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.
Background: Studies show that diabetic patients have a higher incidence of ischemic stroke than non-diabetic patients. In the Framingham study the incidence of thrombotic stroke was 25 times higher in diabetic men and 36 times higher in diabetic women than in those without diabetes
Objectives: aim of this study to analyze topography in diabetic patients.
Type of study: Cross sectional study.
Methods: 48 patients with acute stroke were classified into 4 groups: euglycemic, stress hyperglycemia, newly diagnosed diabetics, and known diabetics.
Results:no significant differences were found in the type, site or size of st
... Show MoreBackground: Coronary Artery Disease (CAD) is one of the largest causes of mortality worldwide. Clopidogrel, antiplatelet drug, has been widely used for management of CAD. The current study aimed to investigate the effect of clopidogrel on the oxidative stress in CAD patients. Methods: One hundred CAD patients, who were followed-up for 5 days after receiving clopidogrel, and 50 healthy volunteers were included in this study. Parameters include catalase (CAT), total antioxidant capacity (TAC), total oxidant capacity (TOC), total protein, albumin, and globulins were determined before and after treatment with clopidogrel. Results: CAT, TAC, and Tp were significantly decreased (P<0.0001) in CAD patients compared to healthy control and
... Show MoreBackground: Coronary artery disease (CAD) is one of the leading causes of death worldwide. Clopidogrel, antiplatelet drug, has been widely used for management of CAD. Arylesterase, the activity of Paraoxonase-1 (PON-1), is mainly contributed in the biotransformation of clopidogrel to its active thiol form. The purpose of this study was to investigate the effect of receiving clopidogrel drug on the arylesterase activities in CAD patients. The effect of receiving clopidogrel drug on the antioxidant activity of arylesterase was also monitored by determination of malondialdehyde (MDA) level. Methods: One hundred CAD patients, who were followed-up for 5 days after reciving clopidogrel, and 50 healthy volunteers were included in our study
... Show MorePolycystic ovary syndrome (PCOS) is an endocrine disorder in women during fertilization age that reflects changing clinical symptoms. The genetic concept of PCOS is unclear and no significant genetic association with PCOS has been established. The level of Follicle stimulating hormone FSH is encoded by FSH receptor (FSHR) and abnormal FSHR affects follicle cogenesis and ovary and consist of 9 introns, 10 exons, and the region of chromosome promoter at 2p21. Sample of 93PCOS patients and 52 controls were collected from Province of Erbil in north of Iraq. Genomic DNA was extracted from the blood and genotype dissected was improved for the two population of study using PCR-RFLP with the restriction enzyme Eam1105I
... Show MoreBackground Cardiovascular disease (CVD) is a leading cause of death worldwide. Ischemic heart disease is a major cause of morbidity and mortality. Lack of blood supply to the brain can cause tissue death if any of the cerebral veins, carotid arteries, or vertebral arteries are blocked. An ischemic stroke describes this type of event. One of the byproducts of methionine metabolism, the demethylation of methionine, is homocysteine, an amino acid that contains sulfur. During myocardial ischemia, the plasma level of homocysteine (Hcy) increases and plays a role in many methylation processes. Hyperhomocysteinemia has only recently been recognized as a major contributor to the increased risk of cardiovascular disease (CVD) owing to its eff
... Show MoreAcute lymphoblastic leukemia (ALL) is one of the most common diseases , so in this study the serum level of malondialdehyde and its relationship with metanephrine was investigated in acute lymphoblastic leukemia patients over one month of treatment. Some biochemical parameters (serum glucose , total serum protein , malondialdehyde ,vitamin C, and metanephrine) changed as well as white blood cell count and blood hemoglobinlevelswere analyzed in sixty patients diagnosed with acute lymphoblastic leukemia over one month of treatment compared to healthy control group.Statistically significant increases (p<0.01) in white blood cell (WBC) count, mean concentrations of malondialdehyde (MDA) (p< 0.05) and metanephrine (p< 0.001) were observed in
... Show MoreBackground: Stroke is an acute neurologic injury and represents the 2nd leading cause of mortality worldwide, and also the most leading cause of acquired disability and morbidity in adults.
Objective: Effect and association between stroke and risk factors.
Type of the study: A retrospective study.
Methods: The study conducted on 312 patients in 2016, all data were collected from patients’ files from the emergency unit, which included basic demographic and disease characteristic, co morbid diseases, risk factors, final diagnosis.
Results: both previous stroke, ischemic heart disease was strong predictor of new
... Show MoreAtrial fibrillation is associates with elevated risk of stroke. The simplest stroke risk assessment schemes are CHADS2 and CHA2DS2-VASc score. Aspirin and oral anticoagulants are recommended for stroke prevention in such patients.
The aim of this study was to assess status of CHADS2 and CHA2DS2-VASc scores in Iraqi atrial fibrillation patients and to report current status of stroke prevention in these patients with either warfarin or aspirin in relation to these scores.
This prospective cross-sectional study was carried out at Tikrit, Samarra, Sharqat, Baquba, and AL-Numaan hospitals from July 2017 to October 2017. CHADS2
... Show MoreBackground: CYP1A1 gene polymorphisms and tobacco smoking are among several risk factors for various types of cancers, but their influence on breast cancer remains controversial. We analyzed the possible association of CYP1A1 gene polymorphisms and tobacco smoking-related breast cancer in women from Iraq. Materials and methods: In this case-control study, gene polymorphism of CYP1A1 gene (CYP1A1m1, T6235C and CYP1A1m2, A4889G) of 199 histologically verified breast cancer patients' and 160 cancer-free control women's specimens were performed by using PCR-based restriction fragment length polymorphism. Results: Three genotype frequencies (TT, TC, and CC) of CYP1A1m1T/C appeared in 16.1, 29.6, and 54.3% of women with breast cancer, respectiv
... Show MoreGestational diabetes mellitus is glucose intolerance of varying degree with onset or first detection duringpregnancy,it can causelong and short term morbidities in both the mother and the child, such as shoulder dystocia,preeclampsia, and high blood pressure. The most powerful endogenous vasoconstrictor peptide, urotensin II, andits receptor are involved in the etiology of gestational diabetes mellitus.Aim of the study: The study’s goal was to see if there is a link between Urotensin II levels and insulin resistancein pregnant women with gestational diabetes.Patients and method: A case-control study that was conducted in obstetrics and gynecology department atBaghdad Teaching hospital from the first of January 2019 to the end of D
... Show More