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
Coronavirus has affected many people around the world and caused an increase in the number of hospitalized patients and deaths. The prediction factor may help the physician to classify whether the patient needs more medical attention to decrease mortality and worsening of symptoms. We aimed to study the possible relationship between C reactive protein level and the severity of symptoms and its effect on the prognosis of the disease. And determine patients who require closer respiratory monitoring and more aggressive supportive therapies to avoid poor prognosis. The data was gathered using medical record data, the patient's medical history, and the onset of symptoms, as well as a blood sample to test the
... Show MoreRheumatoid arthritis (RA) is a systematic autoimmune disorder with chronic inflammation changes of unknown etiology. Various synovial inflammatory and proliferative alterations may contribute to the cartilaginous tissues and invasive bony tissues, leading to destructive joints and malformed bones. This disease is mostly due to infective microorganisms or genetic susceptibility causing immune system disturbances through triggering both T-cells and B-cells. Furthermore, different immune cells may secret cytokines, which are responsible for some RA pathogenesis activity. From ninety individuals, serum sample was collected; thirty of them were normal and sixty cases were patients with RA attended a privet medical clin
... Show MoreAN Adil A, F Basman M, 2009
The issue of communication and communication is receiving increasing attention in both contemporary studies and educational literature, and these studies emphasize the importance of studying communication within the classroom, which inevitably applies to the importance of relationships and tensions in the field of teaching art in particular because it is an emotional field that provides an opportunity for communication competencies and skills to be prominent and take Its wide scope, both among the students themselves and between teachers and students. The means of communication are the vessel in which the cultural relations and the commonalities between people revolve. The process of building relationships between students depends in man
... Show MoreAim of the study is to find any correlation between obesity (insulin resistance) and type I diabetes in children. Obesity and diabetes mellitus are the common health problems, and obesity is common cause of the insulin resistance. The results revealed marked increased in glucose, insulin, HbAlc and insulin resistance in obese diabetic type I patients comparing to control group they were obese and non-obese found to be within normal values for glucose, insulin, FIbAlc , and insulin resistance.
These years Qatar has emerged as an important regional destination of foreign direct investment (FDI), which demonstrates the recent success of several smaller economies in attracting FDI. This paper aims to investigate the causal relationships between inward FDI and economic growth in the particular case of Qatar featured as oil production country. Vector Autoregressive (VAR) Impulse Responses and Granger Causality Tests were adopted as major research methods. Annual data set was used covering from 1990 to 2010. The main results demonstrated the bi-directional causality and long-run relationships between FDI inflows and economic growth in Qatar. And to attract FDI inflows into Qatar, the government shall continue its efforts in const
... Show Moreسعي المجتمع العراقي منذ أكثر من نصف قرن مضى لإعادة استثمار عشرات المليارات من الدولارات من الإيرادات النفطية في القطاع الزراعي وهياكله وبنياته التحية، كإنشاء السدود والخزانات المائية واستصلاح الأراضي والمشاريع الإنتاجية الحيوانية والنباتية وبطاقات كادت تقترب او تتجاوز حاجز طلب السكان من الأغذية والمنتوجات الزراعية التي تغذي الصناعة الا ان الزيادة السكانية وتحسن مستوى الدخل النفطي شكلا انتقالا جدي
... Show MoreIn this search, a new pyrophosphate technique was proved. The technique was employed to single- nucleotide polymorphisms (SNPs), which diagnosis using a one-base extension reaction. Three Mycobacterium tuberculosis genes were chosen (Rpob, InhA, KatG) genes. Fifty-four specimens were used in this study fifty-three proved as drug-resistant specimens by The Iraqi Institute of Chest and Respiratory Diseases in Baghdad.; also one specimen was used as a negative control. The steps of this technique were by used a specific primer within each aliquot that has a short 3-OH end of the base of the target gene that was hybridized to the single-stranded DNA template. Then, the Taq polymerase enzyme and one of either α-thio-dATP, dTTP, dGTP, or dCTP
... Show MoreThe purpose of this study was to examine the association of oral administration of Carbamazepine during pregnancy and the histological changes in the ovaries of mice. Timed-pregnant mice were divided into experimental and control groups. 60 mice in the experimental group received daily oral of 15 mg/kg of carbamazepine via intragastric tube on gestational days 0 to 18. 20 mice were used as control group. They received normal saline via the same route. Dams underwent laparotomy on pregnancy days 13, 15, and 18 and the ovaries were collected. Routine histological processing of the ovaries histology of paraffin sections stained with haemotoxylin and eosin, were conducted. The ovary under the effect of the drug, there was signs of degeneration
... Show MoreThe scarcity of irrigation water requires procedures of specific. One of these procedures is the implementation of the rationing system (a period of the irrigation followed by a period of the dry). This system can have an impact on the properties of irrigation channels. Therefore, the study of rationing system for irrigation channels is important in both water resources and civil engineering, especially if they are constructed with gypseous soil. In order to assess the rationing system on gypseous canals stabilized with a specific ratio of cement, practical experiments were conducted to detect the effect of wetting and drying cycles on the physical and hydraulic behavior of this soil and calculation of some properties of soil such a
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