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: Because of the disturbance in the pituitary gland, growth hormone (GH) secretion will be increased and, as a result, insulin-like growth factor 1 (IGF-1) secretion will be increase as well, leading to a chronic and rare disease called acromegaly disease. One of the most serious complications of acromycaly is diabetes. Insulin resistance, which causes diabetes, occurs in the body because of increased growth hormone secretion Objective: The aim of this work is to estimate some biochemical parameters. These parameters were not studied extensively in the literature such as BALP and LOX and the possibility of using LOX as a new biomarker for acromyalgic patients with diabetic. Patients and Methods: The study was performed on (25) mal
... Show MoreBackground:This is a prospective study of three children presented to us in the Orbital clinic in AL ShahidGazi Al Hariri Hospital with painless proptosiswith suspension of Hydatid disease.Objectives: : Orbital hydatid disease is a rare lesion accounting for less than 1% of the total lesions of the body (1, 2). Orbital cysts presented as a primary lesion in our study which is rare to have such lesion without involvement of other organs (3). Humans represent the intermediate host where the commonly affected organ are liver and the lung (10-15%) (4). Methods:This is a prospective study of three Children presented to us in the Orbital clinic in Al Shahid Ghazi Alhariri Hospital with painless proptosis with suspension of Hydatid disease, dep
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The current study aimed to identify the quality of health services provided by the Omani health sector through the comparison between public and private hospitals in Dhofar Governorate, Oman. A questionnaire has been developed to collect data from 360 patients who received health services in one public Hospital (Sultan Qaboos) and three private Hospitals (Badr Al-Sama, Lifeline, and Al-Hakeeim). The data were analyzed using independent samples T-Test and One Way ANOVA. The results of the study showed that the quality levels of health services offered in private hospitals were better than public hospitals. The study results also reveled that there are significant differences between public hospitals and private hos
... Show MoreBackground: Diabetes mellitus (DM) could be regarded as a set of chronic metabolic disorders which have a common aspect of hyperglycemia. The resistance in the peripheral actions of insulin or impaired insulin secretion could be the reason hepcidin which is a peptide hormone derived from liver, in systemic iron homeostasis is an essential regulator, and its lopsided production participates in the pathogenesis of iron disorders in spectrum. Osteoporosis often accompanies many diseases like ß-thalassemia, hemochromatosis, sickle liver diseases, cell disease and hemosiderosis featured by iron overload, evidences suggest that Iron overload and iron deficiency are suggested by evidences that they affect bone in a negative way, acting
... Show MoreAfter the spread of the function of the scenographer in the modern theater, his vision has become present in most of the theatrical works and because the director is the master of the work and the owner of the vision that appears in front of the audience, the overlap between the visions of each of them was required. This research is an attempt to detect the overlap and disengagement in the work of each of them.
The research is divided into a methodological framework that included the research problem, importance, limits, and purpose, and then the definition of terms. In the theoretical framework, the research dealt with two theoretical sections that pave the way for raising ideas related to this subject: the first section (scenography
Abstract
Objective(s): To determine the interventional program effectiveness on nurses' practices concerning diet instructions for orthopedic patients treated by internal fixation devices.
Methodology: A quantitative approach using prexperimental design is conducted to determine the effectiveness of an interventional program on nurses’ practices regarding orthopedic patients diet instruction and teaching after internal fixation implemented. The study has started from 1st of April 2022 and ended on 15th of December, 2022. The conduction of the study in Misan governorate / Al-Zaharawy surgical hospital. A non-probability, purpo
... Show MoreIn this study, the chamomile flowers (Matricaria recutitaL) which grow in Iraqi Kurdistan region during the seasons of (2008) are collected. The percentage of essential oil was determined by using steam distillation and the extraction of flowers performed with petroleum ether (70-80) ºC and methanol 70% using ultrasonic extraction. Total phenolic compounds were determined from methanol extracts by using Folin-Ciocalteu method. The extracts were evaluated by thin layer chromatography, ultraviolet absorption and the biological activities were evaluated through their antibacterial action against two types of bacteria using hole method. The flowers showed a composition of 0.071% ash, 0.4% essential oil, 3.2% non oily compounds, 4% oil, 1.9% mo
... Show MoreIn the present work, steady, laminar natural convection in nonrectangular enclosures is analyzed numerically with and without fin. Vertical walls insulated while horizontal walls maintained isothermal at different temperature and the fin was placed on horizontal surface. The length of fin was equal (B/L=0.22, 0.44 and 0.66) and thickness of fin was constant. Various parameters are studied: Rayleigh number (from 104 to 107 ), Prandtl number (0.7), number of fin change from (1-3) and aspect ratio (H/L= 0.15 to 0.5). The problem is formulated in terms of the vorticity-stream function procedure. A numerical solution based on program in Fortran 90 with Tec plot program. The finite difference method is used. Streamlines and isotherms are prese
... Show MoreThe importance of Public Relations activity has increased during the last half of the last century as a specialized and modern administrative function in most institutions. It has, moreover, become an integral part of activities of those institutions of various types, due to its pivotal role in building its reputation and drawing a good mental image among its audiences, as well as its influential and basic role in maintaining communication and the communication between its members at its various levels and their job tasks to ensure the greatest amount of understanding and to enhance trust between them. This is why public relations activity has become indispensable in all institutions, and without it, it is difficult to achieve any coordi
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