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 aimed to diagnose and interpretation of impact nature between Communities of practice dimensions (participation and spreading knowledge, confidence, social capital build) deportation strategic change choices (reengineering business process, business re-structuring, business innovation) in construction companies in the Iraqi Ministry of Construction and Housing, the research tested 4 construction companies working in investing sector in Iraq, the research applied on a sample of 102 persons who participated in Communities of practice distributed in several administrative levels (directors, division directors, project directors and engineers) the research used questionnaire as a main tool for dat
... Show MoreThe purpose of this study is to assess the performance of government units (Iraqi hospitals) by trying to determine the possibility of the current governmental accounting system to provide information on the performance reports of government units. In order to improve the efficiency of hospital resources management, the services provided by the hospital should be subject to performance measurement and evaluation The importance of the health sector in the provision of services, in order to raise the efficiency of the performance of services provided by government units has reached the researcher a set of conclusions, the most important
- The financial reports produced by the accounting s
This study offers additional evidence for the occurrence of oil residues within fractures of the basement rocks in the Upper Benue Trough, Nigeria. The data suggests that the observed oil residues were originally generated as light oils, which were later biodegraded into heavy oils. These Upper Benue Trough's oil stains are a valuable tool for hydrocarbon exploration in the region as they indicate the existence of a petroleum system in the basin. We find a strong similarity to the proportions of C27, C28, and C29 regular steranes of oils found in the sandstones and shales of the Bima Formation in the Upper Benue Trough when we plot the relative quantities of these steranes of the investigated basement rock oil types on a ternary gra
... Show MoreThis study aims to know the extent of the impact of Strategic Leadership as an independent variable in Strategic Learning as a dependent variable to help the senior leadership in Anbar University to take the right decisions to develop Strategic Learning programs in light of the circumstances of the Covid-19 and the sudden decisions adopted by the university to switch to E-learning and to blend. The survey was conducted by distributing a questionnaire that was adopted as a primary tool in data collection from the study sample represented by the university's senior leaders, An intentional random sample of (105) was selected from our community of (127), the data were analyzed by (SPSS) Depe
... Show MoreThis work aims to show the nature of the relationship between management by walking around (the independent variable) and strategic renewal (the dependent variable), as well as it shows the effect of the independent variable on the dependent variable. Questionnaire items were considered the main tool for data collection by three basic aspects. The first involved the personal data of the respondents, while the second included items related to management by walking in five dimensions, and the third is strategic renewal items by addressing four dimensions. The tourism sector, while the community has six Excellent grade hotels was taken into account in this wor
... Show Moreيهدف هذا العمل الى بيان طبيعة العلاقة بين الادارة بالتجوال والتجديد الاستراتيجي ، ومدى تأثير المتغير المستقل في المتغير التابع. تضمنت فقرات الاستبانة بوصفه الأداة الرئيسة لجمع البيانات ثلاث جوانب اساسية، تضمن الاول البيانات الشخصية للمستجيبين، فيما تضمن الجانب الثاني الفقرات الخاصة بمتغير الادارة بالتجوال من خلال خمسة ابعاد، فيما اشتمل الجانب الثالث على فقرات التجديد الاستراتيجي عبر تناول اربعة ابعاد. ي
... Show MoreRole of public relations (PR) and from one community to another, depending on the different cultures of these societies in General, and different ethical values established by their practitioners in these communities organizations , public relations in developed societies, and in some developing countries have taken great strides to contribute to the strategic planning and decision-making, in the framework of their commitment to the values and ethical standards for practitioners, In contrast, we find that applied in Iraq still skips phase coordinate with different communication means with the aim of advertising and publicity for the organization. As a result of the limited recognition of the strategic and vital
... Show MoreThe present theoretical study analyzes the legacy of the Chicago School of Urban Sociology and evaluates it in the light of the growth and development of Chicago City and the establishment of sociology in it. Sociology has become an academic discipline recognized in the United States of America in the late nineteenth century, particularly, after the establishment of the first department of sociology in the University of Chicago in 1892. That was during the period of the rapid industrialization and sustainable growth of the Chicago City. The Chicago School relied on Chicago City in particular, as one of the American cities that grew and expanded rapidly in the first two decades of the twentieth century. At the end of the nineteenth centur
... Show MoreAbstract: Background: High percentage of diabetes patients complain from post extraction hemorrhage. Many types of hemostatic materials are used to stop bleeding after teeth extraction: diode lasers are good hemostatic agents owing to their highly absorption by hemoglobin therefore they are used in soft tissue procedures with relatively no effects on dental hard tissues due to their poorly absorption by water and hydroxyapatite. Objectives: The aim of this study is to evaluate the efficiency of diode laser to assist the clot formation after tooth extraction for type II diabetes patients with minimum temperature elevation to prevent periodontal destruction. Materials and methods: From 12 type II diabetes patients (7 males and 5 females wi
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