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.
Monetary policy is an important part of the economic policy to influence the monetary aspect of stabilization, for this reason the research will seek to clarify the extent of the impact of monetary policy in achieving monetary stability in Iraq during the chosen research period, because the Iraqi economy suffers from monetary instability due to political and security turmoil, Therefore, an effective and effective monetary policy is required in terms of reducing inflationary pressures to reach the required monetary stability, in order to create the appropriate monetary environment for the work of the economic and productive sectors. Thus, the research adopted a basic hypothesis that monetary policy in Iraq has a clear impact on achieving mon
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The paper aims to measure an aggregated banking stability index reflecting the degree of stability of the banking system to help policy makers to take the necessary actions to avoid financial crises facing banks and to achieve a banking system with high efficiency in terms of banking risk.
Therefore, the problem of paper is that the Central Bank of Iraq did not seek until 2016 to build a aggregated index for the purpose of identifying the stability of the banking situation in Iraq, but rather on the adoption of scattered indicators, which depend on the mechanism of relative changes in those indicators for the purpose of identifying the situation of b
... Show MoreThe aim of the research is to determine the impact of the Iraqi public budget on IPSASs by conducting the questionnaire; the research was based on the hypothesis that "there is an impact of the adoption of the International Accounting Standards in the general budget of Iraq”. The research concluded that the government accounting system closely interferes with the general budget at all stages. The shifting towards the accrual basis is the first element of the reform package towards reaching the reform of the state budget. Without reforming government accounting, it is almost impossible to develop the budget. IPSASs are a recognized reference to the assessment and development of governmen
... Show MoreThe upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider
... Show MoreBackground: Complete seal of the root canal system following its chemo-mechanical debridement plays a pivotal role for achieving successful endodontic treatment. This can be established by reducing the gaps between the core filling material and root canal wall. Aim: To assess and compare the dislocation resistance of root canals obturated with GuttaFusion® and TotalFill BC sealer versus single cone obturation technique and TotalFill BC sealer after instrumentation of the canals with WaveOne, ProTaper Next and ProTaper Universal system. Material and Method: Sixty extracted human permanent mandibular premolars were conducted in the current study. The teeth were decorated and left the root with 15mm length; the roots were divided randoml
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The current research aims to determine the relationship of the impact of the components of the financing structure, especially financing through debts, as well as the earnings per share in the value of the shares of companies listed in the Iraq Stock Exchange. The research sample and identifying the strength of the combined effect of the ratio of financing through debt and earnings per share in maximizing The market value of the firm and the real value, as well as the variation between these relationships according to model of the real value of the companies and the market value of the research sample companies. The research community is represented by the Iraq Stock Exchange, while a conditional deliberate sample
... Show MoreThe research is conducted on target of investigating the role of growth strategy via diversification in value maximization of a firm in terms of controversies literatures had witnessed. Using a descriptive approach for analyzing and verifying the harmony of variables of research and their conceptualized logic , it could be reached to many conclusions agreed in their essence upon that the related diversification has the major role in value maximization of a firm and the wealth of its owners .
This study includes the application of non-parametric methods in estimating the conditional survival function of the Beran method using both the Nadaraya-Waston and the Priestley-chao weights and using data for Interval censored and Right censored of breast cancer and two types of treatment, Chemotherapy and radiation therapy Considering age is continuous variable, through using (MATLAB) use of the (MSE) To compare weights The results showed a superior weight (Nadaraya-Waston) in estimating the survival function and condition of Both for chemotherapy and radiation therapy.