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 research aims at identifying the extent to which the top management in the organization is interested in managing the talents of its employees, through which it can face the competing organizations, as well as the great challenges faced by all organizations in recent years. The task of attracting and maintaining talented human resources is one of the biggest challenges facing Organizations
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Modern communication and media technology has pioneered new horizons and curried out deep changes in the various fields of social life, It effected enormously human communication as well.
Content one Who late the developments which have effected the social relations ،due to the new media ،especially Face book ,will certainly notice the far cry changes of the social relation net which has been effected ,in a way or another ،the accelerated development ،under the appearance of the so called the virtual society .
Face book has embodied the means – communication ,which has become an important turn point in the social communication .
It is the point the present paper tries to expose an discuss by a field study curried on a sam
Incremental sheet forming (ISF) process offers a high degree of flexibility in the manufacturing of different sheet parts, which makes it an ideal candidate for prototype parts as well as efficient at fabricating various customized products at low production costs compared to traditionally used processes. However, parts produced in this process exhibit notable geometrical inaccuracy and considerable thickness reduction. In this paper, the single point incremental sheet forming variant of the process has been implemented to manufacture a highly customized cranial implant starting from the computed tomography (CT) scan data of the patient's anatomy. A methodology, from the modeling to the realization of the implant, is presented and discus
... Show MoreThis study aimed to provide a theoretical framework for the impact of the Turkish intervention in northern Syria and the extent of its impact on the relations between the two countries.
It also sought to answer the study's main question: What is the impact of the Turkish intervention in northern Syria on Turkish-Syrian relations during the period 2011-2019 ?.
In this study, the historical method, the descriptive method, and the systems analysis method were used, with the aim of arriving at an accurate and realistic understanding of the Turkish-Syrian relations.
The study reached a set of results, the most important of which was that the Syrian-Turkish relations are based on interests, and that all alliances and
... Show MoreThe study aimed to exposure young university students and students talk programs offered by satellite TV exposure, as it represents these programs great importance Information Public Knowledge in general And the youth in private Including Posed From Opinions And ideas About Different Issues Raised Which Charges Opinion, And that Through Application Study Survey To Sample From Students of Diyala University, the Researcher display Public Accrediting Theory To Information Which Provided Means Media To achieve Objectives And satisfy Needs And hypotheses . The Problem Search was Determined Through Study of students of Diyala University exposure Programs Talk And measured&
... Show MoreThe Results of Theoretical Studies and Experiment of Advanced Economies , Have Been Proven That Investment Expenditure Is Not The Only Factor And The Main Source of Production Growth, But Efficient Using Of The Fixed Assets Is More Important In This Process, All That Depends On Groups of Factors Called The Non-Investment Economic Growth, That Are Un-bodied Technical Progress With Organizational Nature.
It's Distinguished Features That it has An Influence on The Production Growth Without Any Large Additional Investment Expenditure Or Any Additional Increment in Inputs And That Can Not Be Reached Without Activating The Factors of Non-Investment Economic Growth, Which is Still Affecting Negatively In T
... Show Morebjective researcher through this research to Put a theoretical framework to strategic orientation the center on the market in the business and the diagnosis and interpretation of the nature of the link between relationships and influencing strategic orientation dimensions Almtmthelh organizations (Entrepreneurial Orientation, market Orientation, Interaction Orientation) and the performance of the Iraqi Private Banks The research community and the level of dimensional and through the use of scale (Balanced Scorecard) Bmnzawradtha the four, the test of this research in the Iraqi banking sector (Gulf Commercial Bank
... Show MoreThe present paper aims at investigating the linguistic image portrayed by UNICEF reports on the Iraqi child from a critical discourse analysis perspective during Covid19 pandemic (2020). The paper attempts to fill a gap in research literature concerning the linguistic construction of the Iraqi child by the UNICEF reports during the critical health crisis of Covid19. Van Leeuwen’s (2008) approach of social actor representation has been adopted for this purpose. From Van Leeuwen’s approach, the category of determination (single determination and overdetermination) has been selected to be the main analytical tool for its high compatibility with the set of objectives put forward to figure out how such a globally effective and
... Show MoreThe different crises and financial collapses place in many companies, particularly in developed countries as a result of administrative and financial corruption return aspects of the task to the role of the company and the external auditor, both in their emphasis on honesty and fairness of financial statements and the Provisions of accounting information and on the contrary to the truth, you may have to the loss of the rights of stakeholders, particularly existing investors, and the loss of confidence of prospective investors in the accounting information contained in the financial statements of these companies, which led to a crisis of confidence and credibility in the profession of accounting and auditing where the wonder of ma
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