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.
Survival 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 MoreThe typical test for diagnosis of severe acute respiratory syndrome coronavirus 2 is a reverse transcription-polymerase chain reaction (RT-PCR) technique, but the chest CT scan might play a complementary role at the first detection of Coronavirus Disease 2019 (COVID-19) pneumonia. Objectives: To determine the sensitivity of CT scan on patients with COVID-19 in Al-Najaf, Iraq, and to compare the accuracy of CT scan with that of RT-PCR technique. Material and Method: This is a prospective study. The patients suspicious of having COVID-19 infection and respiratory symptoms were registered. All patients were diagnosed by RT-PCR and chest CT. Diagnostic performance of CT was intended using RT-PCR as the reference sta
... 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 MoreBackground: Pulpotomy is an accepted treatment for the management of cariously exposed pulps in symptom free primary molars to achieve one of the most important goals for Pedodontists, which is the retention of the pulpally involved deciduous teeth healthy until the time of normal exfoliation. The purpose of this study was to evaluate the relative success of pulpotec, formocresol and Mineral Trioxide Aggregate (MTA) in cariously exposed primary molar teeth, using clinical and radiographical examinations. Materials and methods: Thirty nine children with 45 primary molars requiring pulpotomy were selected in this study, 15 teeth treated by each type of pulpotomy medicament. Clinical and radiographical follow up for the patients was performed
... Show MoreBackground: Laparoscopic surgery for
appendicitis is now a well established and
advanced method of performing general surgical
procedures.
Objectives: To compare the outcome of
laparoscopic and open appendectomies in terms
of operative time, analgesic requirement,
postoperative complications, hospital stay, return
to normal activity and condition of scar.
Methods: This prospective study was carried
out from 1stMay 2008-1st January 2010, involving
110 patients (45 male and 65 female) with
features suggestive of acute appendicitis were
divided into 45 patients laparoscopic
appendectomy (LA) group and 65 patients open
appendectomy (OA) group, after taking informed
consent. LA was done with the
Background: Zinc is involved in a variety of
metabolic processes and it has a well known
antioxidant activity, so the measurement of its serum
level can have a special value in several diseases.
Objectives: The study is designed to determine the
serum zinc level in heart failure patients and to
compare it with that of healthy individuals and to
study the significance of the results obtained.
Methods: Atomic absorption spectrometer
technique was used to determine serum zinc level in
fifty heart failure patients and fifty healthy individuals
who were age and sex matched.
Results: The mean serum zinc level in healthy
individuals was about 45.5% greater than that of heart
failure patients. This diffe
Background: 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.
R
Background: Fibromyalgia syndrome (FMS) is the
most common rheumatic cause of diffuse pain and
multiple regional musculoskeletal pain and disability.
Objective: is to assess the contribution of serum
lipoprotein (A) in the pathogenesis of FMS patients.
Methods: One hundred twenty two FMS patients
were compared with 60 healthy control individuals
who were age and sex matched. All FMS features and
criteria are applied for patients and controls; patients
with secondary FMS were excluded. Serum
Lipoprotein (A): [Lp(A)], body mass index (BMI), &
s.lipid profile were determined for both groups.
Results: There was a statistical significant difference
between patients &controls in serum lipoprotein