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.
Formed leadership skills and organizational trust Based on intellectual that underpinned the current research, as represented leadership skills variable interpretative represented in organizational trust-response variable.
The research aims to test the relationship and the impact of leadership skills dimensions in organizational trust dimensions for the purpose of achieving its objectives were formulated hypotheses main relate to test the effect and the relationship between the variables of research for the purpose of testing those hypotheses applied research on a sample of heads of departments and officials of the people at the center of the Ministry of Higher Education and Scientific Research, where th
... Show MoreThe study aimed at interpreting the role of architectural design quality in in build competitiveness model in accordance with the proposal included the idea of architectural design quality for its removal; interesting design factors of the environment, good design of the spaces, and design aesthetic explanatory variable. The competitiveness dimensions; the level of innovation, stimulate research, and the quality of the company's products, and activating the role of human resources, entrepreneurship, profitability, market share and competitiveness, variable responsive. The study of construction companies in the Ministry of Housing and Construction has taken the Iraqi society for the study. The sample consisted of (48) manage
... Show MoreAbstract
This paper presents an intelligent model reference adaptive control (MRAC) utilizing a self-recurrent wavelet neural network (SRWNN) to control nonlinear systems. The proposed SRWNN is an improved version of a previously reported wavelet neural network (WNN). In particular, this improvement was achieved by adopting two modifications to the original WNN structure. These modifications include, firstly, the utilization of a specific initialization phase to improve the convergence to the optimal weight values, and secondly, the inclusion of self-feedback weights to the wavelons of the wavelet layer. Furthermore, an on-line training procedure was proposed to enhance the control per
... Show MoreGas and Downhole Water Sink, Gravity Drainage, GDWS-AGD, Enhance the Recovery of Oil
The importance of the research in the preparation of special exercises to develop some types of basketball scoring as a contribution to help the physical education teacher to find successful educational alternatives. The purpose of the study was to prepare special exercises for the cognitive (cognitive) survey in the development of motor satisfaction and learning some types of Scoring for basketball for students. Learn about the effect of cognitive exercises in cognitive development in students. The survey included students from the first stage of the Faculty of Physical Education and Sports Science \ University of Diyala (159) divided into 6 people. The sample was randomized by (b) and (b) D) and after dispersion by the standard method In
... Show MoreBackground: Thermocycling simulates the temperature dynamics in the oral environment. This in vitro study done to measure and compare the effect of thermocycling on the shear bond strength of stainless steel and sapphire brackets bonded to human enamel teeth using light cured orthodontic adhesive and debonded at various time, and to measure adhesive remnant index after debonding. Materials and Methods: one-hundred-twenty extracted upper first premolars for orthodontic reason were used in this study; depending on weather thermocycled or not, the sample was divided into two main groups, then within each group 30 teeth were used for stainless-steel brackets (Bionic®) and for sapphire brackets (Pure®). Both groups were subdivided into three
... Show MoreThe search aims to clarify pollution to negative effects on environment and to an increasing in the dangerous polluted materials that discharged out these factories. To make active procedures in order to limit the environmental pollution.
The search problem came from an assumption which has the researched factory is suffering from the lack of applying the international specification ( ISO 14004 ). The research problem assimilated by these questions:
- What is the level or organization in thinking of environmental system according to ISO 14004 .
- What are the requirements used in researched factor