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.
Abstract
Objectives: To assess patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention, and to find out the relationship between patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention
Methodology: A descriptive design was carried out at Al- Nasiriyah Heart Center in Thi-Qar Governorate for the period between May 19th, 2022 to October 25th, 2022. A non-probability sampling was used among (50) patients after their Percutaneous Coronary Intervention. The study instrument that used to collect data was composed of three parts namely: sociodemographic charac
... Show MoreChitinase-3-like 1 protein (YKL-40) is a glycoprotein primarily produced in the arthritic joint and plays a crucial role in inflammatory processes. The aim of the study is to establish the role of YKL-40 as a biomarker for rheumatoid arthritis (RA) compared to proinflammatory biomarkers and disease activity. The study included 58 patients and 18 control. Diseases activity score (DAS-28) and clinical disease activity index (CDAI) were measured. Serum level of YKL-40, tumor necrosis factor-α (TNF-α), interleukin-1B (IL-1β), erythrocyte sedimentation (ESR), rheumatoid factor (RF), C-reactive protein (CRP), and anti-citrullinated protein antibody (ACPA) were assessed. The results showed that the median serum YKL-40 level which was 5.42
... Show Moreprotein oxidation through oxidative stress, which represents the overall status of the protein in the cell/tissue. Due to their increased levels of AOPPs were reported during T2DM. The aim of this study was to assess AOPP level in T2DM subjects with foot ulcer (DFU) and explore its correlation with infection. Type 2 diabetic patients (n=108) and healthy subjects (n=25) were enrolled in this study. The T2DM group was subdivided to diabetic patients without complications (n=25) and eighty-three (83) of them have diabetic foot. They were sub- grouped into two groups according to presence Osteomyelitis and abscess, and in reliance on medical analysis of WBC count and CRP. Group of diabetic without superficial or deep ulcer and no osteomyelitis
... Show MoreAn oil spillage has been a great threat to human life in parts of Koya district, especially through the contamination of domestic water. An attempt was made to find and map the extent of pollution in the area. According to a field survey, more than 17 springs and 34 hand-dug and artesian wells have been contaminated with crude oil. The contamination was recorded recently after loading began of tens of oil tankers in the Taq-Taq oil field, and as a result hundred barrels of oil have spilled into the creeks and soil daily. Hence, 2D resistivity imaging was adopted via four laid-out traverses running normal to the strike of the outcrops. A Wenner-Schlumberger array configuration was used to achieve both vertical and lateral resistivity dist
... Show MoreSchizophrenia(SCZ) is oneof the most destructive and complicated chronic diseases of the human nervous system. Serotonin receptors have been involved in the pathophysiology of psychiatric disorders including schizophrenia. Fortyschizophrenia subjects (14females and 26 males) with an age range of 23– 57 years were enrolled, in addition to twenty healthy control subjects (10female and 10 male) with an age range of 19-44 years.
This study aimed to evaluate the frequency of one single nucleotide polymorphism (SNP), namelyrs643627 in HTR2Agene,inIraqi patients with schizophrenia in comparison with controls, along with the association between this SNP and the incidence of schizophrenia.
The genetic variantrs6436
... Show MoreIntroduction: The association between acute stroke and
renal function is well known. The aim of this study is to
know which group of patients with acute stroke is more
likely to have undiagnosed Chronic Kidney Disease and
which risk factors are more likely to be associated with.
Methods:We studied 77 patients who were diagnosed to
have an acute stroke.Patients were selected between
April2011andJune 2011 using the " 4-variable
Modification of
Diet in Renal Disease Formula " which estimates
Glomerular Filtration Rate using four variables :serum
creatinine ,age ,race and gender.
Results :The study included 38 male and 39 females
patients ,aged (35-95) years. Glomerular Filtration Rate in
patients wi
During the Maastrichtian, the rudists and benthic foraminifera of Aqra Formation underwent two major radiations, the first beginning in early Early Maastrichtian and peaking in the late Early Maastrichtian, and sconed extending from the early Late Maastrichtian to a late Late Maastrichtian peak.The radiations were punctuated and separated by prominent extinction episodes, fit with global Maastrichtian mass extinction.The high level of rudist, endemism [90%] allows definition of true regional origination and extinction pattern; these may represent global pattern for rudists. Radiation and extinction patterns in the northern Iraq [Kurdistan Region] can be variously related to relative sea level fluctuation and the rate of food and clastic
... Show MoreBackground: Hypertension is a chronic medical condition in which the blood pressure in the arteries is elevated, it's classified as either primary (essential) hypertension or secondary hypertension, and it increases the risk of ischemic heart disease, peripheral vascular disease and other cardiovascular diseases. Several classes of medications collectively referred to as antihypertensive drugs like beta blockers, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers, renin inhibitors and statins (HMG-CoA) reductase inhibitor. Statin medication may have some beneficial effects when subjects have dental plaque or signs of periodontitis as gingival bleeding. The purpose of this study were to as
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