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.
A simple, economical and selective method employing ion pair dispersive liquid−liquid microextraction (DLLME) coupled with spectrophotometric determination of carbamazepine (CBZ) in pharmaceutical preparations and biological samples was developed. The method is based on reduction of Mo(VI) to Mo(V) using a combination of ammonium thiocyanate and ascorbic acid in acidic medium to form a red binary Mo(V) thiocyanate complex. After addition of CBZ to the complex, extraction of the formed CBZ−Mo(V)−(SCN)6 was performed using a mixture of methylene chloride and methanol. Then, the measurement of target complex was performed at the wavelength of 470 nm. The important extraction parameters affecting the efficiency of DLLME were studied and o
... Show MoreAmputation of the upper limb significantly hinders the ability of patients to perform activities of daily living. To address this challenge, this paper introduces a novel approach that combines non-invasive methods, specifically Electroencephalography (EEG) and Electromyography (EMG) signals, with advanced machine learning techniques to recognize upper limb movements. The objective is to improve the control and functionality of prosthetic upper limbs through effective pattern recognition. The proposed methodology involves the fusion of EMG and EEG signals, which are processed using time-frequency domain feature extraction techniques. This enables the classification of seven distinct hand and wrist movements. The experiments conducte
... Show MoreBackground: The anterior knee pain is an important chief complaint of the patients with knee osteoarthritis due to patellofemoral pathology. The pain receptors denervation can be achieved by circumferential denervation of the patellar area by a process of electrocautery.
Objectives: The aim of current study is to assess the pain after total knee arthroplasty (TKA) by patelloplastywith and without circumferential denervation via electrocautery at a minimum follow up with 1 year separately for each patient.
Type of the study:Cross- sectional study.
Methods: Thirty five patients,with mean age of about (62.8) years, were enrolled in this pros
... Show MoreBackground: Nowadays there is an increasing of the emphasis on aesthetic, dentist have been concerned about providing aesthetics and functional removable partial dentures to their patients and this was make the mission more difficult because of the goal now is achieving optimal aesthetic of the denture - while maintaining retentive, stable, and conservative to the health of supporting tooth and supporting tissue. The traditional use of metal clasp like cobalt-chromium, gold, stainless-steel and titanium hampers esthetics because of its obvious display conflicts with patient’s prosthetic confidentiality. Acetal resin (poly oxy methylene) may be used as alternative denture clasp material. This material was promoted primarily on the basis of
... Show MoreBackground: Osteoarthritis is a complicated, chronic disorder of cartilage and bone, associated with homeostasis of bio-elements. The current study aims to assess the role of serum progranulin levels among Iraqi patients with knee osteoarthritis. Patients and Methods: The study encompassed 50 patients aged 52.50 ± 3.12 years (25 males and 25 females), admitted to the at the Baghdad Medical City through the period from November 2021 to March 2022. All individuals were identified by physicians in a Rheumatology and Rehabilitation Outpatient Clinic and the clinical data was collected along with the assess¬ment of biochemical parameters. Fasting serum glucose, lipid profile, calcium, magnesium, alkaline phosphatase, vitamin D3, and p
... Show MoreBackground: Various studies conducted in many parts of the world suggest that there is lack of public awareness and knowledge of various aspects related to diabetes. With proper education, awareness, earlier detection and better care, many complications and co-morbidities can be reduced in diabetic population.Objectives: to evaluate the level of awareness of diabetes mellitus type 2 patients regarding their disease and its' complications.Methods: Cross – sectional survey was conducted during November and December 2011, in the Medical centers of Al Baladiat, Mustansyria and Zuafranya, including 145 type 2 diabetic patients (58.6 % males, 41.4% females) who were subjected to self–structured questionnaires regarding different aspects of
... Show MoreABSTRACTBackground Subclinical hypothyroidism is mild thyroid hormone deficiency, defined by elevation of serum thyroid-stimulating hormone concentration despite a normal free T3, free T4 level, can be distinguished by clinical and circumstantial observations from other conditions that cause this constellation of laboratory findings. The aim is to find the prevalence, anthropologic, and metabolic changes associate subclinical hypothyroidism(SH) in adult patients presented to obesity research and therapy unit (ORTU Objective: To find the prevalence of subclinical hypothyroidism (SH) in adult obese patients presented to obesity research and therapy unit (ORTU) in AL-Kindy College of medicine and to describe the anthropologic and metabolic
... Show MoreObjectives of the study: The study aims to assess satisfy of the coronary artery patients for the care product from
the nurse and physician and to find out the relationship between patient satisfaction with the social and the
clinical characteristics of the patients.
Methodology: A descriptive design study conducted using the evaluation approach for the duration of June 3
rd
2012 to January 31, 2013. Non-probability sample of (60) patients who were visiting or admitted (inpatient or
outpatient) to the teaching hospital in Baquba with the diagnosis of coronary artery disease. A questionnaire have
been built and develop by the researcher based on review of literature and previous research, the form included of
(3) p