperm measurement. The inspection was carried out in Salamatic laboratory for pathological analysis in 2015.The result revealed that all of the sperm function parameters registered significant activation in the treatment group. There was a significant increase in both the percentage of the sperm motility grade A and the progressive motility (A+B) of the treatment gr
... Show MoreThis research dealt with the subject of negotiation skills of employees in public relations departments which is one of many skills supposed to be available to these employees. These skills combined help in the success of the job of public relations departments; and give them an important and vital role within the roles distributed in the departments of any government institution wither is governmental or non-governmental.
Negotiation is a skill that requires intelligence, tact, culture, information, intuition, and knowing to use the means of communication to access the information that is useful in reaching satisfactory results
... Show More