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 changes that have occurred in the business environment and scientific and technological progress, as well as the complexity of administrative problems resulting from its practice of various activities, have led to an increase in the responsibilities entrusted to it, and for the purpose of achieving its strategic objectives, which has made the pillars of corporate governance an inevitable matter required by the nature of modern scientific management of the governorate, the success that companies seek is based on the fertile environment and the dialectical relationship between the individual and the company, and to achieve this success there must be a compatible and harmonious audit environment between the internal and external
... Show MoreThe effect of short range correlations on the inelastic Coulomb form factors for excited +2 states (1.982, 3.919, 5.250 and 8.210MeV) and +4 states (3.553, 7.114, 8.960 and 10.310 MeV) in O18 is analyzed. This effect (which depends on the correlation parameterβ) is inserted into the ground state charge density distribution through the Jastrow type correlation function. The single particle harmonic oscillator wave function is used with an oscillator size parameter .b The parameters β and b are adjusted for each excited state separately so as to reproduce the experimental root mean square charge radius of .18O The nucleusO18 is considered as an inert core of C12 with two protons and four neutrons distributed over 212521211sdp−− activ
... Show MoreCovalent modification of protein by drugs may disrupt self-tolerance, leading to lymphocyte activation. Until now, determination of the threshold required for this process has not been possible. Therefore, we performed quantitative mass spectrometric analyses to define the epitopes formed in tolerant and hypersensitive patients taking the β-lactam antibiotic piperacillin and the threshold required for T cell activation. A hydrolyzed piperacillin hapten was detected on four lysine residues of human serum albumin (HSA) isolated from tolerant patients. The level of modified Lys541 ranged from 2.6 to 4.8%. Analysis of plasma from hypersensitive patients revealed the same pattern and leve
Industry represents a cornerstone of the process of economic development and a measure of progress and contribute to increased prosperity and high standard of living.
The researcher analyzed the productivity indicators in industrial facilities large and small at several time periods ranging from 1970 to 2009, according to the economic situation that prevailed in each period.
Different impact of periods under discussion, it made Iraq the cash surpluses during the period 70-1980 then the effects of the war after 1980 and the economic blockade since 1990, and the subsequent events of the year
... Show MoreImproving the environment is a mission that should be conducted by three associates; public authorities, environmentalists and the community. The ignorance of environmental education in Iraq has resulted to an almost environmentally illiterate community, demanding well planned programs to raise their environmental; awareness and education. On the other hand, the decision makers should be well informed about the citizens' environmental preferences to be able to set their priorities for the civil services. Merging the Iraqi citizens in listing their environmental priorities is one of many other approaches for "Environment Education" programs. Globally, such methods have proven to be effective and resulted to widespread understandin
... Show MorePublic spending represents the government’s financial leverage and has a significant impact on real and monetary economic variables, and one of these effects is the effect of public spending on the exchange rate as an important monetary variable for monetary policy, As we know that public spending in Iraq is financed from oil revenues sold in US dollars, and the Ministry of Finance converts the US dollar into Iraqi dinars to finance the government's need to spend within the requirements and obligations of the state's general budget, And converting the US dollar into Iraqi dinars has an impact on the parallel exchange market, even if there is a contractual exchange rate between the Ministry of Finance and the Central Bank of Iraq to
... Show MoreThe effect of 532nm Diode Pumped Solid State (DPSS) laser at power density of 5.234 W/cm2 on the growth of Gram-negative Pseudomonas aeruginosa and Gram-positive Staphylococcus aureus was evaluated. These bacteria were isolated from samples taken from burn and infected wound areas of 55 patients admitted to the burn-wound unit in Al-Kindy teaching hospital in Baghdad during the period from October 2012 to March 2013. Each isolate was identified using microscopic, cultural and biochemical methods. A standard bacterial suspension was prepared for each isolate. Serial dilutions were then prepared and a dilution of 10-5 was selected. Irradiation experiments included four groups: (L-P-) bacterial suspension in saline solution, (L-P+) bacteria
... Show MoreThe objective of this research is to develop a method for applying financial derivatives in the local environment to reduce the risk of foreign exchange rate fluctuations to enhance quality of accounting profits through Financial reporting to local units In accordance with international financial reporting standards, To accomplish this objective was selected a sample of Iraqi units exposed to the risk of fluctuations in foreign currency rates, As the research found:
- many companies and banks in the local environment a lot of losses due to fluctuations in foreign currency exchange rates.
- that financial derivatives in the Iraqi environment represent
the reality of small and medium enterprises analysis reflects weaknesses plaguing these enterprises and strengths that are characterized by, and thus the formulation of appropriate solutions to the obstacles faced by these enterprises to enhance its contribution to the achievement of economic and social development. Iraqi small and medium enterprises suffer from several obstacles stand in front of development and support their competitiveness, the finance one of the main obstacles which impede growth and development of these enterprises, noting the banking system in Iraq reluctance to lend to small and medium-sized enterprises, as a result of the high cost of lending these enterprises compared to large projects, as well as
... Show Moreالاحداث السياسية في العراق بعد 2003 وأثر الانتماء والوعي في التشكيل العراقي المعاصر