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 summary
Informing means informing and informing, which is conveying information to someone and confirming his narration with it. Accordingly, information is its main content..and it has multiple means, including visual, audio and read, and it has become the dominant role in the process of socialization, and much of what we hear, read, or watch in the media is not devoid of a goal, and expresses that scientifically as “charged with values” ( Value Loaded)..Values that are: the set of beliefs that the individual holds towards things, meanings, and various aspects of activity, which direct his desires and attitudes towards them, and determine for him acceptable and unacceptable behavior, right and wrong, and all of this
... Show MoreThe purpose of this research is to highlight the nature of the relationship between the mental abilities of decision makers and strategic orientation . The intellectual capacity of decision-makers is the cornerstone for the implementation of all the tasks and duties of the Organization and constitutes the most important of its capabilities. As a result of the sharp changes in the environment in which it operates, this organization must accurately define its strategic directions to ensure its
survival and continuity. The problem of field research was to answer a fundamental question: Is the Iraqi director aware of how to employ mental abilities in strategic direc
... Show MoreThe quality of the financial reports depends on set of accounting standards ,most of wich have been studied for the purpose of ascertaining the relationship between the standard used and the quality of the financial reports that contribute significantly to improving the financial performance of the institution, Research aims to detect the relationship between forensic accounting and the quality of financial reports, The research included a key hypothesis that forensic accountability could be applied to improve the quality of financial reporting, A sample of gentlemen (external auditors, tax assessors, judges, university professors, shareholders) (45
... Show MoreThis research sheds light on the physical environment role in creating the place attachment, by discussing one of the important factors in the attachment creation, it is the concept place dependence, consisting of two important dimensions: the place quality and the place expectation; they contain a number of the supporter physical environment sub-indicators for place attachment. Eight physical indicators were reached; they were found to have a close relationship to the place attachment, including: the open and green spaces existence, land use diversity, diversity of housing types, dwelling / population density, accessibility, transport network development degree, transport multiple mo
The research aims to contribute to the consolidation of scientific knowledge of compliance control and its role in verifying the proper disposal of funds to manage the wheel of the economy towards achieving targeted development and preserving public money, as well as clarifying the role of tax revenues in strengthening the public treasury and achieving social justice. The analytical descriptive approach was adopted in the process of analyzing The quantitative data collected through personal interviews, and the research reached a set of conclusions, the most important of which is the contribution of compliance control according to its three principles. (Transparency, accountability, and inclusiveness) on the availability
... Show MoreBusiness Ethics play a major role in explaining the behavior of those interested in the management of tourism enterprises in the field of management gains, which sometimes turn to manipulation in the specification of the service of tourism and influence in the technical characteristics at the expense of the brand and market share, as well as misleading beneficiaries about the fact that the performance of the service of tourism, may depend activities tourist dramatically when submitting and sharing various services on the types of mutual relations the framework for moral distinct, in interaction or direct contact between producers of tourism services and tourists or their beneficiaries, in order to provide comfort and recreation a
... Show MoreThe research problem is that the traditional methods of internal auditing are somewhat heavy with long and rigid procedures for the members of the audit process team, especially in light of the current developments that are reflected in the business environment and internal audit reports, so it is necessary to reconsider the traditional internal audit work method and assess the extent of its development by agile methods to reduce the time of the audit process on the activities and elements that add value and direct the effort and time to the activities and elements that add value to the work of the economic unit and the report of the internal auditor.
The research aims to study the possibility of applying agile internal auditing
... Show MoreBackground: Plants used in folk medicine for
the treatment of peptic ulcer diseases is a very
promising approach to overcome the limitations of
classical medicines.
Aim: To explore the efficacy of medicinal
plants, namely turmeric, garlic and marshmallow,
in eradication of H. pylori.
Methods: This prospective study was carried out
on 225 of well-known dyspeptic patients who were
divided into four groups; a control group (received
classical medical therapy) and three other groups
that received one of the three medicinal plants,
plus the same therapy used in the control group.
The follow up was done by using a questionnaire
form, endoscopic examination, and determination
of serum levels of anti
This research studies the effectiveness of the symbol in the Iraqi monodrama texts. The methodological framework is devoted to the research problem and the need for conducting it, its importance, the purpose of research, and the definition of the most important terms. The research problem dealt with the concept of the effectiveness of the symbol, the monodrama, and the working levels of the symbol in the monodrama texts of the author, in addition to the disclosure of the artistic vision embodied by the playwright in the use of the symbol within the literary product, as well as the development of the creative process. The research problem was defined by the following question: How effective is the symbol in the Iraqi Monodrama texts?
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