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 tax policy is an important tool of fiscal policy tools which is usedasits multiple tools the State seeks to achieve objectives, such as theachievement of economic development.The importance of the research comes from the importance ofeconomic development resulting from economic policies and prudent fiscaland appropriate to the economic situation of Iraq at the moment is the mostimportant tax policy that taxes one of the most important financial instruments.The research aims to clarify the role of tax policy in developing of theIraqi economy.In an effort to achieve the goals researchers tried to prove thehypothesis ((The tax policy and through multiple tools that seeks to contributeto the achievement of economic development in Iraq)).
... Show MoreInsurance is one of effective high-impact activities in the economic and social aspects of development and that the insurance companies after the creation of stability, balance and support other sectors. The insurance of financial institutions with economic and social importance has an impact on the development and help shoulder the burden of risk and distribution. And measuring Indicators of service and cost her help in evaluating the performance and activity of insurance, and the study of sectors needed by society, institutions and individuals and development of the company. Covering all aspects of life and activity. In this study will focus on the insurance sector in the field of car accidents and so plentiful and their problems and d
... Show MoreIl semble que Khattabi était un linguiste, avec un endroit linguistique pour comprendre les textes de conversations et des mots étranges en particulier. Langue, et chacun avait ses arguments et ses preuves. Ses corrections incluaient la mélodie dans les mouvements, telle qu'une dilution plus serrée, la dilution de l'agitateur, le remplacement d'un autre mouvement, ou une autre rotation des mouvements, et le changement de structure morphologique du mot qui en résultait, ainsi que l'alerte sur les conséquences des lettres, Certaines de ces erreurs sont dues à la langue, et certaines sont considérées comme un type de déformation ou de fausse représentation connue de certains spécialistes, ce qui constitue un précédent louable
... Show MoreThe research tried to show the importance of Administrative Control being one of the important means in administrative work; they work on the review and audit work done and error handling explored in the work and prevent the occurrence and ascertain the extent of implementation of the planned targets, and therefore this is reflected in raising the efficiency of the performance of the tax examiner and complete the work as soon as possible and the highest efficiency and reduce the gaps that may occur between the parties of the tax settling accounts and dealt with in the theoretical side of the search to the research problem, namely with whether operating management oversight to improve the performance and increase the efficiency of t
... Show MoreThe research aims to verify that there is an influence between innovative marketing and the organization's reputation by brand mediation.
The research problem is that the Oil Marketing Company (SOMO) needs innovative, unconventional methods in marketing its products and improving its reputation by adopting a solid brand that adds value to the product.
The importance of the research: The importance of the research is highlighted as it deals with essential variables in business organizations that help increase customer loyalty by adopting a distinctive brand.
The research started from four main hypotheses to explore correlations and influence between researc
... Show MoreNowadays, university education stands in front of both students who feel they are weak and teachers who are addicted to using traditional and dependent teaching. This has led to have negative repercussions on the learner from different aspects, including the mental aspect and the academic achievement process. Therefore, the present research is concerned with finding a new teaching method that adopts the motivation by the fear of failure technique. Thus, the study aims to examine the effect of adopting this method on students’ academic achievement. To achieve this aim, an experimental method was used, and an achievement test was built for the curriculum material of level two students. The pretest test was applied on 17 male and female s
... Show MoreThis study seeks to address the impact of marketing knowledge dimensions (product, price, promotion, distribution) on the organizational performance in relation to a number of variables which are (efficiency, effectiveness, market share, customer satisfaction), and seeks to reveal the role of marketing knowledge in organizational performance.
In order to achieve the objective of the study the researcher has adopted a hypothetical model that reflects the logical relationships between the variables of the study. In order to reveal the nature of these relationships, several hypotheses have been presented as tentative solutions and this study seeks to verify the validity of these hypotheses.
... Show MoreThe study was planned to evaluate the effect of adding Guanidinoacetic acid in some characteristics of the sperm of the rams. This study was conducted in the animal field of the Animal Production Department / Faculty of Agricultural Engineering Sciences / University of Baghdad, for the period from 5/8/2018 to 28/2/2019. In this experiment, 3 rams were used at the age of 2-2.5 years and weighed 50-54 kg. The semen was collected early in the morning and once a week and the semen was pooled to remove the individual differences. The treatments were divided: GAA-free control group, treatment T1 (0.05 mg / 100 ml GAA), T2 treatment (0.1 mg / 100 ml GAA) and T3 treatment (0.2 mg / 100 ml GAA). The results of the study showed a significant decrease
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