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: This study evaluate the immunohistochemical expression profile of transforming growth factor beta-1 in inflamed gingival tissue of patients with gingivitis and chronic periodontitis compared to healthy subjects and, determine the correlation between this cytokine and the clinical periodontal parameters, intensity of inflammation and chronic periodontitis severity. Materials and methods: Gingival tissue specimens were taken from 23 chronic periodontitis patients, 20 gingivitis patients and 20 periodontally healthy subjects. The periodontal status was evaluated by dichotomous measurements of the clinical periodontal parameters (PLI, GI, BOP, PPD, CAL). The gingival specimens were fixed immediately in 10% formalin and processed ro
... Show MoreA harvested prey-predator model with infectious disease in preyis investigated. It is assumed that the predator feeds on the infected prey only according to Holling type-II functional response. The existence, uniqueness and boundedness of the solution of the model are investigated. The local stability analysis of the harvested prey-predator model is carried out. The necessary and sufficient conditions for the persistence of the model are also obtained. Finally, the global dynamics of this model is investigated analytically as well as numerically. It is observed that, the model have different types of dynamical behaviors including chaos.
Background: Dysfunction of sinoatrial node is a set of abnormal rhythms which are resulted from the sinoatrial node malfunction of the sinus node, the chief natural cardiac pacemaker. The common, and occasionally, the single method for treatment of heart arrhythmias was implantation of pacemaker, which reduce symptoms exactly occurs after implantation. Aim: To detect the role of smoking on cardiac electrophysiology parameters in sinus node dysfunction in Iraqi patients such as SNRT and AH. Methods: A cross sectional study, was conducted on 59 patient ranging between 20-50 years old and involving 35 female and 24 male patients, suffering from an unexplained symptoms of sinoatrial node dysfunction (SND). The enrolled participants were gathere
... Show MorePerhaps it is of paramount importance for researchers to present grammatical topics with a uniqueness that distinguishes them from everything else that may overlap with them, and a specificity that distances them from much of what may be thought to be similar to them or similar to them. The subject pronoun is one of these topics that should be considered. Due to the uniqueness of this pronoun among the rest of the family of pronouns, with features and adverbs that deserve research and study, and then analysis and treatment; Because of its scientific value, it goes hand in hand with other pronouns. This topic would not have drawn my attention or received much of it had it not raised some fundamental questions, including, f
... Show MoreThree different types of nozzles (different wear rate) were used in this study. They are classified depending on the severity of their wear to three groups: new, worn and damaged nozzles. Those nozzles were spraying with the same application rate (303 l/ha) on two-year field trials; this was achieved by changing the spraying pressure for each group of nozzles in order to get the same application rate. This practice is usually done by operators of sprayers, who calibrate the sprayers on the same application rate every year without changing the nozzles, so they tend to reduce the spraying pressure in order to compensate the flow rate increase due to the nozzles yearly wear. Two types of
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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 MoreThe purpose of this study is to investigate the effect of credit risk indicators on the Arab Gulf countries' banks Profitability over the period of 2015 to 2017. The banking credit risk was calculated using non-performing loans ratio affecting banks profitability indicators like net income and by using fixed effect and random effect model analyses, the study found that increasing in non-performing loans ratio will decrease the net income in gulf banks, the study also found that personal loans represent the largest share of loans granted in gulf banks. Also, the study recommends the importance of developing the capabilities of credit departments in commercial banks in dealing with bad loans, and studying the financial statem
... 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
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