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 research synthesis variables of competitive advantage and the mechanism achieved by focusing on knowledge abilities and strategic of the administrative leadership, and governments and the developed countries took the racing frantically and my destiny to invest more money and resources to development of wealth and human knowledge is so choice investment winner always and who Aaikhyee never, because God Almighty give humans the abilities of all other creatures and that these abilities varying from person to person, there is the problem of search provoking questions about the essence of what it's about research and both sides theoretical and field, the objective of this research
... Show MoreThis research aims to study the mechanism of application of international specification requirements (ISO 9001: 2015) at the Iraqi Center- Korean Vocational Training return to vocational training department at the Ministry of Labour and Social Affairs for the purpose of preparing and creating the center to get a certificate of conformity with the requirements of the standard (ISO 9001: 2015) that would elevate the level of performance and services provided in the respondent Center after it is identified and the study of the reality of the quality management system by identifying strengths and weaknesses in the system to diagnose the gap and find ways to address that gap, and adopted the researchers the case study method to conduc
... Show MoreObjective: preparing exercises for the third intensity zone for strength and speed for the legs, and identifying their effect on some physiological and biochemical indicators for (the level of lactic acid concentration, the concentration of sodium bicarbonate, the concentration level of (potassium K+) and (sodium Na+) in the blood, and the number of breathing times (RF) Research methodology: the experimental research method was adopted by designing the experimental and control groups on a sample of Army Sports Club players amounting to (16) players, deliberately selected (100%) from their community using a comprehensive enumeration method, and then divided into two groups of equal number, After determining the tests for physiologica
... Show MoreThe aim of this paper is to know the persuasive methods and public relations strategies in building the reputation of the United Arab Emirates, since the UAE is progressing among the international indicators in good reputation. The researcher used the survey method, using the content analysis tool, to analyze the publications of the UAE Ministry of Foreign Affairs and International Cooperation for the period from 10/1/2021 to 12/31/2021.The researcher reached a set of results, the most important of which are: The UAE Foreign Ministry relied on public relations strategies in order to build a good reputation for the country, as it focused on the media strategy and gave little importance to the consensus-building strategy, as well as focuse
... Show MoreBackground. The use of modern aids and technology has contributed greatly to football development, the goalkeeper is the most important position in the team, and the use of devices gave objective readings about the goalkeeper's ability in terms of skill and physical aspects. Objectives. The research aimed to prepare exercises using an electronic device to measure the knee bending angle because of its great importance in developing the skill of catching and dimensions of the high ball for football goalkeepers. Methods. The researchers used the experimental method, and the sample consisted of (4) male goalkeepers under 15 years of age, one of the research procedures was to determine the biomechanical variables affecting the development of the
... Show MoreA field study was conducted on a sample of the public in Baghdad to study the audience's exposure to the television promotion of pharmaceutical products and their trends in order to determine the rate of exposure of the public to the television promotion of pharmaceutical products according to the theory of uses and rumors and to determine the public's attitudes towards television promotion of pharmaceutical products. A survey of (25) a questions was distributed to a sample of the audience of 150 people. The statistical program SPSS was used to unload the data and for the calculation of frequencies and percentages and correlation coefficients. The research reached several results, Most importantly, the television promotion is well receiv
... Show MoreAbstract
The prevention of bankruptcy not only prolongs the economic life of the company and increases its financial performance, but also helps to improve the general economic well-being of the country. Therefore, forecasting the financial shortfall can affect various factors and affect different aspects of the company, including dividends. In this regard, this study examines the prediction of the financial deficit of companies that use the logistic regression method and its impact on the earnings per share of companies listed on the Iraqi Stock Exchange. The time period of the research is from 2015 to 2020, where 33 companies that were accepted in the Iraqi Stock Exchange were selected as a sample, and the res
... Show MoreReceipt date: 2/2/2021 accepted date: 4/6/2021 Publication date: 12/31/2021
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The approval of the federal general budget in Iraq is one of the most important competencies of the legislative authority , Being one of the important financial and monetary policy instruments on which the state depends for its economic growth , Hence, the obstruction of the approval of the federal b
... Show MoreThis paper deals with the process of evaluating the performance of agricultural activity in Iraq and in particular the agricultural initiative launched by Prime Minister Nuri al-Maliki, during the period from 2008 - 2011. Where it is possible to use criteria or indicators that are fabricated by a statement on the calendar and the results of which may be by comparing planned performance with actual performance or the evaluation of the actual performance of successive periods selected. With an emphasis on the agricultural initiative is subject to the evaluation process by implementing and destinations specialized loan funds its own projects as one of the agricultural lending. With the need to co
... Show MoreThe research aims to identify Determination talent management dimensions of (attracting talent, developing talent, directing talent, performance management talent, retain talent) in the entrepreneurial performance of the organization dimensions of (advance planning, efficiency, effectiveness), so search occupies the extreme importance of being treated important and recent issue of the performance Entrepreneuria, management talent, aware of the importance of the subject and expected results of the company surveyed, was an analysis of data obtained through field visits in addition to the questionnaire and interviews, highlights were the results that have been reached to take the sample into account all the management requirements knack of att
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