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.
Potentially inappropriate prescribing is the prescribing of a medication that may cause more harm than benefit, the elderly population aged 65 years or older is more prone to potentially inappropriate prescribing because of alterations in their physiology, pharmacokinetics, and pharmacodynamics as well as polypharmacy and comorbidities, Beers list is a screening tool that help doctors to detect potentially inappropriate prescribing in geriatric patients and is designed to solve this problem, the aim of this study is to measure the prevalence of potentially inappropriate prescribing among psychiatric patients using the Beers criteria as an assessment tool and find the relationship between duration of hospitalization, comorbidities and pol
... Show MoreThree hundred and fifty five patients with hepatitis were investigated in this study all cases gave negative result with HBs Ag , IgM-anti HCV , IgM-anti HEV, IgM-anti HDV and anti-HIV tests . The frequency of IgM-anti HAV was 113 and the percentage was 32 % in all ages but when these patients divided into five groups dependent on ages. The highest percentage of IgM-anti HAV was (45%) in age <10 and the percentage declined with age increase till to 9% in age >41 year.
It is becoming a public health issue to predict which expectant women will develop gestational diabetes mellitus (GDM). The goal of this case control research is to investigate the role of maternal oxidative stress levels in the first, second, and third trimesters, as well as other factors, in the development of gestational diabetes mellitus (GDM). Methods Between October and December 2021, 142 women participated in this research. The 101 GDM patients were split into three groups based on their gestation (T1, T2, and T3), and 41 healthy pregnant women were chosen as the comparison group. TAS and TOS levels of oxidative stress and XO were calculated using a Spectrophotometer for colorimetric techniques; fasting and random sugar levels, as
... Show MoreTwo dwarf snakes were discovered, Eirenis thospitis Schmidtler & Lanza from Sereen mountain, north east of Arbil and E. rothii Jan from Saffin mountain North of Arbil city North of Iraqi Kurdistan. Supported by description and important notes on variation. In addition summarized list for 9 species of the genus Eirenis Jan in Iraq is also presented.
Osteoarthritis (OA) is a series of aggressive destructive inflammatory processes. Synovitis is common both at an early and a late phase. This disease may be uniquely singular in some site but phylogenetically related at some point in time to produce a common outcome of dysfunction, disability, socioeconomic destruction and sometimes socioeconomic failure. Articular cartilage, subchondral bone and synovial membrane are the site of major abnormalities in this disease process. Rheumatoid factor (RF) represents one of the routine laboratory tests that made for all patients have joint complaints.Chloroquine phosphate (CQP) is agent belong to disease modifying osteoathritic drugs (DMOADs). Chloroquine and their derivatives have been used for t
... Show Morehe study aimed to purify of Leucine aminopeptidase (LAP) from sera of hyperthyroidism patients and its relation to some thyroid hormones (TSH, T 3 , T 4 ) of subclinical hyperthyroidism and hyperthyroidism patients with lipid peroxidation levels that may be play a role in this diseases. Specimens were collected during the time from Nov 2017 until Jan 2018 from Endocrine and Diabetes Center, blood samples were collected from fifty healthy control and one hundred patients, patients were divided into two groups consisted of (50) with hyperthyroidism and (50) with subclinical hyperthyroidism. The aged for all subjects ranged (15-60) years with body mass ranged ((25- 29) kg/m 2 . The purification is done by addition of ammonium sulfate, dial
... Show MoreThe relationship of hyperuricemia to kidney disease, diabetes, hypertension and the risk of cardiovascular diseases remain controversial. The aim of this study is to evaluate the use of uric acid (UA) levels to find the higher risk of cardiovascular disease (CVD) in patients with end stage renal disease that have diabetic nephropathy (DN), nephropathy with hypertension (NH) and patients with both diabetic nephropathy with hypertension (DNH). This study deals with 115 patients with end-stage renal disease under hemodialysis sub-grouped into 35 patients with (DN), 40 patients with (NH), and 40 patients with (DNH). Some biochemical parameters were determined in the serum of all participants such as HbA1c, fasting blood glucose (FBG), UA, urea,
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