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: Several studies suggested that skeletal system is adversely affected by diabetes and is associated with increased risk of osteoporosis and fragility fractures
Objectives: The study was a case-control study that designed to assess the level of bone turnover markers (BTMs) among patients with type 2 diabetes mellitus (T2DM) and to investigate the effect of body weight and diabetic control on the level of bone turnover
Type of the study: Cross- sectional study.
Methods: The present study included 100 postmenopausal women with type 2 diabetes mellitus. Sixty-six non-diabetic postmenopausal women were enrolled as a control. Fasting b
... Show MoreSurvival analysis is one of the types of data analysis that describes the time period until the occurrence of an event of interest such as death or other events of importance in determining what will happen to the phenomenon studied. There may be more than one endpoint for the event, in which case it is called Competing risks. The purpose of this research is to apply the dynamic approach in the analysis of discrete survival time in order to estimate the effect of covariates over time, as well as modeling the nonlinear relationship between the covariates and the discrete hazard function through the use of the multinomial logistic model and the multivariate Cox model. For the purpose of conducting the estimation process for both the discrete
... Show MoreBackground: Rheumatoid arthritis is a chronic destructive inflammatory disease associated with destruction of joint connective tissues and bones, affecting 0.5%–1% of the population worldwide reporting higher prevalence of periodontitis among rheumatoid arthritis patients. The purpose of this study is to estimate level of salivary C-reactive protein in relation to the occurrence and severity of the periodontal disease and other oral parameters among group of patients with rheumatoid arthritis Material and methods: Fifty women patients with rheumatoid arthritis; twenty five on Methotrexate treatment and twenty five on combination treatment of Methotrexate and Etanercept selected as study groups with an age range (30-40) years old and
... Show MoreThe aim of this study was investigating the correlation between elevation of Prolactin levels and the increase of the concentrations of total sialic acids. The study was performed on 149 women consisted of 93 infertile hyperprolactinimic women (patients), age ranged16-38 years old, and 56 normoprolactinemic women as a control group, 18-37 years old. Serum prolactin (PRL) and gonadotroph hormones (Follicle stimulating hormone FSH and Luteinizing hormone LH) were measured using enzymatic immunoassay (EIA) method, resorcinol method for serum total sialic acids (SIA). Patients were divided into four groups, each group represented the level of prolactin of infertile women as follow: G1= (21-30), G2= (31-40), G3= (41-50), and G4= (51-60) ng/mL. S
... Show MoreReflect the sustainable development of the interaction of three key elements are the economic component and the social component and the environmental component while focusing economic component to achieve economic growth and focuses social element to achieve social justice in the distribution of income and achieve prosperity, the environmental component related fields and including emphasizes the protection of the environment and to ensure the continuation and sustainability of resources physical, biological and form in which it believes the interaction required for development process real and effective and sustainable, and is considered the province of Kurdistan Iraq of important areas where the movement of developmental mount
... Show MoreThe aim of the research is to find out the nature of the relationship between the interrelationships and the interrelationships between risk management strategies (avoiding danger, risk exposure, risk exhibition, preventive programs and activities to reduce risks) and the dangers of container transportation, as an independent variable in the dangers of container transportation as a dependent variable, the study started from the problem that the company suffers from The practical aspect of the study was applied at the National Insurance Corporation, and the researcher designed a diagram according to the study's schematic diagram. The study, and for the purpose of data and information related to that, it relied on the descriptive a
... Show MoreBackground: Dialysis is in common use to treat patients
with end stage renal failure .However longstanding dialysis
harboring some cellular changes in various body fluids.
This study was conducted in order to detect these changes
in urine.
Objective: The study was conducted to detect cellular
changes in urine of patients with longstanding dialysis.
Method: Fifty-three urine samples were examined
cytologically obtained from patients with longstanding
dialysis during 6 months period. Freshly voided midstream
urine samples were taken . Samples were centrifuged and 2
to 3 drops of sediments were smeared on 2 glass slides and
fixed in 95% ethyl alcohol then stained with Hand E stain
to be evaluated.
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