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.
Over the last two decades, several sustainability assessment methods have developed as key accelerators for the development and improvement of sustainable industrial buildings. Some of these systems, like as LEED or BREEAM, are considered international, whereas others, such as Pearl Rating Systems (PRS), are local. Although they all share similar goals, they can lead to the construction of green buildings or the improvement of the efficiency of existing conventional buildings. Each technique has its structure, certification process, and weighting norms. The inequalities have prompted various questions about whether global assessment systems appropriately consider the country’s national settings. This study aims to compare the Pear
... Show MoreBecause of the fierce competition between service organizations on the one hand and the increasing demands of customers on the other. Therefore, these organizations sought to distinguish their service by taking care of all aspects. One of these important aspects is the service encounter environment and its reflection on customer emotions, so we choose the current research to clarify the importance and impact on customer satisfaction, the problem of research is how the interest of Iraqi restaurants in the service encounter environment and how to care about its elements and whether this interest is sufficient to reflect the satisfaction of the customer. the goal of the current research was to clarify how much the application of the
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The goal of this research is to know the quality of working life and its impact on the level of the organizational sense of alienation among a sample of teaching Anbar University in the center of Baghdad. Find and seek to achieve a number of cognitive and practical goals.
Where the quality of work life constitutes one of the main sources to enable organizations of excellence in light of the volatile environment, as is one of alienation regulatory organizations avoid the phenomena that occur because of their negative effects on performance and thus achieve their goals. The most research problem in question the existence of the main deficiencies in the application of the concepts of organiz
... Show More<span lang="EN-US">Diabetes is one of the deadliest diseases in the world that can lead to stroke, blindness, organ failure, and amputation of lower limbs. Researches state that diabetes can be controlled if it is detected at an early stage. Scientists are becoming more interested in classification algorithms in diagnosing diseases. In this study, we have analyzed the performance of five classification algorithms namely naïve Bayes, support vector machine, multi layer perceptron artificial neural network, decision tree, and random forest using diabetes dataset that contains the information of 2000 female patients. Various metrics were applied in evaluating the performance of the classifiers such as precision, area under the c
... Show MoreThe study investigates the possibility of utilizing public interactive sculptures to enhance physical activity in Saudi Arabia. The paper uses a descriptive-analytical methodology to identify the characteristics of interactive sculptures promoting physical activity in public areas as follows: The size and space of the work area are appropriate to the type of physical activity that is achieved, and the importance of the work site in the city and its relation to the surrounding space, identifying participants at the same time and their relationship to ensure safe interaction, as well as the relationship between the esthetic and intellectual concept of working in the community. The study concludes that three technical proposals were present
... Show MoreThe following dilutions -710X46, -610X46, -510X46 of Bacillus thuringiensis were used for bioassay against the different larval instar of the potato tuber moth Phthorimaea operculella by the spraying method, the results showed that there was no significant influence in the percentage of egg hatching in comparison with the control. The sensitivity of larval stages was reduced with the increasing the age and exposure period. The study also showed that the larvae infected with B.t. stopped feeding, movement and a general paralysis causing the death of larva after (24-48) hours , and the larva color was changed from the natural waxy colour to brown finally to the black after death.
The research aims to demonstrate the impact of internal audit in Iraqi economic units on enhancing social performance reports, through the statistical models used, as a survey list (for the independent variant) of the search, which contains five axes of each axis, contains a set of The questions were prepared on the basis of the standards issued by the Institute of Internal Auditors (IIA) and were distributed to a sample of internal auditors, as for (for the approved variable) the researcher obtained numerical data represented by the financial statements of the research sample and used statistical models such as model (Kolmakrov-Smirnov) is a good match (goodness of fit) which assumes that the data is distributed naturally as wel
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