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 study aims at studying and analyzing the subject of marketing vigilance as it is one of the modern approaches in the marketing field that can be used to face changes in the competitive and strategic environment and that represents quick reactions on the part of the institution to ensure its survival and distinctiveness other aims are: Consolidating the strength of the marketing organization and its success continuously, represented by changes in the market share, awareness of the institution's position in the market and its relations with competing tourism companies, diversification of tourism services, as well as an analysis of the competitive strategic position of tourism institutions for the purpose of conducting a r
... Show MoreThis research aims to clarify the conceptual framework of social entrepreneurship shows the importance of the development of social entrepreneurship according to the contextual aspects and the social value achieved from these works. It also identifies the degree of level of a sample of women entrepreneurs in Iraq for the extent of the relationship between social entrepreneurship and women's empowerment. It also explains the impact of entrepreneurial work in empowering women and the extent to which there are individual differences between the average scores of the sample members’ estimation of the level of social entrepreneurship according to social status, age group, educational qualification, and specialization according to the s
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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 MoreThe conservatorship is a legal action to protect troubled banks from credit risk and bankruptcy risk that banks cannot hedge them .The Central Bank role has to protect the financial system from these risks by controlling and supervising. This research studied these risks and explained the role of The Central Bank. This research presented and analyzed the legal framework for supervision and the imposition of conservatorship bank to address the effects that have been achieved as a result of poor management and weak internal controls. Baraka Bank for Investment and Finance was a research sample to measure the financial ratios for the troubled bank, and analysis the results that led to put the conservatorship. The research depends on the hyp
... Show MoreAfter 2003 Iraq witnessed a rapid development in the number and kind of non-governmental organizations in addition to the increase in their sources.A lot of obstacles and constraints hinder the development of the said organizations and one of the most important and prominent obstacles is their administrative and accounting structure that affect directly on the existence, continuity and survival of these organizations.This research discussed the concept the non-governmental organizations and reaching the assessment of internal control System in these organizations. Therefore, the researcher has assessed the internal control System applied National Olympic Committee of Iraq. The study showed vulnerabilities in the internal control the said
... Show MoreInternal 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
... Show MoreThe current research includes a look at the participation of Iraqi women in the combat roles, which starts from the assumption of the democratic transition that must be led - in one of its aspect - until the army or the military foundation to become a "citizen army," the matter which is represented a demand increasingly needed in the experiences of Democratic transformation that facing serious security challenges such as in Iraq, this means that the army or security foundation - which is involved in counterterrorism - should not reflect a specific group in society , and hence embody the most important democratic principles, which are equality and equal opportunities, especially gender equality. On the other hand, the influence of armed conf
... Show MoreAdolescence important and sensitive stage in social terms, being a stage where learns teenager bear social responsibilities and composition of their ideas about family life, as well as it is the stage where the teenager looking to himself for an important place in the community to become independent socially people, so it highlights the role of Social Work to do better effort and I believe him in order to prepare for the adolescent stage of adolescence and help him overcome the problems so that makes it adapts to the society in which he lives
This study investigates the role of identity as a critical factor in mediating the relationship between local and regional politics within the broader context of international relations (IR). While identity is frequently acknowledged as a catalyst for political instability and conflict, its function in fostering interdependence across political levels remains underexplored, particularly through empirical research. To address this gap, the study adopts a quantitative methodology, drawing on theories of identity politics and interdependence. A structured survey was administered to assess public perceptions of identity's influence on international engagement and its bridging role between domestic and regional political dynamics. The fi
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