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 control system is a safety valve that preserves economic units assets and ensure the accuracy of financial data, as well as to obligation in the laws, regulations, administrative policies ,and improve the efficiency, effectiveness and economic of operation, so it has become imperative for these units attention to internal and developed control system The research problem in exposure the economic units when the exercise of their business to many of the risks to growth or hinder the achievement of its objectives and the risks (financial, operational, strategy, risk) and not it rely on risk Assessment according to modern scientific methods, as in Brown's risk Classification, Which led to the weakness of the internal control identif
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Objective(s): To evaluate the level of Psychological Empowerment among Nurses as perceived by their Point of View, and identify the differences in nurses' Psychological Empowerment with regard to age, gender, graduation level, and years of work employment.
Methodology: A descriptive analytic design was conducted on nurses in Psycho-social health Units in Primary Health Care Centers in Kirkuk Governorate, to achieve the objectives of the study. A convenient (non-probability) sample of 84 nurses was selected. The data collected through self-report method for the period from 25th August to 10th October 2022. The questionnaire was adopted
... Show MoreThis study addressed the work stress sources and level of the communicator in public relations in governmental institutions in the United Arab Emirates. The importance of this study is the lack of studies on work stress of the communicator in public relations. The study aimed to investigate the work stress source Physical, individual, groups, organizational and Professional source which effect on the performance of communicator in public relations. The researcher used the descriptive approach and questionnaire as an essential tool for collecting information. Some of the important results of the study are The communicator in public relations facing stress in work by 42% which affect on his performance by average level. The organizational
... Show MoreThe investment portfolio of financial instruments & banking relatively new in the banking sector & the world of investment &capital markets in spite of its importance & its advantages in terms of the nature of the diversity of investment instruments as well as reduce the risk of investment & its contribution to the revitalization of the banks & the financial market , economic, &characterized by developments accelerated under information & communications technology , as is the portfolio tool vehicle of investment tools that provide for people who want to invest & they can not manag
... Show MoreBackground: Saliva is a specific bio-fluid with important biomarkers. Analyzing any alternation in these markers could give valuable information, in relation to oral health status parameters. The aim of this study was to investigate the level of α -amylase in unstimulated whole saliva of healthy, primary school children in relation to some oral health parameters. Materials and Methods: A questionnaires consisted of demography and medical histories of participants were filled by children families. Saliva samples were collected for 5- minutes between 9:00 -11:00 AM from 114 healthy students aged 6-13 years, divided into four age groups. Flow- rate, Plaque and Gingival Index were assessed and dentition status was investigated by DMFT/dmft
... Show MoreThe aim of the research is to demonstrate the impact of the dimensions of the marketing vigilance represented by (environmental scanning, diagnostic capacity, validity and decision-making) and to attract deposits represented by (customer relationship management strategy, distribution strategy (location), promotion strategy), as the research was applied in each of Banks (Assyria International, Iraqi Middle East Investment, Business Bay, Iraqi Investment, Babel, Al Mansour Investment), and the questionnaire was adopted as a main tool for collecting data and information from a sample of (110) who are in the position (department manager, department manager, assistant Section Director, Division Officer, Unit Officer), and the statistical prog
... Show MoreThe letter is defined as a message directed by the sender to another party, the future. The aim is to convey, clarify or explain a particular point or subject, and in the form of direct oral communication through speech that contains a set of words and words, The future can discuss the sender directly to exchange ideas with each other, or it may be written and in this case does not require direct interaction between the matchmaker and the recipient. As a result of the different sources and topics of the discourse, and the different types of categories addressed to the speech, and the number, it has been divided into several types.
And schools of discourse analysis emerged in the early eighties of the last century and has spread and ha
Supervised By : Prof. dr. Shaker Jaseem Mohammed This research aims to identify the (effectiveness of Bayer's strategy in the development of deductive thinking among students in the fifth grade literary material European history) and to achieve the goal set researcher null hypothesis of the following: • There is no statistically significant difference between the average scores of the experimental group which studied the use of Bayer's strategy and the control group, which studied the use of the usual way in the development of deductive reasoning. The study sample consisted of (84 students) of the students in the fifth grade literary breeding Baghdad / Karkh second Directorate for the academic year 2015-2016 were distributed Aanhaldras
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