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:
The research seeks to identify the role of the International Assurance Standard (3402) in the auditor's procedures, as the importance of the research stems from providing assurance services for control tools through reports that are prepared according to this standard, which contribute to strengthening audit procedures through a proposed assurance program. Many conclusions were reached, the most important of which The assurance operations are considered among the operations with a special assignme
... Show MoreTHE ROLE OF ELECTRONIC-PAYMENT SERVICE PROVIDERS IN THE DEVELOPMENT OF E-BANKING IN IRAQ - AN APPLIED RESEARCH IN CENTRAL BANK OF IRAQ
rhabditid Mesorhabditis franseni Fuchs, 1933 (Family, Mesorhabditidae) and pratylenchid nematode Pratylenchus goodeyi Sher and Allen, 1953 (Family, Pratylenchidae). They were illustrated by molecular aspects. All specimens of both genera were cultured and reproduced for DNA extraction. M. franseni (IRQ.ZAh2 PP528819.1 isolate) was characterized. P. goodeyi (IRQ.ZAh5 PP535537 isolate) was also characterized. Selected specimens of these two species were molecularly characterized using the partial ITS-rRNA gene sequences. The ITS-rRNA sequence of IRQ.ZAh2 PP528819.1 isolate had a range of (98.62%-100%) sequence homology with ITS-rRNA sequence of M. franseni available in NCBI database. While, the ITS-rRNA sequence of IRQ.ZAh5 PP535537 isolate h
... Show MoreTo evaluate impact the difference in stages ofage and related incidence of hemodialysis patients.Two hundred and fifty patients undergoing hemodialysis were collected from general hospital in Baghdad city /Iraq. The samples with renal failure before hemodialysis were divided into (138) male,( 112)female. The sera were separated from samples to physiological investigation. We found that renal failure was more predominant among the patients ages group ranging from (51-70) years old. The results shows A significant increase in the levels of urea, creatinine, in younger patients (≤ 30 years) when compared with older patients (>70 years). Furthermore a significant decrease in serum levels of total protein in patients in older patients (>7
... Show MoreHyperthyroidism or thyrotoxicosis occurs due to excess release of thyroid hormone. These hormones regulate the body’s energy balance and have effects on adipokine level. There are several reports suggesting interrelation between adipokines (resistin and leptin) with thyroid dysfunction. Objectives: This study was established to investigate the effect of thyroid hormones in hyperthyroidism state on the level of some adipokines, leptin and resistin; in comparison with control. Patients and Methods: The present study included 50 Iraqi female patients with hyperthyroidism with age ranged between 30-58 years and 30 healthy controls with age ranged between 30-53 years. Serum samples were collected from study groups. The levels of thyroid hormon
... Show MoreThe present study was aimed to find out the role of humoral immunity in the pathogenesis of psoriasis. Complements C3, C4 and immunoglobulin IgE .The study included 55 Iraqi patients with psoriasis 30 (15 females ,15 males) were untreated with any drugs. The other patient group consisted of 25 (9 female and 16 male) treated with a biological treatment (infliximab) ,and 30 (13 males ,12 females) healthy control group. Blood sample were withdrawn (5) ml of venous blood for both patients and members of the control ,to conduct the Immunological tests to determine the quantitative for each of total IgE by using (ELISA) and C3,C4 by Single Radial Immunodiffuse (SIRD). The results showed significant increase in the level of probability (P <0.0
... Show MoreThe study aimed to investigate the role of Dectin-1 and Card-9 in pathogenicity of inflammatory bowel disease (IBD). This investigations involved 150 blood samples for IBD patients which divided in to two groups (50 for crohns disease CD (G2) and 50 for ulcerative colitis UC (G3)). All a apparently (male and female) attended to) Al-Kindy hospital) in Baghdad city, department of Gastroenterology. and all of thin were diagnosis by consulters medical staff and pathologists with age range 15-65years average 40 years. in addition to 50 blood samples were collected from apparently healthy individuals as control group (G1). 10 ml were withdrawn from all participants, 5ml for the immunological study which carried by ELISA technique and 5 ml used fo
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