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.
Objective:To Evaluate of Estradiol and Prolactin hormones levels for Breast Cancer women in
Baghdad City.
Methodology: The current study was conducted on 60 breast cancer women and 40 apparently
healthy subjects to evaluate the levels of estradiol and prolactin "hormones in the serum" of
({premenopausal & postmenopausal}) breast cancer and healthy controle women. Estradiol and
prolactin hormones estimated for all cases by using the IMMULITE 2000 instrument that performs
chemiluminescent immunoassays results are calculated for each sample.Data were analysed using
SPSS-18.data of two groups was comparison by the student's t-test.
Results: The results showed a non significant""(P>0.05) elevation in the –mean
In this paper, customers’ expectations are continually shifting due to the business environment’s growing competition and substantial changes. As a result, organisations no longer viewed it as a static objective but as an ever-evolving aim. From this vantage point, the research has explored the accounting literature in search of novel approaches to addressing the strategic dimensions of quality, cost and time. Getting them to respond positively to the customer’s requests also requires recognising their needs and controlling their impact on these dimensions. With the removal of operations that do not contribute any value to the product’s value chain and a reduction in manufacturing costs through continuous improvement, the ou
... Show MoreThe entrance process re-engineering one of the main entrances of administrative and technology appropriate to keep pace with scientific progress and the continuing changes in business environment and for the purpose of achieving the goal sought by the organizations in the pursuit of rapid developments and renewable energy in the market competition by changing its operations and activities of the radical change which contributes to an effective contribution to reducing the cost of product or service taking into account the quality improvement in the management of change to keep the increase value and speed of placing on the market to meet customer needs and desires to achieve a
... Show MoreThis study examines the syntactic and semantic functions of the conscience of the chapter and the grammatical disagreement in its diagnosis between two famous linguists: Sibuyh and fur. Also, the conscience of the chapter occupies an important synthetic space in the construction of the Arabic sentence, identified by the Arab scientists, as linguistic analysts, have a strong sense of language and careful observation, they revealed it in their linguistic composition through the analysis of nominal structures, and found that it I come in specific syntactic patterns and grammatical templates that have certain characteristics that are unique to them because of the conscience of separation in their compositional space.
Background: Several risk managem-ent standards had been developed including the Project Management Institute, the National Institute of Standards and Technology, actuarial societies, and ISO standards.
Objective: The study aimed at evaluating risk management among managers of model and ordinary primary health care centers in Baghdad City and comparing the risk management among these centers.
Methods: A descriptive comparative des
... Show MoreAbstract:
Under the state scenario, fiscal policy will not be able to use the oil surpluses optimally and economically and society, as long as these surpluses are not directed by public expenditure towards new productive investments and by following the path of fiscal policy after one year 2003 and until 2013 we note that it is based on the method of spending (excessive) consumption, and did not take any action towards the budget deficit planned at the beginning of the fiscal year, and the actual surplus at the end of the fiscal year, which represents the highest expenditure in the budget, Salaries and wages of workers in various government agencies with the expansion of spending on the security side.&n
... Show MoreIs the subject of environmental analysis of the important issues that should occupy the attention of the departments of banks in general and banks in particular, the research sample, regardless of their size and the nature of its activity, So if the current era and witnessing rapid developments and changes, making the banking environment is more complex and interconnected than ever, And it became not possible for banks to be aware and understand the external environment variables without an analysis of the various constituent elements and influential heavily in its financial and administrative,Therefore research aims to find out the relationship between the external environment and banking facilities analysis application on the Rafidain
... Show MoreAbstract:
This study aims to identify the level of patients’ satisfaction among a sample of hospitalized patients in the targeted hospital (Al-Kindy Teaching Hospital, and Al-Yarmook Teaching Hospital). Moreover, this study highlights the reality of services for patients, especially in the targeted governmental teaching hospitals. The Patient Satisfaction with Nursing Care (PSNCS) has been measured in these hospitals through the revised scale by Tang et al, (2013).This scale includes four major domains; Health Information (5 items), Influencing Support (4 items), Decision Control (4 items), Specialized Technical Competence (7 items). The method of surveying patients’ opinions about the degree
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