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: Sex variations in coronary artery disease (CAD) are well documented. However, sex differences in coronary artery calcium (CAC) and its role in the detection of coronary artery stenosis remain controversial. Objective: To assess the impact of sex variation on coronary artery calcification and its efficacy in predicting coronary artery stenosis. Methods: This is a cross-sectional observational study including 230 consecutive patients with suspected CAD (120 men and 110 women) referred for coronary computed tomography angiography (CCTA). The study analyzed sex-based differences in the sensitivity and specificity of coronary artery calcification (CAC) for detecting moderate to severe stenosis across various coronary arteries
... Show MoreThis research aims to find out the relationship of risk behavior & job satisfaction for workers in the emergency program in the international relief agency (UNRWA) in the Gaza Strip and the level of each of them, and to achieve that we have been conducting research on the strength of "210" sample employees of the emergency program staff in the international relief agency in Gaza governorates, and try to answer the research questions the researcher through the use of measurements of risk behavior and job satisfaction are two of the researcher, The researcher has used several statistical methods to identify the validity and reliability of scales and access to research and interpretations of the results, and these methods: the m
... Show MoreThe status of the semi total stoppage and non-use and waste of economic made studying and analyzing Dutch disease of high importance because it is a major cause in aggravation of this status which happened to the Iraqi economy in almost complete way and the relative big importance that oil source has and its domination on the largest percentage in the gross domestic product and exports that Iraqi economy is relying largely in funding the national budget made the concentration of the study on this subject an important and necessary within the important economic events that Iraqi economy witnessed after 2003 till 2016 to give a clear and an overall picture of the reality of the unilateral Iraqi economy under the status of semi tota
... Show MoreThe public budget is regarded a main tool for economic and social development. The preparation of the public budget constitute an important stream which enriches the developmental efforts and the definition of its priorities, therefore it is the focus point of many specializations. The public budget has numerous functions. It is a means to precise and to execute the political and economic goals of the executive authority, a mirror of the economic structure which reflects its strength and weakness points, specifies its revenues and others. Since the parliament is the voice of the society which expresses its interests, then, it must monitor the performance of the government so that the participation of the legislative authority in
... Show MoreThe grain hardness, wet and dry gluten contents, protein and ash contents are determined in grains from different cultivars of wheat which are important in food products, either which are present in raw materials or in final products. Wheat is also a very important food raw material, and flour as the final product of milling. The importance of knowing the physical and chemical properties of wheat and flour is due to the determination of quality and kind of flour which is produced after the milling process. In this work, some physical and chemical properties of different wheat cultivars are determined and the comparisons of these characteristics are performed in both wheat and flour. Uruq Wheat sample (W5) has the highest results when compar
... Show MoreObjective(s): To assess parents' attitude toward immunization and its relation with their compliance and to find out the relationship between parents' attitude and their socio-demographic characteristics.
Methodology: A descriptive design is conducted from the period of 19th September 2020 to the 6th of March 2021. A non-probability (convenient) sample of (292) parents was selected from (5) primary health care centers in Karbala city. These centers are distributed throughout (2) primary health care sectors selected randomly as (20%) from each sectors. The questionnaire is developed and composed of three parts: First part: parent's socio-demographic characteristics, Second part: parents' attitude domain, which involves (13 items), and
Introduction and Aim: The pro-inflammatory cytokine IL-39, a member of the IL-12 family plays a key role in the inflammatory response by modulating immune cell activity and inflammation. A literature search shows no study undertaken for the effect of IL-39's on arthritis so far. Hence, the purpose of this study was to investigate the role of IL-39 in rheumatoid arthritis. Materials and Methods: This study involved 80 patients with rheumatoid arthritis registered at the Rheumatology Clinic at Baghdad teaching hospital. The patients were divided into three groups based on treatments received. Group 1 included patients who were not on any treatment for arthritis, Group 2 with patients on hydroxychloroquine and or prednisone treatment,
... Show MoreObjective: The aim of the study was to estimate the action atorvastatin(20mg/day) on bone biochemical markers dyslipidemic men. Methodology: This study was conducted between May 2015 and November 2015 in Al-Basrah General hospital in Basra, Iraq, to evaluate important role of atorvastatin (20mg/day)(Lipitor® Pfizer Pharma GmbH.Germany) on bone biochemical markers. Thirty men patients who had been admitted for a variety of medical problems included in the study. All the patients had previously been diagnosed with Dyslipidemia by specialist physician in internal medicine and all patients age below 55 yea
Objective: The study aimed to assess the postoperative nurses' intervention for the patients with laparoscopic
cholecystectomy and to determine the relationship between Nurses' interventions and their demographic
characteristics.
Methodology: Quantitative design (a descriptive study) was started from 20th November 2012 up to 1st
September 2013. Non-probability (purposive sample) of (50) nurses, who were working in surgical wards, were
selected from Baghdad teaching hospitals (Baghdad Teaching Hospital, Digestives System and Liver Teaching
Hospital, AL-Kindy Teaching Hospital, and AL-Kadhimiyia Teaching Hospita). The data were collected through
the use of a constructed questionnaire, which consisted of two parts; the
Background : To assess the actual practice of breast self-examination (BSE), as an early detection tool for breast cancer, among a sample of patients affected with breast cancer in Iraq.Methods: A random sample of 200 female patients with breast cancer was analyzed to evaluate the extent of their actual practice of breast self-examination before the diagnosis of the disease. The examined variables included the age of the patients, marital status, education, occupation, smoking habit, family history of cancer, frequency of gravidity, parity and abortions. Results: The age of patients ranged from (24-70) years with a mean age of 48 years. The highest frequency of the examined sample
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