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 art of postmodernism has undergone a number of changes in the course of art and art schools, as art has left the traditional means and paved the way for this artistic transformation to change the materials, techniques, methods and visions as a result of the changes that occurred in the thought and this change played an important role in the artist's vision, To demolish and destroy all of the above and to reconsider the formal systems and intellectual contexts and expressive modes, so it is necessary for the whole art to keep up with the variables of the era and its elements. The current research aims to: "Detect the transformations of form in postmodern art in the projects of students of the Department of Art Education".
Sinc
... Show MoreResearchers often equate database accounting models in general and the Resources-Events-Agents (REA) accounting model in particular with events accounting as proposed by Sorter (1969). In fact, REA accounting, database accounting, and events accounting are very different. Because REA accounting has become a popular topic in AIS research, it is important to agree on exactly what is meant by certain ideas, both in concept and in historical origin. This article clarifies the analyzing framework of REA accounting model and highlights the differences between the terms events accounting, database accounting, semantically-modeled accounting, and REA accounting. It als
... Show MoreThe objective of the research is to identify the effect of the five-finger strategy on the holistic thinking of chemistry students in the second intermediate grade, where the sample consisted of 60 female students in a second classfrom one of the intermediate schools in Baghdad city, divided into two groups: control and experimental. The experimental design was based on the partial control; the scientific course was defined in the third and fourth chapters of the science book of the second intermediate grade.The two research tools were prepared: the attainment test with the scientific course and the holistic thinking scale paragraph (36) of multiple-choice pre- and posttest. The results showed a statistically significant difference between
... Show MoreAbstract
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 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 current research presents a study of the sculptural body in the space of the theatrical show through reviewing most of the ideas, propositions and workings presented by philosophers and directors within the space of the show, that there were various experiences of employing those spatial formations through the mediator (the space) based on sculpturing the body in achieving those formations, which contributed in building a symbolic picture of various structural connotations. That was formulated through the research chapters, which include the first chapter (the methodological framework) which consists of two sections. The first section (the duality of space formation and imaginations). The second section (sculptural body sequences in
... Show MoreAPDBN Rashid, Review of International Geographical Education Online (RIGEO), 2021
It has been an increase concern of scientific and professional accounting sides on disclosure especially after appearance of business firms and accounting development with its relationship to financial statements which are considered to be outputs of the activity results. The preparing of financial statements and auditing of those accounts according to normal principles and standards of accounting on both local and international levels. Accounting disclosure can be seen an importance through discover all fundamental and necessary information for proper supply. Therefore, the research will highlight on public companies commitment in Iraq for basis and standards which have taken disclosure in financial data. The conceptual frame of t
... Show MoreThe present study is considered a pioneer investigation that deal with the terrestrial brown garden snail Cornu aspersum (Müller), in Iraq. Cornu aspersum however is considered an exotic species in many parts of the world ,The species is most probably infiltrates with plants transferred from one place to another. The species has gained importance in many ways. Nutritionally, the species is consumed as food item in many countries, but in other cases it is considered as pest for the damage it causes when feeding on valuable plant shoots. It also has medical importance for its role and ability in healing wounds, burns and remedy of other skin problems. This snail species however may act as a vector for some parasitic nematodes that
... Show MoreThis study found that one of the constructive, necessary, beneficial, most effective, and cost-effective ways to meet the great challenge of rising energy prices is to develop and improve energy quality and efficiency. The process of improving the quality of energy and its means has been carried out in many buildings and around the world. It was found that the thermal insulation process in buildings and educational facilities has become the primary tool for improving energy efficiency, enabling us to improve and develop the internal thermal environment quality processes recommended for users (student - teacher). An excellent and essential empirical study has been conducted to calculate the fundamental values of the
... Show More