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 aim of the research is to know the characteristics of both variables in order to be able the to construct the integrated framework of its paragraphs through the available information on both inspirational leadership and organizational health. as fundamental variables of research, as well as the extent of the influence of the inspirational variable as an independent variable in the organizational health variable as a variable in its three physical, mental and social dimensions. The research is important to stimulate the behavior side of the staff. Which is one of the top concerns of senior management in the ministry, because of its great importance in increasing the effectiveness of the performance of e
... Show MoreThe aim of the research is to identify the extent of the ability to ensure the integrated reports by the auditor in verifying the credibility of these reports, and their implications for the benefit of all parties dealing with the economic unit, as well as measuring the impact of the assurance procedures followed by the auditors and their role in confirming these reports.
The research methodology was designed after studying the previous literature related to the research variables, and then the relationship between these variables was tested, through the use of a questionnaire list. A questionnaire targeting the community of auditors in the local environment, and the results of the study wer
... Show MoreThe reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual
... Show MoreThe subject of the organizational Ambidexterity of the vital Topics through which it seeks organizations to provide mentalities renewable for their members and maintain its survival and continuity according to different organizational methods of access for strategic success. The research aims to demonstrate the impact of organizational Ambidexterity in achieving strategic success in the National bank of Iraq, and the questionnaire was prepared as a tool for collecting data and information through sample survey of (16) managers and heads of departments , The results were analyzed by using the statistical program (SPSS) in calculating mean, standard deviation, percent and test (f), coefficie
... Show MoreInfertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, infertility affects approximately 15% of all couples trying to conceive. Male infertility is responsible for about 50% of the infertility cases. Chromosomal abnormalities and Y-chromosome microdeletions are the most common genetic causes of male infertility. Klinefelter syndrome (KS) is the most prevalent factor of the chromosomal abnormality in the infertile male. Azoospermia Factor (AZF) microdeletions located on the Y chromosome are one of the recurrent genetic cause of male infertility. This study aims to investigate the prevalence of chromosomal anoma
... Show MoreThe measurements of major and trace elements in different brands of milk powder selected from the Iraqis market via the X-ray fluorescence (XRF) Technique have been studied in the present work. The result of the measurements reveals the high concentrations of sodium, phosphorus, sulfur, chlorine, potassium, calcium and magnesium. Furthermore, low concentrations of aluminum, silicon, iron, bromine, molybdenum, iodine, barium, titanium, manganese, cobalt, chrome, nickel, copper, zinc and lead were detected. Neutron activation analysis (NAA) and Kjeldahl technique were also employed to determine the concentrations of nitrogen. It was found that the nitrogen concentration was in the range of (1.96 - 3.23) % which is within the permissible li
... Show MoreThis study was conducted to detect C.sakazakii PIF and raw milk. Two hundred samples of PIF were taken from the infected hospital infants who used this type of milk and from the local markets in addition to 16 sample of raw milk were collected. The study is the first to report the isolation of C. sakazakii and Enterobacter spp. from raw milk in Iraq. The distribution of C.sakazakii and Enterobacter spp. among the presumptive isolates using Vitek-GN2 system gave 1/16(6.25%) isolates of C.sakazakii and 4/16 (25%) isolates of Enterobacter spp. Enterobacter spp. isolates include (E.cloacae ssp. cloacae and E.cloacae ssp. dissolvens, E.hormaechei, and E.ludwigii) that isolate from raw milk Differences in between percentages of each isolate perse
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