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.
Internal Audit is one of the most important backers of corporate governance, the researcher expanded his interest in this subject to examine the efficiency of Internal Auditors at the Arab Bank and its branches in Jordan to achieve Accountability which enhances the Corporate Governance and to identify the effect of the International Internal Audit Standards in strengthening the role of Internal Auditors in Accountability, and the effect of Attribute and Performance Standards in Accountability. The researcher applied descriptive analysis method to define the role of Internal Audit in the Arab Bank in achieving one of the basic principles of Corporate Governance assimilated in Accountability. The researcher’s sources include
... Show MoreKurdish language multifunctional morphemes indicate the different functional morphological, syntactical, and semantic tasks of the morphemes. The present study discusses the multifunctional task of the Morpheme Le in Kurdish Language. The Morpheme Le has marginally been included in other studies, yet up to the present times, there has not been a research inclusively dedicated to thoroughly discuss and clarify its multifunctional aspects. The present study is divided into two chapters: Chapter one discusses the theoretical aspect of chapter two that is entirely concerned with the practical aspect of the morpheme Le. The first part of chapter one sheds light on the morphological aspect of the morpheme while part two discusses
... Show MoreThis paper is a part of a cytological studies of the genus Bromus L. in Iraq . Cl number for 103 specimens ropro^eming l^species determined . The course of meiosis including an analysis of chromosome configuradon for 27 collections belonging to 8 species were investigated . Meiosis was regular in most species . Tetraploid for B.scoparius L. (new cytotype ) and hexaploid ?'or " Kunth. were re^rted for the first time, cytological findings were supported the view of maintaining the closely related species B.danthoniae Trin. and B.lanceolatus Roth, as distinct species .
Background: Post-extraction alveolar ridge resorption is unavoidable phenomenon ending with insufficient ridge width. Measuring the physical dimensions of the available bone before implant surgery is an important aspect of diagnosis and treatment planning. Bone height can be calculated from radiographs, while bucco-lingual ridge width can be measured by conventional tomography, CT scanning and ridge mapping.
Radiographic techniques have certain disadvantages. Therefore the ridge mapping technique was used as an option for determining alveolar ridge width.
The purpose of this study was to compare the validity of alveolar ridge width measurements obtained with ridge mapping technique before surgical flap reflection against
... Show MoreThe research aims to apply the activities of the green value chain as one of the modern administrative techniques that economic units resort to develop solutions to the pollution problems that occur due to the activity of economic units and their products that may cause damage to the environment as well as the waste of natural resources and to identify the production of environmentally friendly products and reduce the costs of environmental failure of both types Internal and external that may be borne by economic units such as taxes, fines and compensation due to nonobservance of environmental requirements and the preservation of human health and protection of the environment. To achieve the goal of the research, the researchers rel
... Show MoreThe 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 MoreIn The Bluest Eye (1970) , Toni Morrison addresses a timeless problem of white racial dominance in the United States and points to the impact it has on the life of black females growing up in the 1930's. Morrison in this novel explores how Western standards of ideal beauty are created and propagated with and among the black community. The novel not only portrays the lives of those whose dark skinned and negroid features blight their lives; it also shows how the standards of white beauty are imposed on black youth to cause a damage of one's self-love and esteem which usually occurs when beauty goes unrecognized
The study analyzed the current situation of public hospitals in the capital of Baghdad exclusively and diagnosed the resources available; especially after the high demand for these hospitals as a result of the citizen’s need to review the hospital to take care of them, especially after the Corona pandemic. Eight major hospitals in Baghdad were selected to determine the current reality of providing fire safety tools or equipment and what are the preventive measures needed to reduce it. The results after practical study showed many defects and weaknesses in the current situation due to their reliance on the traditional management to manage and provide all preventive measures and safet