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.
The advertisement is important in maximizing the resources of journalistic institutions. It helps them to perform their duties and also establishes their independence. However, this type of communication has often overlapped with other types of communication, including media and publicity.
Those in charge of the press bear responsibility in this regard, as some of them harness the advertisement for personal purposes; or detrimental to media content. Many communication authorities have drawn attention to the danger of confusing the concepts and levels of the three activities and have moved towards establishing rules to reduce overlap between them.
The aim of this research is to try to disengage the concept of advertising,
... Show MoreBackground. Aneurysms of the distal anterior cerebral artery (DACA) are uncommon; they often form near the pericallosal-callosomarginal junction and are typically small. To our knowledge, giant DACA aneurysms developing from the more distant parts of the anterior cerebral artery (ACA), A4-5, have been described only once in the literature. Case description. A 66-year-old gentleman reported with a brief loss of consciousness followed by weakness in his right lower leg. The patient was admitted with a Glasgow Coma Score (GCS) of 15. A computed tomography (CT) scan of the head revealed a left hyperdense mass in the frontal parasagittal supracallosal region. Contrast MRI revealed a heterogeneously enhancing mass measuring 35x30x25 mm. C
... Show MoreBackground: This study evaluated the influence of different fiber formulations incorporation in resin composite on cuspal deflection (CD) of endodontically-treated teeth with mesio-occluso-distal (MOD) cavities. Materials and Methods: Thirty-two freshly extracted maxillary premolar teeth received MOD cavity preparation followed by endodontic treatment using single cone obturation technique, and divided into: Group I: direct composite resin only using a centripetal technique, Group II: direct composite resin with short fiber-reinforced composite (everX Flow), Group III: direct composite resin with leno wave ultra-high molecular weight polyethylene (LWUHMWPE) fibers placed on the cavity floor, and Group IV: direct composite resin with LWUHMWP
... Show MoreBackground. Dental implantation has become a standard procedure with high success rates, relying on achieving osseointegration between the implant surface and surrounding bone tissue. Polyether ether ketone (PEEK) is a promising alternative to traditional dental implant materials like titanium, but its osseointegration capabilities are limited due to its hydrophobic nature and reduced surface roughness. Objective. The aim of the study is to increase the surface roughness and hydrophilicity of PEEK by treating the surface with piranha solution and then coating the surface with epigallocatechin-3-gallate (EGCG) by electrospraying technique. Materials and Methods. The study includes four groups intended to investigate the effect of pir
... Show MoreThe study aimed to examine the phonological processing profile for students with and without reading disabilities in cycle 1 schools of basic education in the Governorate of Muscat, Sultanate of Oman. The study participants included 306 students, 165 students with reading disabilities and 141 students without reading disabilities. The Comprehensive Test of Phonological Processing (CTOPP) and Working Memory Test (WMT) were administered to the participants. The results of the study showed that the mean score of students without reading disabilities was higher than that of students of reading disabilities in all measures of phonological processing, and that there are statistically significant differences on the case of students in all
... Show MoreIraq within the ranks of the fledgling communities characterized by a broad base of the population pyramid, because they pose the age group (under 15 years) of a large proportion of the community, as it exceeded the proportion (40%) during the years of research extended (1986-2010) Despite the relative decline in the rates fertility during that period, but the proportion of young people remained high, especially for groups of at least five years, amounting to about 14% in 2012, a little more than the proportion of what constitutes age group (5-9 above) years, where it was (13%) and this naturally predicts continuing population increases in coming decades, due to the entry of those numbers of individuals in the reproductive stage,
... Show MoreCholesteryl ester transfer protein gene contains some single nucleotide polymorphisms, which have been associated with serum high-density lipoprotein concentration and other lipoproteins. This study is done for determining of cholesteryl ester transfer protein polymorphism and evaluate its effect on serum lipid profile concentrations in some hyperlipidemic patients compared with healthy subjects in Salah Al-din governorate-Iraq. Blood samples were taken from (90) patients suffering from hyperlipidemia, and (70) samples that were apparently healthy controls. Serum lipid concentrations were measured by enzymatic assays. The polymorphism was genotyped using polymerase chain reaction restriction fragment length polymorphism analysis.&n
... Show MoreBackground: Benign Prostate Hypertrophy(BPH)is a common urological problem worldwide which is defined as denomatous hyperplasia of the periurethralpart of prostate gland that occurs especially in men over 50 years old and that tend to obstruct urination by constriction the urethra Objectives: The study was aimed to investigate the level of Malondialdehyde (MDA), Nitric Oxide (NO) and Superoxide Dismutase (SOD) as an antioxidant, besides other factors such as the level of Lipids Profile (Total Chlosterol (TC), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C), Very Low Density Lipoprotein Cholesterol (VLDL-C), and Triglyceride (TG))in patients suffer from BPH . Methods: In this study ;clinical ,spec
... Show More