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 achievement of economic and social welfare for individual is the main target to all policies that adopted by all countries worldwide either were economic, social, political or others. The obtaining of education by individuals and especially the higher education is one of the most important determinates in achieving the wellbeing and lasted economic development. This is because via the higher education new fields can be opened in front of individuals in order to get adequate jobs associated with their scientific specialization. This is allowing educated individuals gain higher income that can reduce the gap of income inequality.
Thus, this paper aims to analysis the n
... Show MoreThe objective of the research is to identify the efficiency of risk management in various names at Baghdad International Airport in the face of various risks (financial - technical - human - natural ..) facing the sample of the search of the General Establishment of Civil Aviation and the Iraqi Airways Company where the researcher identified the hypothesis that summarizes There is a significant significant correlation between risk management, risk management and risk review and assessment. The researcher used the means of research from observation and interviews with the relevant officials in this field, as well as used the questionnaire and distributed a sample of 170 employees in the field of risk management (SMS Department) in Iraqi A
... Show MoreA mounted specimen of a mustelid animal deposited in the Kurdistan Museum of Natural History, Salahaddin University, Erbil proved to be Mustela erminea (Linnaeus, 1758) and represents a new record for the mammalian fauna of Iraq. Its measurements and some biological noted are provided. Also, two passerine birds; the Red-headed bunting, Emberiza bruniceps Brandt, 1841(Family, Emberizidae) and the Variable wheatear, Oenanthe picata (Blyth, 1847) (Family, Muscicapidae) were recorded for the first time in Iraq. Furthermore, the tree frog Hyla savignyi Audouin, 1829 was found in two locations north east of Iraq with spotted dorsum and having interesting behavior in having the capabil
... Show MoreOne of the main environmental problems which affect extensively the areas in the world is soil salinity. Traditional data collection methods are neither enough for considering this important environmental problem nor accurate for soil studies. Remote sensing data could overcome most of these problems. Although satellite images are commonly used for these studies, however there are still needs to find the best calibration between the data and real situations in each specified area. Landsat satellite (TM & ETM+) images have been analyzed to study soil pollution (Exacerbation of salinity in the soil without the use of abandoned agricultural for a long time) at west of Baghdad city of Iraqi country for the years 1990, 2001 & 2007. All of the th
... Show MoreObjectives: To assess the quality of life for adult patients with peptic ulcers in the city of Sulaimani.
Methodology: A descriptive study, using the assessment approach was conducted on patients with peptic ulcer
disease from January 12th, 2009 to September 30th, 2009. A purposive "non-probability" sample of (100) paƟents
(males and females) with peptic ulcers who attended Kurdistan Center for Gastroenterology and Hepatology were
selected for the study. A questionnaire was adapted from the World Health Organization quality of life questionnaire
(1998) for the purpose of the study. It is comprised of (3) parts that included sociodemographic characteristics form,
medical history form and adult peptic ulcers patients' qu
Background: Significant numbers of patients with spinal tuberculosis (TB), especially in developing countries, still present late after disease onset with severe neurological deficits.
Objective:This study was conducted to assess the outcome of surgery in patients with tuberculosis of the spine with motor deficits.
Type of the study: Retrospective study.
Methods: We retrospectively analyzed data obtained in all the patients with severe motor deficits due to spinal TB admitted to and surgically treated in four hospitals in Baghdad/Iraq during the period from January 2012 to January 2014. History, examination, imaging, histological, postoperative, a
... Show MoreThis study included 46 patients with liver hydatid cyst diagnosed clinically and surgically, control group consist of 22 were naïve from infection had been confirmed by specialist. The patients were divided according to the size of the cysts into more and less than 5 cm diameter size, were 33 and 13 respectively. Also it divided into primary and secondary hydatid cyst infection which were 30 and 16 respectively. The role of immunological response against hydatid cyst parasite, showed a significant increased in humoral immunoglobulins (IgG, IgA, IgM and IgE) which were significantly higher in the hydatid cyst infection than control. Also significant increased in immunoglobulins in secondary infection than primary infection, beside significa
... Show MoreVisceral leishmaniasis (VL) or kala-azar is one of the worlds most neglected tropical diseases in mortality and fourth in morbidity, rK39 dipstick was used to diagnose the suspected infected patients as cheapest simple technique which can differentiate recent from chronic infection, for disease out-coming, naïve T-lymphocyte cells should be differentiated into pathogen-specific immunity responses, such as T-helper 1(Th-1) or (Th-2). HLA-G is a special protein defined as nonclassical HLA class I molecule can suppress the immune system through prevention of T-cell function by foul all T-cell mechanisms. So, this study aimed to detect and evaluate the level of sHLA-G in the sera of patients infected with VL. The results showed that there was
... Show MoreBackground: Psoriasis is a common inflammatory condition worldwide, with an average prevalence ranging from 2% to 3%. However, the incidence of psoriasis varies among different ethnic groups and regions. Elevated leptin levels have been associated with increased cellular proliferation, including T-cells. Additionally, high leptin levels may stimulate the synthesis of proinflammatory cytokines such as ILـ6 and TNFـα. Objectives: To evaluate the effect of Apremilast on Leptin in obese psoriatic patients. Subjects and Methods: Thirty patients with psoriasis were included in This prospective cohort study to measure the levels of serum Leptin by using the ELISA technique, before and after receiving Apremilast. Result: The present work
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