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 aim of this research is to measure and analyze the gap between the actual reality and the requirements of the environmental management system in the middle refineries company/refinery cycle according to ISO14001: 2015, as well as to measure the availability of a clean production strategy and test the relationship and impact between the availability of the requirements of the standard and a clean production strategy for the actual reality in the company.
The research problem was determined by the extent to which the requirements of the environmental management system are applied according to ISO14001: 2015 in the middle refineries company? To what extent are the required clean production strategies ava
... Show MoreMany reasons combined behind the Standing of U.S. against Britain in its aggression against Egypt in 1956; the consensus of world opinion on the need to stop the aggression and the fear of the Soviet military intervention which mean a new world war.
United States desired to weaken British influences in the region in general to get new oil gains in the Arabian Gulf and Egypt at the expense of Britain. The exiting of Britain from the area served U.S. strategic interests in the Middle East in general and Egypt in particular to keep the flow of oil for U.S advantage.
The United States wanted to keep its image in the region to apply its future political projects including Eisenhower Project, which intended to take the position of Britis
Financial Reporting Quality (FRQ) is one of the important topics in the financial management, it has the impact on the users decisions, it also effect on many other variables i.e dividend, therefore. This paper aims to provide a diameter of Financial Reporting Quality (FRQ) level for the companies listed on the Iraqi Stock Exchange. It also tries to show the FRQ effects on the dividend policy. The study sample was 13 listed companies in the Iraqi Stock Exchange for the period from 2007 to 2011. Kothari et al. 2005 model has been used to measure the FRQ, on the other hand the common stock share of the dividend was used to measure the dividend.
Many conclusions have been driven by the research
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Abstract has many advantages as has historically been one of the regions leading cultural centers . for centuries , it has been a center of commertial and financial operations in Iraq. it is also rich in archeological sites and natural resources, but because of its wars and implementation of urban development strategies are effective and sustainable , so contracted the secretariat of Baghdad with the company (khatib and scirntiffic) for the preparation of the comprehensive development plan for the city of Baghdad in 2030 and funded by the world bank and the fact that the plan was approved ( three stages of it ) and only one phase remains the fourth stage, which is under discussion the aim of the
... Show MoreThe study aims to identify the impact of competency-based training in its dimensions (skills, cognitive abilities, attitudes, and attitudes) in improving the performance of employees (achievement, strategic thinking and problem solving) in Jordanian university hospitals.
The study based on analytical descriptive method. The study population consisted of the Jordanian University Hospitals, the University Hospital of Jordan and the King Abdullah Hospital, as applied study case. The sample of the study consists of all upper and middle administrative employees of these hospitals; questionnaire distributed all of them and the number of valid questionnaires for analysis were 182 questionnaire.
... Show MoreThe emergence of oil fields and subsequent changes in adjacent land use are known to affect settlements and communities. Everywhere the industry emerges, there is little understanding about the impact of oil fields on land use in the surrounding areas. The oil industry in Iraq is one of the most important industries and is almost the main industry in the Iraqi economic sector, and it is very clear that this industry is spread over large areas, and at the same time adjoins with population communities linked to it developmentally.
The rapid development and expansion of oil extraction activities in various regions has led to many challenges related to land-use planning and management. Here, the problem of research arises on th
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This research aims to develop a unit as part of a sixth-grade Arabic language textbook and measure its effectiveness in the development of twenty-first-century skills of female students. The author adopted the experimental approach with a quasi-experimental design of the pre-post single-group. A list of the major skills was derived from the framework for the 21st-century skills of the mother tongue that was developed by the Partnership for 21st-Century Skills and reviewed and adjusted by some specialists. According to their views, the unit was developed. The study targeted 15 sub-skills falling under three main skills. The results of the study showed the effectiveness of the developed unit in the develo
... Show MoreThe aim of the research is to indicate the degree of arrangement of the tax branches discussed and the level of efficiency of their performance according to the dimensions approved in the tax diagnostic tool (TADAT). The checklist has been approved as a main tool in collecting data and information from the tax branches of the General Authority for Taxes and the number (8) branches represented by (Karrada , Karakh Center, Al-Rusafa, New Baghdad, Al-Dora, Karakh Al-Tafim, Al-Kadhimiya, Al-Bayaa), The statistical program (spss) was used to calculate the weighted arithmetic media, and we reached the research to a number of conclusions, the most important of which were: - Each of the subsections (Karkh Al-Ahram and Karrada) achieved an
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