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.
Previous reports demonstrated the effectiveness of silibinin hemisuccinate as a potential intraocular pressure-lowering agent. The exact mechanism by which silibinin exerted this effect has not yet been documented, but might suggested to interfere with aqueous humor formation. The present study was designed to evaluate the comparative efficacy of silibinin as IOP lowering agent to that of betaxolol in normotensive rabbits, and the interaction of silibinin with betaxolol as a way for investigating the possible mechanism of action of silibinin in this respect. The effects of instillation of 0.75% silibinin solution and 0.5% betaxolol eye drops in the eyes of normotensive rabbits were evaluated using indentation tonometry. The results showe
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Abstract
This research deals with Building A probabilistic Linear programming model representing, the operation of production in the Middle Refinery Company (Dura, Semawa, Najaif) Considering the demand of each product (Gasoline, Kerosene,Gas Oil, Fuel Oil ).are random variables ,follows certain probability distribution, which are testing by using Statistical programme (Easy fit), thes distribution are found to be Cauchy distribution ,Erlang distribution ,Pareto distribution ,Normal distribution ,and General Extreme value distribution . &
... Show MoreBackground: Background: Diabetes mellitus is a life-threatening disease. Global prevalence of diabetes mellitus is increasing rapidly providing a worrying indication and major threat to global health unless interventions are created through community awareness and knowledge regarding different aspect of DM.
Aims: To assess the level of awareness regarding diabetes risk factors, prevention and management among community members in Baqubah city and to identify any association between awareness level and some variables.
Methods: Across sectional study was carried out from the 1st of January - 30th of November 2019 in all primary health care centers (six centers) in center of Baqubah city. A convenien
... Show MoreCytokines are signaling molecules between inflammatory cells that play a significant role in the pathogenesis of a disease. Among these cytokines are interleukins (ILs) 17A and 33, and accordingly, the current case-control study sought to investigate the role of each of the two cytokines in the risk of developing multiple sclerosis (MS). Sixty-eight relapsing-remitting MS (RRMS) Iraqi patients and twenty healthy individuals (control group) were enrolled. Enzyme linked immunosorbent assay (ELISA) kits were used to determine serum levels of IL-17A and IL-33. Results revealed that IL-17A and IL-33 levels were significantly higher in MS patients than in controls (14.1 ± 4.5 vs. 7.5 ± 3.8 pg/mL; p < 0.001 and 65.3 ± 16
... Show MoreBackground: The majorities of statin-treated patients, in whom low-density lipoprotein cholesterol (LDL-C) targets have been achieved, have had recurrent cardiovascular events (CVE) with an absolute rate remain even higher among patients with disorders of insulin resistance, metabolic syndrome (MetS) and type2 diabetes mellitus (T2DM) as compared to patients devoid of these conditions.Objectives: Provide updated key messages of lipid and lipoprotein abnormalities as indicator for cardiovascular disease (CVD) risk in patients with T2DM and obesity, as well as the current evidence-based treatment targets and interventions to reduce this risk.Key messages: The Residual Risk Reduction Initiative (R3I) emphasized atherogenic dyslipidemia (AD)
... Show MoreAbstract:
The underlying objective of the international standard No. (6) to assist in accounting applications for the extractive industries, taking into consideration the goals and objectives contained in the sixteenth of the private International Accounting Standards criterion accounting for land, machinery and equipment, as well as Standard No. axes (38) relating to intangible assets, and in order to create a vision of a comprehensive development needs oil in order to exact evaluation of policies related to the particular needs and draw a comprehensive frameworks with respect to treatment of expenditures and revenues in the oil production industry, is also interested in Standard No. (6) within the primary objectiv
... Show MoreIn this paper, the species of the genus of Chlaenius Bonelli, 1810 (Coleoptera, Carabidae) were reviewed, and it was revealed that there are 21 confirmed species in Iraq; among them, the species of Chlaenius hamifer Chaudoir, 1856 was recorded for the first time in Iraq.
Diagnostic characters, a redescription of some of the morphological features, photographs and illustrations are provided for the new record species in this investigation.
Until today, one of the leading predominant infections is Urinary tract infection (UTI). It exerts a huge burden on health systems worldwide each year. Treating UTIs empirically with antimicrobials improves morbidity rates. This study aims to assess the prevalence of UTI-associated bacteria in adult patients and to determine their antibiotic susceptibility profile. A retrospective study was conducted for adult outpatients who visited Al-Diwaniya tertiary hospitals from January 2020 till February 2022 to review their medical and lab records in addition to sociodemographic data. A total of 256 patients’ records were included of which 204 (79.7%) belong to females and 52 (20.3%) were males with an average age of 39.22±17.10 years. The pr
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