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: Although mammography is a powerful screening tool in detection of early breast cancer, it is imperfect, particularly for women with dense breast, which have a higher risk to develop cancer and decrease the sensitivity of mammogram, Automated breast ultrasound is a recently introduced ultrasonography technique, developed with the purpose to standardize breast ultrasonography and overcome some limitations of handheld ultrasound, this study aims to evaluate the diagnostic efficacy of Automated breast ultrasound and compare it with handheld ultrasound in the detection and characterization of breast lesions in women with dense breasts. Objectives: To evaluate the diagnostic efficacy of Automated breast ultrasound and compare
... Show MorePolycystic ovary syndrome (PCOS) referring to a syndrome that is recognized as a life-course disease and has both metabolic and reproductive signs; main pathophysiological cause includes insulin resistance, hyperandrogenism, and oxidative stress state. The study aimed to assess the impact of combining Myoinositol and Metformin, the main insulin-sensitizing drugs, on improving clinical, metabolic, and hormonal parameters in females with PCOS. A clinical trial that was prospective, randomized, and comparative on 54 patients (aged 18-40 y) are divided into three groups: group1 patients allocated to receive Myo-inositol(4g), group2 patients assigned to receive Metformin(1g) and group3 patients assigned to receive Myo-inositol(4g) + Metformin
... Show MoreBackground: Although mammography is a powerful screening tool in detection of early breast cancer, it is imperfect, particularly for women with dense breast, which have a higher risk to develop cancer and decrease the sensitivity of mammogram, Automated breast ultrasound is a recently introduced ultrasonography technique, developed with the purpose to standardize breast ultrasonography and overcome some limitations of handheld ultrasound, this study aims to evaluate the diagnostic efficacy of Automated breast ultrasound and compare it with handheld ultrasound in the detection and characterization of breast lesions in women with dense breasts.
Objectives:<
... Show MoreVocational education has great importance to comprehensive national development as it provides intermediate cadres able of operating the factories and laboratories in the farms and fields beside the work in the fields of health, service, administration and commercial. Due to the importance of this type of education in society, it is necessary to do a qualitative reform of vocational education in order to make the educational staffs get the necessary basic expertise to adapt the requirements of the labor market and try to rearrange and organize the workforce through put long-term economic and social policy through certain planning open to the workforce. The workforces structure according to gradual expansion in all the national ec
... Show MoreThis study aimed at identifying the extent to which the social worker used the techniques of group discussion in the professional practice with the groups of school activity in the schools of Tubas governorate in light of some variables (gender, years of experience, academic qualification). The analytical descriptive method was used due to its suitability for the objectives of the study. A questionnaire was designed to collect data that included (30) items, distributed in three areas .The validity and reliability of the tool were verified and then distributed to the study sample.
The results of the study showed that the highest averages were in the discussion stage domain, where the pre-discussion stage was m
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Analyzing the size of the interrelationships between the main economic sectors in the Iraqi economy is an important necessity to know the impact of each sector on other economic sectors on the basis of the interrelationships and reciprocity between them, and what these relationships have achieved in terms of enhancing development and increasing the gross domestic product. To achieve the objectives of the study, we relied on mathematical (quantitative) analysis using user-product tables. Issued by the Ministry of Planning / Central Bureau of Statistics and Research (Directorate of National Accounts) for the economic sectors that make up the Iraqi economy. The study conc
... Show MoreA single step extraction-cleanup procedure using porous membrane-protected micro-solid phase extraction (μ-SPE) in conjunction with liquid chromatography–tandem mass spectrometry for the extraction and determination of aflatoxins (AFs) B1, B2, G1 and G2 from food was successfully developed. After the extraction, AFs were desorbed from the μ-SPE device by ultrasonication using acetonitrile. The optimum extraction conditions were: sorbent material, C8; sorbent mass, 20 mg; extraction time, 90 min; stirring speed, 1000 rpm; sample volume, 10 mL; desorption solvent, acetonitrile; solvent volume, 350 μL and ultrasonication period, 25 min without salt addition. Under the optimum conditions, enrichment factor of 11, 9, 9 and 10 for AFG2, AFG1
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