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: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca
... Show MoreThe present study was set to investigate the potential association between the level of Interleukin-6 (IL-6), as a key component of the pro-inflammatory response, with different thalassemia’s biological and clinical features. For this purpose, one hundred fifty blood samples were collected from 100 beta-thalassemia patients, who attended the Genetic Hematology Centre at Ibn Al- Baladi Hospital in Baghdad, Iraq, and 50 healthy subjects who were employed as a control group. IL-6 levels were estimated using an ELISA Kit, whereas other thalassemia-related clinical features (such as HbA, HbF, ferritin, blood transfusions, splenectomy status, and the history of frequent infection) were additionally assessed. The results of the present s
... Show MoreThe main function of a power system is to supply the customer load demands as economically as possible. Risk criterion is the probability of not meeting the load. This paper presents a methodology to assess probabilistic risk criteria of Al-Qudus plant before and after expansion; as this plant consists of ten generating units presently and the Ministry Of Electricity (MOE) is intending to compact four units to it in order to improve the performance of Iraqi power system especially at Baghdad region. The assessment is calculated by a program using Matlab programming language; version 7.6. Results show that the planned risk is (0.003095) that is (35 times) less than that in the present plant risk; (0.1091); which represents respectable imp
... Show MoreThis study aimed at an analytical comparison of the Internal Auditing Standards issued by the Institute of Internal Auditors (IIA) and the Guidance Manual for Audit Units issued by the Federal Audit Bureau to show the compatibility and differences between them and the possibility of applying the IIA standards to economic units in Iraq. The guideline was generally not covered by all the internal audit units. There is a lack of keeping pace with changes in internal auditing at the international level and there is a need to strengthen the Guideline on Internal Auditing Standards II A), which is characterized by the preparation of an internal document containing the objectives, powers and responsibilities of the internal audit work as well a
... Show MoreThe most frequently diagnosed condition in women at the age of reproduction is the polycystic ovarian syndrome (PCOS).it could be related to a complex endocrine condition, due to its heterogeneity and uncertainty about its etiology, as the clinical highlights of PCOS incorporate those related to reproductive signs such as decreased frequency of ovulation, irregular menstrual cycles, decreased fertility. Carnitine plays a substantial role in weight loss, glucose tolerance, insulin function and fatty acid metabolism. Thus carnitine plays a crucial role in controlling obesity, insulin resistance, oxidative stress that are associated with PCOS .While, AGEs are a diverse group of reactive molecules that are formed end
... Show MoreFresh water resources in terms of water quality is a crucial issue worldwide. In Egypt, the Nile River is the main source of fresh water in the country and monitoring its water quality is a major task on governments and research levels. In the present case study, the physical, chemical and algal distribution in Nile River was monitored over two seasons (winter and summer) in 2019. The aims of the study were to check the seasonal variation among the different water parameters and also to check the correlations between those parameters. Water samples were collected from the Nile in Cairo governorate in EGYPT. The different physiochemical and microbiological properties in water samples were assessed. The studied parameters were included: te
... Show MoreThe aim of the research is to prepare motor sense exercises for developing motor and physiological abilities of backstroke and forward stroke service skill in badminton and investigated their effect. The research is adopted the experimental method with two groups design. The sample of the research is 8 players (13-15 years). The sample is divided into two groups of 4 players for each group. Both groups are exposed to pre and post tests, after the experimented were finished, the results are statically analyzed. The results have showed that there are positive developing abilities of motor and physiological of service skill in badminton. Finally, these prepared exercises are recommended for developing players’ abilities in badminton.
The current study is designed to achieve the goal of early detection of heart disease because it is the main risk of death. Some biomarkers were measured as well as the percentage of the effect of certain risk factors in people with myocardial infarction and heart failure. The study included 40 serum samples from people with heart disease. The effectiveness of the creatine kinase (CK-MB), as well as its temporal and albumin effects, as well as sodium ions in people with myocardial infarction and heart failure, were compared with the control group. as shown below:
-The first group consisted of 25 blood samples from people with myocardial infarction and 15 serum samples from people with heart failure. Blood
... Show MoreAge, hypertension, and diabetes can cause significant alterations in arterial structure and function, including changes in lumen diameter (LD), intimal-medial thickness (IMT), flow velocities, and arterial compliance. These are also considered risk markers of atherosclerosis and cerebrovascular disease. A difference between right and left carotid artery blood flow and IMT has been reported by some researchers, and a difference in the incidence of nonlacunar stroke has been reported between the right and left brain hemispheres. The aim of this study was to determine whether there are differences between the right and left common carotid arteries and internal carotid arteries in patient