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 concept of deficit in public budget becomes a chronic economic phenomenon in most of the world, whether the advanced countries or developing countries. Despite the difference in the visions of the economic schools to accept or reject the deficit in public budget but the opinion that prevailed is the necessity of the state to reduce the public spending which led to a continuous deficits in the public budget which consequently increased the government borrowing ,increase income taxes and wealth, consequently this weakened the in motivation in private investment which contributed to the increase of in factionary stagnation , so that governments have to cover the lack of local funding sources which become difficult to be eq
... Show MoreWorld statistics proved that the most of work dangerous accidents, which causes death, are occurred in the construction works. These accidents related to many causes such as loss of workers experience and ignoring rules of safety requirements, especially young workers. Due to the risk of accidents that may occur in the site of work, the idea of this study crystallized to show the relationship between the age of worker and number of injuries and accidents, to identify the causes of these injuries, and to put the appropriate solutions to avoid or reduce the risk of work injuries. Also, the research shows the main principles of safety requirements to forming a clear picture about the subject of the study. A questioner form was prepared to c
... Show MoreThis research aims to know the impact of leadership integrity as explanatory variable including its dimensions (courage, asceticism, justice, rationality, and humanity) on organizational conflict as responding variable. This research depended on the descriptive- constructive approach through the responses of a sample of (79) employees from (Real Estate Office of The State) in Al-Najaf province. The analyzing of the study done by using (Smart PLS) program to calculate (R2, t, p). Many results concluded and one of them, there is significant impact correlation of the leadership integrity on organizational conflict. There are many suggestions have been reached depending on the results reached and one of them is the necessity of de
... Show MoreThe financial statements must accurately, clearly and fairly present the financial situation and financial statements should be reliable as well. Pursuant to Board Decision No. (74) 2020, CBI obliges banks, according to the Banking Law No. (94) for the year 2004, Article (33) paragraph 2 concerning real estate owned from previous years and expropriated as a result debt settlement , to apply a real estate liquidation provision at a rate of 20% for each property expropriated and at a rate of 100% for each year of delay up to (5) years .also from the significance of the issue of real estates that become a property of banks as a result of debt settlement and the pr
... Show MoreThe objective of this study was to investigate the prophylactic roles of human enteric derived Lactobacillus plantarum L1 (Ll) and Lactobacillus paracasei L2 (L2), on EHEC O157:H7 infection in rodent models (In vivo). The Lactobacillus suspensions (L1 and L2) were individually and orally administered to experimental rats at a daily two consecutives of 100 μl (108 CFU/ ml/rat) for up to two weeks. Thereafter, on the 8th day of experiment rats were orally challenged with one dose infection of EHEC (105 CFU/ml/rat). Animals mortality and illness symptoms have been monitored. There was no fatal EHEC infection in rats that had been pre‑colonized with the Lactobacillus strains, while most of EHEC infected rats were died (90%). The
... Show MoreThis research shows the problem of the economic development of underdeveloped countries in an unconventional way, as these papers explain the problems of the economic development. This research not only reviews the problems, but it illustrates them in a philosophical way, basis of the data of modernity, this mean it is a process of connecting between the absence of the modernity values and the failure of development in underdeveloped countries. The Search follows the descriptive approach to get to the goal of search by four main axes. The first axis includes clarifying modernity and its principles, the second axis includes clarifying the economic development , the third axis includes the features of the mod
... Show MoreA field study aimed at identifying the degree of satisfaction of secondary school principals with regard to the role of universities and their obstacles in developing their administrative skills. It adopted the descriptive analytical approach. The research community consisted of (249) male and female principals in the schools of Baghdad (Al-Rusafa and Karkh), and the research sample was chosen by the simple random stratified method at a percentage of (40%) of the research community, and the number of the sample was (100) male and female principals. A questionnaire consisting of (40) items distributed between two domains was developed. Its validity and reliability were confirmed. The researcher used the (SPS
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