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 process of granting loans by banks is the confidence they give to their customers, but this trust should not be a cornerstone in granting loans even if granted these loans on the basis of sound banking should involve risks that may be exposed to the bank because of the failure of the client to meet The bank's financial obligations to the bank due to the unexpected economic conditions affecting the customers, which makes them in a state of faltering, which weaken the ability of banks to provide loans, which are the most important sources of revenue and profits, so the problem of non-performing loans is one of the main problems facing most of the banks Which impede the functioning of its work and the reasons that led to the agg
... Show MorePlay a movie role now is very dangerous on a large scale, in the transfer of data in a language of thought and life -strong common understanding , tools and more permeable and effectiveness in the formation of thought and conscience of recipients. Which is an instrument of culture and knowledge , and a means of effective educational tools that aim to improve the community , also plays a prominent role in shaping society's values , and customs , and the arts , as well as used as a means of guiding , counseling and cultural enlightenment , cinema and TV gives the viewer the ability to move from one place to another by the watch and compare it to what it is , which raises the desire to improve the level , where nearly movie scenes in variou
... Show MoreThe research dealt with the case stock repurchase policy of Emaar Real Estate Company one of listed companies in Dubai Stock exchange. The research has launched from the cognitive dimensions of repurchasing policy which took great concern in the literatures of financial management, and also this policy became as substitute for distributing the monitory profit in the last three decades in the international financial markets, but it did not get any importance in the Arab Markets such as that of the Arab Gulf in addition to the Iraqi Stock Exchange.
The research summarized a set of conclusions, the most important one was the consistence of analysis result with the test of the major two hypotheses (The first
... Show MorePurpose: Despite the high clinical accuracy of dynamic navigation, inherent sources of error exist. The purpose of this study was to improve the accuracy of dynamic navigated surgical procedures in the edentulous maxilla by identifying the optimal configuration of intra-oral points that results in the lowest possible registration error for direct clinical implementation. Materials and methods: Six different 4-area configurations were tested by 3 operators against positive and negative controls (8-areas and 3-areas, respectively) using a skull model. The two dynamic navigation systems (X-Guide® and NaviDent®) and the two registration methods (bone surface tracing and fiducial markers) produced four registration groups. The accuracy of the
... Show MoreExpectation in poetry is the ability of the poet to exceed the existence of the universe . It is the revealing of the hidden and the familiar. This feature of expecting is not related to the modern poetry only . It is a well - known feature that has long been assigned to old poetry like Al-Mutannabi an Al-Mu`arri who had their own unique ways of expecting and going beyond the current time and touching the future and making it a reality. Based on their awareness ,mature thinking and talent , they had the ability of reading what is to come ,even if they were mere suppositions and tentative readings. As for the modern poetry , we have poets like Amal Dunqil , Adonis ,and Al-Sayyab whose poems became expectati
... Show MoreWriting as a female playwright in theatre gives a deeper depiction of woman’s real- self. Beth Henley has succeeded in providing a new realist vision of women’s abilities to face their inevitable tragic fates and how to conquer their despair. In Crimes of the Heart, the playwright uses certain method to present the development of the heroines’ characters through blending the tragic events with a comic frame. In fact, Henley focuses on the simple humorous activities more that the importance of the tragic event to present her vision of how to survive and face the crisis of life.
Crimes of the Heart is a play that is concerned about three sisters whose lives are headed in distinctly different directions; howe
... Show MoreThe research aims to identify the importance of using analytical procedures in the detection of creative accounting practices. To achieve this goal, (100) questionnaires were prepared and distributed to the auditors in the Federal Financial Supervision Bureau and the authorized auditors' offices and practitioners of the auditing profession in Iraq. For the purpose of testing the research hypothesis and analyzing data, some appropriate statistical methods have been used and the use of the statistical program (SPSS) to analyze the data. The results of the research showed that the analytical procedures and tests applied by the auditor have a role in revealing and limiting creative accounting practices and methods and that auditors u
... Show MoreThe problem of solid waste from domestic, industrial, commercial and medical sources is one of the most important problems facing the local administration in all Iraqi cities. The danger of this problem increases with the rapid increase in the population, changing lifestyles, consumption patterns, limited land suitable for landfill, and high costs of collection and disposal. This research aims to solve these problems by determining the locations of current landfills located in the outskirts of Baghdad Governorate. The ArcGIS program was used, where the sites of the landfills were determined on the map and through the available data about the areas. it was concluded that the existing landfill sites do not meet environmental conditions and
... Show MoreThis research deals with the audio part of the cinematic film, which is the sound and its elements inside the space of the cinema picture. It also deals with the psychological side of the sound and the effects made by the sound on the audience through the carefully studied use of the film maker in employing the sound and the picture. For the importance of this element, most of the directors were aware of the seriousness that sound causes to the cinematography, and consequently working as a whole such as the indications, meanings, symbols, metaphors ,transitions…etc. The research included the methodological framework which consists of the research problem, in which the researcher ma
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