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 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
... 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 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 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 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
After 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 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 MoreIntroduction: Knowledge management plays a crucial role in students’ ability to acquire, organize, retrieve, and apply information, impacting academic performance. In sports sciences, especially in combat sports like boxing, effective knowledge management supports both theoretical understanding and practical skill application. Despite exposure to boxing through training and media, students’ academic performance remains inconsistent. Objective: This study examines the relationship between knowledge management and cognitive achievement among second-year students in the College of Physical Education and Sport Sciences at the University of Basrah. It evaluates how students manage knowledge and its impact on their retention and application
... Show MoreOn of the direct causes which led to the global financial crisis 2008 is decrease or collapse in liquidity of large financial institutions which is reflected on investments of a considerable number of institutions and persons.
This study aim's through out its three sections to explain the disclosure level of financial institutions which affected by Financial Crisis from liquidity information which explained in the statement of cash flow according to Timeliness and Completeness.
The study concluded an important result the company of research sample was disclosure in Timeliness and Completeness from all of accounting information is related in liquidity or that related in result of operations and financial position. The more
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