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 study aimed to identification the effect of brainstorming in linguistically grow of garten child the sample of study is composed from (48)male and female children have been distributed for two groups,one of them is experimental and another is disciplined for every per of garten and pre education,and they have been awarded in a number of variations. For measuring the subordinate variation(linguistically grow)the researcher prepared ascale for this purpose that consist of two parts:the first part the scale of linguistically grow of garten child(4-5 years)and the second part the scale of linguistically grow of pre education child (5-6 years).Consist of every one from (20)shapes of linguistically grow shapes for garten chil
... Show MoreCaryl Churchill's Top Girls (1982) reveals how women have achieved a point of strength and independence in their battle to face men's oppression throughout history. Churchill has replicated recent transitions in the 1980s and 1990s in works that depict these movements' central concerns and contradictions as they change. Similarly, her theater is a result of many problems and shifts in hegemonic modes of production during this time. This paper traces the achievements of the major character of Top Girls, Marlene, in her way of life and her handling of the struggles of other women around her. Because of this strength, Marlene is compared to the British Prime Minister, Thatcher. Therefore, this paper will shed light on the term of T
... Show MoreA simple, rapid and sensitive spectrophotometric method has been developed for the determination of captopril in aqueous solution. The method is based on reaction of captopril with 2,3-dichloro 1,4- naphthoquinon(Dichlone) in neutral medium to form a stable yellow colored product which shows maximum absorption at 347 nm with molar absorptivity of 5.6 ×103 L.mole-1. cm-1. The proposed method is applied successfully for determination of captopril in commercial pharmaceutical tablets.
This research Sought to Determine the Relationship and impact between the tax knowledge in dimensions of the tax compliance costs (monetary costs, time costs, psychic costs) Since the sample included 81 individuals represented by the Executive directors and Financial and Accountant working in the Joint-stock company, A questionnaire was used as a tool for data collection and its analysis. For the purpose of analyzing the research data the statistical package for social science, SPSS. The most important tools used in the statistical analysis are:(standard deviation, and simple linear regression, percentages, arithmetic mean, Cronbach's alpha, F-test, T- Test). The research found a weakness attenti
... Show MoreCrop coefficient for cherries was evaluated by measure the water consumption in Michigan State to find its variation with time as the plant growth. Crop coefficients value (Kc) for cherries were predicated by Michigan State University (MSU) and also by Food and Agriculture Organization (FAO) according to consume of water through the season. In this paper crop coefficients for cherries are modified accordingly to the actual measurements of soil moisture content. Actual evapotranspiration (consumptive use) were measured by the soil moisture readings using Time Domain Reflectometers (TDR), and compared with the actual potential evapotranspiration that calculated by using modified Penman-Monteith equation which depends on metrological statio
... Show MoreThis study aims to explain the role of green target costing technique in improving the relationship with suppliers in a sample of industrial companies listed on the Iraq Stock Exchange. The descriptive analytical approach was used, where a questionnaire was designed that included a set of questions that were directed to a sample of 84 individuals including production managers, finance managers, quality managers, and purchasing managers in these companies. The study uses some statistical analyzes such as correlation analysis and regression analysis to analyze the questionnaires. The study finds a positive impact of the green target costing technique on improving the relationship with suppliers. The results indicate that the relation
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This research aims to determine the nature of tacit knowledge relationship and its impact on building the electronic human resources management, as it constitutes the most prominent tacit knowledge resources owned by the Organization for being a stand out in the skill, knowledge and intellectual capacity of human resources, as the electronic human resources management is a contemporary trend that adopted by the organization in the performance of all tasks and duties related workers have remained in the contemporary environment in which it operates.
and have indicated the research problem to the low level of awareness of the ad
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