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 aims to find out the effectiveness of using the Google classroom educational platform in teaching mathematics curricula from the viewpoint of teachers in the Governorate of Al Dhahirah, Sultanate of Oman. The researcher adopted the descriptive-analytical approach. To collect the needed data, a questionnaire of two dimensions was used. It includes (13) items to measure the effectiveness of using the Google classroom in teaching mathematics curricula from the teacher's point of view and includes (10) items to measure the difficulties of using the Google classroom in teaching mathematics curricula from the teachers' point of view. These tools were applied to (32) male and (31) female as the study sample. They represent mathematics
... Show MoreThe study showed significant differences between the average weight lens and the average amount protein in the lens between that Kestrel Falco tinnunculus L. and the Collared Dove Streptopelia decaocto F. , also the study electrical migration of lens proteins having one bundle of crystalline –? in Kestrel compared with three bundles in Collared Dove, two bundles of crystalline – ? in both , and crystalline – ? appeared as one bundle in both birds.
The tax system, like any other system, as a set of elements and parts that complement each other and are interrelated and interact to achieve specific goals, and is a natural reflection of the economic, social and political conditions prevailing in society, and therefore the objectives of tax policy formulated in line with the objectives of economic policy in general, which means that any change in economic policy clearly affects fiscal policy measures and fiscal policy in particular.
The problem of searching for the impact of foreign direct investment in the Iraqi tax system was focused on the study the of foreign direct investment and therole played in developing and improving the economic reality and its implicatio
... Show MoreThe research aims to measure the efficiency of health services Quality in the province of Karbala, using the Data Envelopment analysis Models in ( 2006). According to these models the degree of efficiency ranging between zero and unity. We estimate Scale efficiency for two types of orientation direction, which are input and output oriented direction.
The results showed, according Input-oriented efficiency that the levels of Scale efficiency on average is ( 0.975), in the province of Karbala. While the index of Output-oriented efficiency on average is (o.946).
A significant amount of apiaries is destroyed in most areas of Iraq by attacking of the hornet
This study aims to the little impact of accounting financial performance (AFP) analysis on the money market in the Iraqi economy. Potentially limiting future market activity could be international risks and obstacles, which in turn could cause issues and crises (Shah & Jan, 2014; Bakhtiyarovich, 2020). The study concept was inspired by the recognition that there must be communication between the importance of the AFP analysis of the Iraqi securities market and the country’s financial and economic institutions. The sample of the study included ten Iraqi banks listed in the Iraq Stock Exchange (ISE) for the period 2010–2020. The three mathematical models included in the statistical analysis served as the basis for projectin
... Show MoreThe transfer of training process occupies a great importance in achieving the ultimate goal of participating in the training programs , it is sure that this does not take place without the support of the working environment for trainees, and The research aims to personification role the work environment characteristics of supporting the transfer of training.
The research problem is the weakness transfer of training to the work en
... Show MoreThe goal of this paper is to show the kinematic characteristics of gaseous stellar dynamics using scaling coefficient relationships (such as Tully-Fisher) in different spiral galaxies. We selected a sample of types of spiral morphology (116 early, 150 intermediate, and 146 late) from previous literature work, and used statistical software (statistic-win-program) to find out the associations of multiple factors under investigation, such as the main kinematic properties of the gaseous-stellar (mass, luminosity, rotational speed, and baryons) in different types of spiral galaxies. We concluded that there is a robust positive connection between Log Vrot.max.) and Log Mstar(B-V), as well as between Log Vrot.max. and Log Mbar (
... Show MoreThe research aims to identify the role of strategic improvisation as an independent variable with its dimensions (Building the Solution, Intuition, Adaptation, and Spontaneity) and the Entrepreneurial Orientation as a dependent variable with its dimensions (Identifying Opportunities, Creativity, Adopting risk, and Vision). This research has been applied in the Rafidain Bank and its branches (Sunk, People, Al-Firdaws, and Alawiya); it used the questionnaire as a basic tool for collecting information. The sample was intentionality, which included all the heads of departments in the bank’s branches, which amounted to (33) workers, and data on the questionnaire paragraphs of 28 were processed using the SPSS V.23 and AMOS V.23). The most impor
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