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.
This study was aimed to explore the impact of social concepts about tribe, clan and women, on internal audit performance. These concepts are considered to be components of the organizational culture and performance of internal audit practice, with respect to the individual and collective performance within the institution. The study, furthermore, was intended to investigate and understand the role of the organizational culture of the tribal, clan and women components with regard to their role in society, in Qatar.
To achieve these objectives, the researcher followed the descriptive analytical approach, using a questionnaire directed to experts and staff working in the banking sector, with the view to test
... Show MoreThe research current (Comment formal for Hruvijat in contemporary Iraqi porcelain). In an attempt to study the Arab character that inspired the Iraqi artist of all intellectual its terms of reference and stylistic by taking advantage of the cultural heritage and the rebuilding of the character to create a system ride of relationships that focus on structural body ceramic body ideas and multiple implications are invested in the structural fabric of the products of contemporary ceramic .vdila for ways to achieve and processing techniques and transmission of functional specificity (blogging) and cosmetic particularly to semantics derive from the content and expresses itself templates ceramic raw materials and by building works of art in pla
... Show MoreThe first chapter included the frame approach on research in which we discuss instigation in Iraqi drama as it as an active sign to enrich the structure of the speech so the researcher limits the problem of his research which is to follow the important of instigation in the Iraqi theatrical discourse. this chapter also contains the important of the research and its aim and limits. And reflected the importance of research in approaching the concept of instigation and effectiveness within the paths of the Iraqi, theatrical discourse.The 2nd chapter included the two sections and reviewed in the first section manifestations of incitement in the global theatrical discourse. the 2rd studied instigation in the Arab theatrical discourse. The 3rd
... Show MorePublic relations have become vital functions in modern institutions in the complex business world. They play an important role in facilitating the process of communication between the institution and its audiences and achieve mutual understanding between the parties as public relations play this important role based on research and analysis, policy formulation and programming programs and communication with the public.
The significance of this research comes from the challenges faced by public relations in state institutions. Misunderstandings and ambiguities still plague most workers in this field, especially in defining the concept, objectives and basic functions of public rela
... Show MoreA mathematical model is developed which predicates the performance of cylindrical ion exchange bed involving comparing of axial dispersion model for cation exchange column with different assumption, this model permits the performance to predicate the residence time within the bed with the variance, axial dispersion and Pecklet No. to indicated deviation from plug flow model.
Two type of systems are chosen for positive ions first with divalent ions (Ca+2) to exchange with resin of Na+1form used as application in water softener units and second with monovalent ions (Na+1) to exchange with resin of H+1 form used as application in deionize water units &n
... Show MoreDomestic violence, or as sometimes known as family abuse, is usually related to a domestic or local setting as in cohabitation or in marriage. It can take the forms of being physical, verbal, economic or emotional. Globally, most of the domestic violence is overwhelmingly directed to females as they tend to experience and receive severe forms of violence, most likely because they do not involve their intimate, or sometimes even non-intimate partners, in the process of mental and physical self-defense.
Sometimes countries justify domestic violence directed to females, they may be leg
... Show MorePicasso ceramics represented illuminated sign in ceramic art and excelled in accord ceramic art dimension aesthetically, and put it in a new prospects, despite the simplicity of the forms turn into a magical images and multiple interpretations.
So the search deliberately to choose purposive (37) samples divided into four groups, as follows: -
A flat shapes / palets or saucers / the vases /modified vases .
benefiting from indicators were spawned from literature ,to analyzing samples within the totals for the identification systems act forming art work`s:-
(1)Picasso's ceramic work product of a deliberate process represented a capacity of technical experience, and formal
(2)The system configuration in the ceramic art works c
Human values are the most important concepts that the interest of society has to relay on these conceptual values. Any society will not be stabilized unless adheres to the right principles and values, all nations need such principles and values to stabilize. If any society doesn’t implement the human values that monotheistic religions urges equality between human, the far the society from the religious principles, the less there would be valence between human. The valence is urgent necessity in the current time. The far people get away from values and principles, the more they lose their freedom and dignity, therefore individual has to live with dignity and respect through the adherence to these values and principles. Apparently, equal
... Show MoreThe great raise and development of residential buildings in modern cities worldwide as a result of urban extends leads to environmental and social problems, that make the designers looking for more complicated and innovative solutions. To encounter these, most advanced technologies in construction had been used resulting buildings had become higher, which was moved away from the land called residential housing. And with the development of these buildings, increase in the inhabitants inside; generate distant from nature, which increased the need for interactive outdoor recreational spaces open green in its high sections, was an alternative or complementary option to outer space at the ground level. Therefore, the research problem has emer
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