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.
Research on the role of organizational change in easing the organizational conflict focuses for being one of the important topics and relatively modern and which have a significant impact on the future of organizations, so this study was to identify the relationship and the impact of organizational change and of deportation (technological, organizational structure, human resources, the change in the task) at the organizational conflict in the Earth company link Iraq, in order to reach the goals of the research, it has been the development of a questionnaire distributed to a random sample of (100) composed employees from managers and heads of departments and the people and staff at the Earth company link Iraq, the study found: the
... Show MoreThe research addresses a fundamental Islamic jurisprudential Purposeful issue, which is (Sharia), and to indicate the impact of this on Islamic jurisprudence, deriving rulings and extracting purposes, and to repel the illusion that this issue is only doctrinal, and clarifying the aspects of similarities and links between them by explaining the origin of deriving the purposes of Islamic Law (Sharia) through the meanings and wisdom learned from the texts and the explanation of the rulings. The rulings of Islamic Law (Sharia) have urged bringing benefits and repelling harms, and that the path to do so is reason and its production. I began the research by defining the purposes of Islamic Law (Sharia), then defining the rule of rational right
... Show MoreThe purpose of research is highlighting the role of tax expenses in promoting direct foreign investment in Iraq, The main objective of the increase in the field of tax expenses is to manage the competition in the production of goods and services locally, in addition to the various qualities of the economical. As the search contributes to the idea of the role of the policy of the tax expenses in the promotion of foreign companies operating in Iraq. The analytical and transparent transparency used by adoption of cases of the relevant body of the tax body. For each image or form of tax expenses have been reliably related to the promotion of direct foreign investment, the taxpayers highlighted the annual controls, tax cuts as the sample was
... Show MoreIn this study, 191 specimens of insects that infect species of the Fabaceae family, including:
The research discusses the formal transformation in urban structure, all the cities around the world have undergone a series of formal transformations, resulting in radical transformations to their functions. And to calculate this transformation the descriptive analytical method was applied to this research. First, local urban management data and Landsat-9 visual data were used after processing by GIS. Then, the data were processed mathematically based on their engineering sequences. The aims of this research were as follows: to explore the formal transformations in cities, their dimensions and their consequences and impacts; to identify the underlying causes of their occurrence by deriving realistic results from trends in such degrees of t
... Show MoreBackground: Primary Health care (PHC) is unanimous to be the cornerstone of a person-centered health system. While the adoption of a well-function, two-way, and organized referral system is the mainstay in the development of an efficient healthcare delivery system.
Objective: To Assess the practice & opinion of doctors in the hospitals toward the referral system. to determine the doctors in the hospital's commitment to referral system instructions and guidelines.
Subjects and Methods: A cross-sectional study with analytic elements was conducted in nine Iraqi governorates. Eight doctors from each health directorate, resulting in a tot
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