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.
Abstract A description study was carried through out the present study aimed to assess health education provided by nurses to patient with gall stone "obstructive jaundice". The study was conducted at 4 teaching hospital, Baghdad teaching hospital, Al-Karama teaching hospital, Al-Yarmook teaching hospital, Al-Kendy teaching hospital where choloecystectomy was performed, in the period from first of June 2004 to end of July 2004. Data were collected through the use of questionnaire an interview from which was developed for the purpose of the present study. A non-probability (purposive) sample which was consist
Abstract
Objective(s): A descriptive study aimed to determine nurses' knowledge about chest physiotherapy techniques for patients with Corona virus disease and observe the relationship between nurses' knowledge and their socio-demographic characteristics.
Methodology: The study was directed in isolation units of Al- Hussein teaching hospitals in Thi-Qar, Iraq for the period from June 1st, 2022 to November 27th, 2022. Non- probability (purposively) sample comprised 41 nurses. A questionnaire was used for data collection and it consists of two parts: the first part comprises socio demographic features, the second part includes self- administered questionnaire sheet wa
... Show MoreObjective(s): To determine the impact of health education program toward their end-stage renal failure (ESRF)
patients’ knowledge through a follow-up approach each two months post program implementation for six months.
Methodology: "Follow-up" longitudinal design by using time series approach of data analysis and the application of
pre-post tests approach for the study group and the control group. The study is conducted in Al-Shahid Ghazi Hariri
Teaching Hospital for Surgical Specialties/Centre for Disease and Renal Transplant, and Al-Khayal private Hospital for
renal disease and transplantation during the period from August, 29th
, 2010 through February, 28th
, 2011. To achieve
the objectives of the study, purp
Uropathogenic specific protein is a genotoxic protein targeting the DNA, leading to mutations and modifications in the normal cell's DNA and subsequently, cancer development. This study aims to determine the prevalence of the usp gene in Uropathogenic Escherichia coli isolated from females with urinary tract infections and study its correlation with biofilm formation. One hundred and five urine specimens were collected from female patients (20 to 55 years old) with urinary tract infections attending hospitals. Traditional laboratory methods using selective and differential culture media were used for initial bacterial isolation and identification, and molecular techniques that targeted a segment of the 16SrRNA gene with a specific primer pa
... Show MoreBackground: Diabetes mellitus is a major risk factor for chronic periodontitis (CP) and hyperglycemia has an important role in the enhancement of the severity of the periodontitis. It has been reported that the progression of CP causes shifting of the balance between bone formation and resorption toward osteoclastic resorption, and this will lead to the release of collagenous bone breakdown products into the local tissues and the systemic circulation. Cross-linked N-telopeptide of type I collagen (NTx) is the amino-terminal peptides of type I collagen which is released during the process of bone resorption. This study was conducted to determine the effects of nonsurgical periodontal therapy on serum level of NTx in type 2 diabetic patients
... Show MoreThrough an experimental program of eighteen specimens presented in this paper, the bond strength between reinforcing bar and rubberized concrete was produced by adding waste tire rubber instead of natural aggregate. The fine and coarse aggregate was replaced in 0%, 25%, and 50% with the small pieces of a waste tire. Natural aggregate replacement ratio, rebar size, embedded rebar length, the rebar yield stress of rebar, cover, and concrete compressive strength were studied in this investigation. Ultimate bond stress, bond stress-slip response, and failure modes were presented. The experimental results reported that a reduction of 19% in bond strength was noticed in 50% replaced rubberized concrete compared with convention
... Show MoreThe Legend between reality and its future Treatment in threatre analytics study
The security environment for Northeast Asia is extremely important, as it includes most of the international actors (United States of America, China, Russian Federation and Japan), which gives the nature of the interactions of these forces a special importance for the region.
Because of the multiplicity of policies and interests of the active forces in the region, the result has been an unstable regional environment where the interests of the major powers often clash repeatedly on many related issues, which is coupled with the growing efforts of many powers to adopt policies that differ from what they did in the past This resulted in different patterns of relations, which were mainly characterized by competition over regional lea
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