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.
Abstract
The research aims to identify the strategic leadership and its role in activating the Organisational Performance, which is an analytical study of the views of the heads of scientific departments at General Authority of groundwater researcher's quest focused towards building a theoretical framework suitable for strategic leadership and performance Organisational and itُs dimensions.To achieve the aims of the research is designed to identify the researcher included (35) items to collect the raw data from the research sample consisting of 33 of the heads of departments. Data was collected by questionnaire, field visits, interviews and some official documents to complete the search data. It has also been used a numb
... Show MoreThis research aims to learn about public relations programs and their role to enhance the morale of the State land Transport Company employees.The researcher relied on the survey method and use a questionnaire and scale tools to collect information from workers in the Department of Relations and Media and employees in all departments.
The research reached several conclusions, including:
1- Public relations seek to increase workers’ confidence in senior management and motivate them to improve their production, as well as their relentless endeavor to bring workers closer by following multiple and varied forms of communication with them.
2- The results of the study showed that there was a negative i
Abstract:
It is essential to provide health care directly or indirectly based on laboratory tests in order of diagnosing diseases. There is an urgent need for the results of such tests to be accurate and reliable. Therefore, the International Organization for Standardization has prepared special standards for medical laboratories to prove their efficiency, presented in standards 15189: 2012. The aim of the research is to determine the possibility of the Al-alwiya Women's Hospital in meeting the requirements of the standards 15189: 2012, which includes administrative requirements consisting of fifteen items and technical requirements consisting of ten items. The research is important because laboratories shou
... Show Moreيسعى البحث إلى الاهتمام بإحدى الوظائف المهمة في إدارة الموارد البشرية وهي تقويم الأداء التي تواجه مجموعة من الانتقادات والآراء السلبية، اذ ظهر في الأّونة الأخيرة أنموذج جديد يمكن إن يتجاوز تلك السلبيات وهو أنموذج التغذية العكسية المتعدد المصادر درجة .وقد حاول الباحثان توظيف هذا المفهوم في اثنتين من المنظمات العامة العراقية هما (دائرة كهرباء الوسط) التابعة لوزارة الكهرباء
و (دائرة الماء والمجاري) ال
The division partitioning technique has been used to analyze the four electron systems into six-pairs electronic wave functions for ( for the Beryllium atom in its excited state (1s2 2s 3s ) and like ions ( B+1 ,C+2 ) using Hartree-Fock wave functions . The aim of this work is to study atomic scattering form factor f(s) for and nuclear magnetic shielding constant. The results are obtained numerically by using the computer software (Mathcad).
Refrigerant R134a has been widely utilized in automotive air conditioning systems (AACSs); R134a has a high global warming potential (GWP) of 1430 despite having zero ozone depletion potential (ODP). Coming refrigeration systems must include refrigerants with low GWP and zero ODP. The aim of this experimental study is to evaluate the thermal performance of an (AAC) with different values of compressor speeds, i.e., (1000, 1700, and 2400 rpm) and two thermal loads, i.e., (500 and 1000 Watt) with the absence and presence of liquid suction heat exchanger (LSHX) using R134a. The results showed that adding LSHX enhanced the COP cycle by 7.18%, 10.7%, and 3.09% for the first, second, and third speed, respectively, at 500 Watt, while the en
... Show MoreThe purpose of this paper is to identifying the values of some physical and Bio- Kinematic variables during the performance of the jump spike serve skill, and identifying the effect of the proposed training program using intermittent training to develop some physical and Bio- Kinematic variables and accuracy of the jump spike serve skill among the research sample. The experimental method was used and the research was conducted on a deliberately chosen sample of the players of the Army Club, who were primarily advanced in volleyball, and the number of the sample was (10) players. The conclusions were reached that the proposed training program using intermittent training has a positive effect on some of the physical and Bio- Kinematic variabl
... Show MoreBackground: This study compared in vitro the marginal adaptation of three different, low shrink, direct posterior composites Filtekâ„¢ P60 (packable composite), Filtekâ„¢ P90 (Silorane-based composite) and Sonic fillâ„¢ (nanohybrid composite) at three different composite/enamel interface regions (occlusal, proximal and gingival regions) of a standardized Class II MO cavity after thermal changes and mechanical load cycling by scanning electron microscopy. Materials and methods:Thirty six sound human maxillary first premolars of approximately comparable sizes were divided into three main groups of (12 teeth) in each according to the type of restorative material that was used: group (A) the teeth were restored with Filtekâ„¢ P6
... Show MoreThrough this article, we studied the peristaltic motion of “Hyperbolic Tangent” fluid in the geometry of curvature channel by using the analysis of large wavelength and less of Reynolds number. The matter has controlled mathematically by the partial differential equations of continuity, motion, heat transfer. In the study, we used the impact of radial magnetic force. The obtained coupled non-linear equations of above equations have solved by an approximation technical. Locked formula solutions of the stream function, axial velocity, heat function has evaluated. The influence of curvature is analysed and took it into account. The impact of sundry variables on the inflow features ha