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.
Abstract:
The internal audit is considered the safety valve for senior management in all institutions. It aims to protect property, and raise the efficiency and effectiveness of the administrative performance, by following up on compliance with laws and instructions and the application of regulations in a way that increases the administrative performance of the department. The internal audit is possible to determine Weaknesses or imbalances in the administrative performance. To achieve this goal, an analytical descriptive methodology was adopted. The Baghdad Health Department / Al-Rosana was considered as society for this s
... Show MoreAbstract: The aim of the research identify the effect of using the five-finger strategy in learning a movement chain on the balance beam apparatus for students in the third stage in the College of Physical Education and Sports Science, as well as to identify which groups (experimental and controlling) are better in learning the kinematic chain on the balance beam device, has been used The experimental approach is to design the experimental and control groups with pre-and post-test. The research sample was represented by third-graders, as the third division (j) was chosen by lot to represent the experimental group, and a division Third (i) to represent the control group, after which (10) students from each division were tested by lot to repr
... Show MoreCitizenship education is the effective educational tool in building a citizen who is able to participate in building his country. This can only come through the educational efforts that teachers make in the classroom. Such a step requires teachers to have knowledge of citizenship education, its principles, and the foundations for its development. Thus, the study aims to examine the degree of social studies teachers' knowledge of the dimensions of citizenship education at the basic education schools in the Sultanate of Oman. It also aims to examine its relationship with a set of variables. The researchers used the quantitative descriptive approach to achieve the objectives of the study. It further adopted a test tool, which consisted in i
... Show MoreThe research aims to employ one of the most important strategies for recovery from the crisis of the Covid-19 pandemic, which ravaged the economies of the entire world and its various sectors, including the banking sector, through financial technology that is based on digital transformation to achieve financial sustainability and the creation of innovative financial value chains in light of the decline in the banking sector as a result of The negative effects of the Covid-19 pandemic, be guided by the relevant international accounting standards to control the risks associated with financial technology. To recover from the Covid-19 crisis, the research came out with a set of recommendations, most notably financial technology from
... Show MoreThe research aimed to study the decision-making of the administrative bodies of sports clubs participating in the Iraqi Football Premier League for the 2022-2023 season. The researchers used the descriptive approach (survey study) to suit the nature of the research. The research community is represented by members of the administrative bodies of the sports clubs participating in the Iraqi Premier Football League for the 2022-2023 season, who number (177) members of the administrative body. The researchers used the questionnaire to collect the necessary data to achieve the goal of researching The method of applying a questionnaire aimed to identify the decision-making of the administrative bodies of sports clubs. The most important r
... Show MoreThis research highlights the light on the general framework of accounting discloser in the Islamic banks, and show the types and the concepts of Cost Efficiency, In this present study, the sample included Fourteen Islamic banks, where the data was collected from the annual financial reports. Accordingly, the study in order to achieve the aims and access to the results based on the analytical method and the descriptive analysis, and conducted a Simple & Multiple Linear Regression analysis, in order to test hypotheses of the research by using of statistical analysis software (SPSS). The research has arrived to many results such as: the commitment of Islamic banks working in the Kingdome of Bahrain (Wholesale) to the requirements of the
... Show MoreThe twentieth century witnessed developments, transformations and artistic revolutions, including what was witnessed in Arab art, especially contemporary Iraqi plastic art, and as a result, research and studies have increased that dealt with its topics in different ways, which has become a presence that gave it its own language and unique discourse, especially the body, thus opening the way for its employment in composition, to become a form. It denotes interpretable meanings through its various formal representations, which are artistic, cultural and cognitive products. The modernity of the Iraqi formation in the body has passed through different roles, so it started to deal with the body as a representation that reflects the real envir
... Show MoreThe research aimed to identify the effectiveness of instructional design according to whole brain theory of Herman in the achievement of chemistry at the fifth scientific students at a secondary school of the General Directorate for Educational in Diyala / Baladruz in Iraq. The research sample Consisted of (57 student, (29) students as experimental group studied according to instructional design strategies for whole brain theory of Herrmann and (28) a student as a control group studied by the usual way for two semesters, a prepared achievement test as article and objective type of multiple choice, the coefficient stability of alpha-Cronbach equation reached (0.86). The research Results showed the presence of a statistically significant d
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Should be the goal of Government controls, including environmental controls and safety laws to protect citizens from the harmful effects of negative secreted by human's additions and changes in the environment. and perhaps the protection aspects of the protection of citizens from the adverse effects of communications towers, including those produced by towers of health effects. The people the right to choose the nature of the physical environment, which should not be imposed on them by others. Communications towers are one of the main problems that have been
... Show MoreSince cancer is becoming a leading cause of death worldwide, efforts should be concentrated on understanding its underlying biological alterations that would be utilized in disease management, especially prevention strategies. Within this context, multiple bodies of evidence have highlighted leptin’s practical and promising role, a peptide hormone extracted from adipose and fatty tissues with other adipokines, in promoting the proliferation, migration, and metastatic invasion of breast carcinoma cells. Excessive blood leptin levels and hyperleptinemia increase body fat content and stimulate appetite. Also, high leptin level is believed to be associated with several conditions, including overeating, emotional stress, inflammation, obesity,
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