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 study aimed to identify the treatment of the press image of the Great Return Marches in the French international news agency AFP by knowing the most important issues, their direction and the degree of interest in them. The study belongs to the descriptive research, and used the survey method, within the context of the content analysis method, and the researcher relied on the content analysis form tool and the interview tool to collect data. The study population is represented in the photos published by the French News Agency about the Great Return Marches during the period (end of March / 2018 until the end of November / 2019. The researcher chose an intentional sample using the Complete Census method. The study material represented
... Show MoreAfter we completed this book search we must extraction most important the findings.
Event of war a majar impact on same as all human being but signed and its impact in the
psyche of iraqi woman unparalleled result of the suffering that were produced by these wars
that contributed to the destabilization of Her life at all levels a woman has lost her father,
husband and son an brother as well as extreme poverty caused by the economic blockade
brought in to existence wars that exacerbated the suffering was the woman to work and
economic in order to provide a living for her and her family and pre – empt the dreams and
ambitions so he excelled writer Iraqi in portraying the succession of wars that ate every thing
and
Marketing information system (KMIS) is an essential factor of developing business’ performance and getting sustainable success. The main goal of the research is to measure effect of MIS on customer orientation and product innovation. Also, another goal is to analyze the mediation role of product innovation in relationship MIS and customer orientation. This study sought to analyze the marketing information system and measure its effect on the customer orientation and product innovation. The data of the study were collected using questionnaire. The data were analyzed using statistical tools and SPSS programming. The results of the study showed that the KMIS can positively and significantly effect product innovation. Also, t
... Show MoreThe impact of digital transformation on the relationship between commercial bank customers’ empowerment and competitive advantage
The current research aimed at deducing the psychological contents of Suliman dialogue with the Hodhod and statement applications in school counseling. The researcher followed the Islamic approach in the search, which deals with the study of events, phenomena and practices through a broad understanding of Islamic principles and limitations associated with the general framework of Islam. In addition to the deductive approach is derived from a sub-rule is a general provision.
The research revealed many of the psychological contents, including: the importance of continuing care counselor psychological learners, and follow-up field to their problems, conditions, listen good horseshoe to defend himself, clarify the motives of his ac
In this paper, an eco-epidemiological prey-predator system when the predator is subjected to the weak Allee effect, and harvesting was proposed and studied. The set of ordinary differential equations that simulate the system’s dynamic is constructed. The impact of fear and Allee’s effect on the system's dynamic behavior is one of our main objectives. The properties of the solution of the system were studied. All possible equilibrium points were determined, and their local, as well as global stabilities, were investigated. The possibility of the occurrence of local bifurcation was studied. Numerical simulation was used to further evaluate the global dynamics and understood the effects of varying parameters on the asymptotic behavior of t
... Show MoreThe audit profession today gets an increasing interest by the financial , economic and legal contemporary societies , because of the importance of the technical & neutral auditor’s opinion to the financial reports beneficiaries in order to enable them making their investment decisions , but some of them whom suffered damage or loss when they made that decisions according to the mentioned financial statements which consolidated with auditor’s report , exposed the function to a responsibility and credibility crisis in addition to missing the trust especially at the latest years. They always ask why or what is the reason that cause the auditor didn’t giving us any warning signs about the economic mater for that companies.
ABSTRACT Background: Diabetes and periodontitis are complicated prolonged disorders through a recognized two-way association. There is elongated-conventional mark that hyperglycaemia in diabetes is affected on immune-inflammatory response and disturb the action of osteoclast and in balance bone turnover, which might rise the person vulnerability to the progress of prolonged periodontitis. Osteocalcin is one of the greatest plentiful matrix proteins originate in bones and produced absolutely there. Small osteocalcin crumbles are noticed in regions of bone remodeling and are in fact degradation products of the bone matrix, that is released outside cells into the Gingival Crevicular Fluid (GCF) and saliva after destruction of periodontal tissu
... Show MoreThe study aims at knowing students’ academic assistance at the Department of Kindergarten. It further aims to know the difference of academic assistance among these students with respects to variables like (college of education for women, Baghdad, Thi-Qar). It also aims to know about the difference according to the academic level variable, in addition to its relation to some other variables. To achieve the objectives of the study, a number of university female students were selected from both Baghdad an Thi-Qar Universities in the academic year 2019-2020. The sample of the participants consisted of (400) students from the (second, third, and fourth) levels. To measure the study variable represented by the concept of academic assistance
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