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: Invasion in oral cancer involves alterations in cell-cell and cell-matrix interactions that accompanied by loss of cell adhesion. Catenins stabilize cellular adherence junctions by binding to E-cadherin, which further mediates cell-cell adhesion and regulates proliferation and differentiation of epithelial cells. The Wnt/β-catenin pathway is one of the major signaling pathways in cell proliferation, oncogenesis, and epithelial-mesenchymal transition. Aims of the study: to detect immunohistochemical distribution pattern and different subcellular localization of β-catenin in oral squamous cell carcinoma and relate such expression to Bryne’s invasive grading system. Materials and Methods: This study included 30 paraffi
... Show MoreThis research aims to examine the relationship between hydrothermal alteration and mineralization (ore mineralogy) in the study area and geological structures in the deformation mechanism. The hydrothermal alteration was determined based on petrographic analysis, and ore mineralogy which was determined based on the ore microscopic analysis. The deformation mechanism is determined by paleo stress analysis using win-tensor, and the direction of principal stress on joints/veins and faults is calculated by the right-dihedron method. Hydrothermal alteration includes silicification, argillic, propylitic, and phyllic alterations; and ore mineralogy consists of stibnite, cinnabar, pyrite, chalcopyrite, sphalerite, covellite, hematite, and a
... Show MoreObjectives: To determine the effectiveness of post-abortion family planning counseling program on nurses and midwives' practices and to predict the variables which may effect on their practices Methodology: A quasi experimental study was conducted from 23th April 2017 to 14th March 2018 in three governorates in Middle Euphrates of Iraq: (Holy Karbala, Al - Najef Al Ashraf and Babylon) on nurses and midwives who work at maternity hospitals. Systematic random sampling was used to select 122 nurses and midwives, (60) of them for study group and (62) for control group. A checklist is an instrument that evaluate the practices which included 50 items. Validity of content was determined through reviewing it by (16) experts and reliability of to
... Show MoreAlthough many technological improvements are occurring in power production worldwide, power plants in third world countries are still using old technologies that are causing thermal pollution to the water bodies. Power facilities that dump hot water into water bodies are damaging aquatic life. In the study, the impact of the Al Dora thermal power plant on a nearby stretch of Tigris River in Baghdad city was assessed by measuring the temperature of the disposed of hot water in various cross-sections of the selected stretch of Tigris River, including measuring the thermal mixing length. The measurements were conducted in winter, spring, and summer. For field measurements, it was found that the impact of recovery distances
... Show MoreField experiment was conducted to test the effect of saline water and fertilizers rate on Pisum sativum L. plants . Treatments of the experiment included two levels of water salinity (2, 7 dSm-1) as a main plot and three levels of potash fertilization K2SO4 (44%K) namely 150 control, 300 and 450 kg/Donum as a sub plot. Results indicated that irrigation of plant with saline water 7 dSm-¹ caused a significant decrease in K and P contents specially in the upper parts of the plants , the percentage of the K increased (2.80%) under 2 dSm-¹of irrigation water and 300 kg/ donum fertilizer rate in the upper leaves, However K decreased(1.10%) in lower leaves under 7 dSm-¹ and 300 kg/donum fertilizer. while P increased in pods und
... Show MoreBackground: Lowering the amount of iodinated contrast material and tube voltage may increase pulmonary artery opacification and thrombus identification without compromising picture quality.
Objectives: To explore the efficiency of using lower tube voltage and a lower contrast medium dose for conducting computed tomography for pulmonary angiography (CTPA) aiming to increase its accuracy in detecting pulmonary thromboembolism (PTE).
Subjects and Methods:100 patients scheduled for CTPA with a preoperative diagnosis of PTE were grouped into two: group A, (50 patients) got 1 mL/kg at 120 kV and group B, (50 patients) received 0.5 mL/kg at 80 kV.The tec
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