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: Most prevalent chronic liver disease in developed and developing nations is non-alcoholic fatty liver disease. From fatty liver, which often has benign, non-progressive clinical history, to non-alcoholic steatohepatitis, a more serious variant of fatty liver that can lead to cirrhosis and end-stage liver disease, non-alcoholic fatty liver disease encompasses broad spectrum of diseases. The gold standard for determining extent of hepatic fibrosis is still liver biopsy; however, number of noninvasive tests have been established to make diagnosis and assess effectiveness of treatment.
Objective: Aim of study was to assess effectiveness of the combination of fibroscan and
... Show More
Salmonella is approved as a common foodborne pathogen, causing major health problems throughout the world particularly in low‐ and middle‐income countries. Low-level fluoroquinolone resistance is conferred by both chromosomal and plasmid-encoded resistance, this research was carried out look into the occurrence rate of qnrA,qnrB and qnrS genes in Salmonella enterica serotype Typhi Cipr ofloxacin-resistant insulate from blood samples of patients with typhoid fever. Fifteen Salmonella enterica serotype Typhi isolated previously from patients with typhoid fever were included in this study. All bacterial isolates were confirmed to have ciprofloxacin
... Show MoreBackground: One of the most predominant periodontal diseases is the plaque induced gingivitis. For the past 20 years, super-oxidized solutions have be..
The health care industry is witnessing an increasing trend in the use of generic medicines because of their presumed low cost compared with innovator medicines. The aim of this study was to determine and compare the performance of the copy drug Osveral®and its innovator drug deferasirox (Exjade®).
A prospective observational study including 223 patients receiving the branded medicine Exjade®and 101 patients receiving the copy Osveral®was carried out. Data were assessed for a 1-year period and included clinical symptoms, serum ferrit
Type 2 diabetes mellitus is often characterized by hyperglycemia as a result of increased insulin resistance in hepatic/peripheral tissues and pancreactic B-cell dysfunction. Approximately 92% of patients with type 2 diabetes mellitus demonstrate insulin resistance, however hyperglycemia is always a consequence of insulin deficiency. This study was done on 120 patients newly diagnosed diabetes type 2 characterized by dyslipidemia that is increased triglycerides and decreased HDL. Hypoglycemia and weight gain are common problem with oral sulfonyl urea drugs. In this work three different oral hypoglycemic drugs repaglinide and glibenclamide (insulin secretagogues) and rosiglitazone (insulin sensitizer) were used for treatment of patients w
... Show MoreHormones, their receptors, and the associated signaling pathways make compelling drug targets because of their wide-ranging biological significance to study the role of asprosin in obese male patients with diabetic mellitus type II. ELISA method was used to assay asprosin and insulin. Blood was taken with drawn sample from 30 obese normal patients with age range (40-60) years, 30 diabetic patients with age range (40-60) years at duration of disease (1-5) years and 30 normal healthy patients. The mean difference between T2DM according to insulin % (23.8±0.6) was increased than the mean of IFG (17.7±1.0) (P 0.000). The mean difference between T2DM according to asprosin (122.1±21.8) was increased than the mean of IFG (51.4±2.7) (P 0
... Show MoreBackground and Objectives: Urinary tract infections (UTIs), among a wide range of microbial infections, are of a double-edged worry with health-care and economic implications. They are serious diseases that can influence various parts of the urinary tract. The aim of this study was characterization of the enteric bacteria isolated from urine of human UTIs and studying their antimicrobial sensitivity. Materials and methods: A total of 50 urine samples were collected from patients with UTIs of both genders. The isolates identification was done using routine diagnostic methods and confirmed by Vitek2. Antimicrobial susceptibility was done against 10 antimicrobials. Results: Both genders of human were found to suffer from urinary tract problems
... Show MoreObjective(s): To determine the quality of life for adults with a chronic obstructive pulmonary disease.
Methodology: A descriptive study was carried out on (80) patients with a chronic obstructive pulmonary disease from
December 2008 through October 2009 with special inclusion criteria (adult paƟents from 18 years and above exclude
the patients who suffer complication related of disease and from psychological problems and other chronic illnesses.
The data were analyzed through the application of descriptive data analysis approach and inferential data approach.
Result: The study indicated that the determination of QoL for COPD depended on the level of effect .The grades
according to R.S are: "high" effect of disease in