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 : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a d
... Show MoreCeliac disease (CD) is an immune-mediated disorder caused by gluten in genetically susceptible individuals characterized by chronic inflammation that essentially affects the small intestine. Objective: this study was designed to measure the potential role of some serological biomarkers including vitamin B12 and homocysteine (HCY) in the progression of CD as well as their relations to global DNA methylation (5mC). Materials and methods. Forty CD patients were enrolled in the study with an average age of (36.60 ± 2.03) years (range between 15 and 60). The diagnosis of the disease was confirmed by serological examinations and intestinal endoscopy in Gastroenterology and Liver Teaching Hospital in the Medical City Hospital in Baghdad
... Show MoreBACKGROUND: HLA-B27 can effect clinical presentation and course of ankylosing spondylitis. Different detection techniques of HLA-B27 are available with variable sensitivities and specificities. OBJECTIVE: To compare serologic and molecular diagnostic techniques of detecting HLA-B27 status and to correlate it with some clinical variables among ankylosing spondylitis patients. PATIENTS AND METHODS: A cross-sectional study was conducted on 83 Iraqi patients with ankylosing spondylitis. Clinical and laboratory evaluations were reported. HLA-B27 status was determined in all patients by real-time PCR using HLA-B27 RealFast™ kit; ELISA method was used as well to detect soluble serum HLA-B27 antigens using Human Leukocyte Antigen® kit. RESULTS:
... Show MoreInsurance actions has become a task of the vital foundations on which the international economy depends, where its presence helped in the development of economic resources in which human resource is considered the most important of these resources. Insurance companies play the biggest role in protecting this resource and minimizing the impact of the dangers that verify this condition.Human has worked hard to get rid of the dangers and its harm, and to devise many ways to prevent them. A risk management is considered within human’s creations in order to create a society with fewer negative risks impacts.
On this basis, th
... Show MoreThe purpose of this study was to measure serum levels of insulin-like growth factor-binding protein (IGFBP7), Insulin-like Growth Factor 1 (IGF-1), Growth Hormone (GH), Interleukin 6 (IL-6) and insulin in acromegaly patients and healthy controls. The acromegaly group had 60 patients, while the population group had 30 people who had never had acromegaly before. The concentration of IGFBP7, IGF-1, GH, IL-6, and insulin were determined. The results of the present study indicate that IGFBP7 level in the acromegaly group was significantly lower (1.690.07 ng/mL vs. 2.740.12 ng/mL, respectively, p = 0.001). IGF-1, GH, IL-6, and insulin concentrations were also significantly higher in acromegaly patients. The diagnostic accuracy (2.194) was exce
... Show MoreWere collected three types of medicinal plants from their natural habitat after Astkhalasalziot volatile manner steam distillation and determine the quality and quantity of vehicles chemical for each of the oils obtained using a technique JC discouraged when you merge oily thyme and lemon grass against bacteria either when using oils in three did not have a different effect
The importance of this research lies in shedding light on the concept of techno-strategy for information management from vital and important topics that showed response for change in all areas of life. As this necessitates the updating and changing of it in order to achieve its strategic goals and enhance its technological advantage. The research problem looked at the role of the information technology system (ITS) in enhancing risk management in general directorates for sports and school activity from the viewpoint of its department heads. The research aimed at the relationship of information techno-strategy in risk management and the ratios of the contribution of information techno-strategy in risk management from the viewpoint of heads o
... Show MoreThe aims of this study the infection with parasites Entamoeba histolytica and Giardia lamblia and prevalence rates and their relationship with gende , age group , the number of family members and source of drinking water among the patients at attending the Bint Al Huda and Al- Hussin Teaching hospital in Nassriyia city in Thi- Qar province , it was noticed that the percentage of parasitic infection at females was 38.55% and at males was 61.45% and the percentage of parasitic infection with Entamoeba histolytica 97% was higher than the percentage of parasitic infection with Giardia lamblia 3%,and the reduction of percentage of infection is associated with increasing of the number of family member ,the percentage of infection was 49% at the
... Show MoreBridging the Gap between Graphemes and Phonemes in the Phonetic Transcription
The purpose of this paper is to identifying some of the physical, kinetic and electrical capabilities of the working muscles of patients with simple hemiplegic cerebral palsy, preparation of special exercises (rehabilitation and water) accompanied by symmetrical electrical stimulation in the rehabilitation of working muscles for patients with simple hemiplegic cerebral palsy, and identifying the effect of exercises, especially (rehabilitation and water), accompanied by symmetrical electrical stimulation, on some physical, kinetic and electrical capabilities in rehabilitating working muscles for patients with simple hemiplegic cerebral palsy. The researcher used the experimental approach with a one-group design with two pre and post-tests du
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