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: Prolapsed intervertebral disc is an important and common cause of low backache. MRI has now become universally accepted investigation for prolapsed intervertebral disc. We, however, regularly come across situations, when MRI shows diffuse disc bulges, even at multiple levels, which cannot be correlated clinically and when such cases are operated, no significant disc prolapse is found resulting in negative exploration.Objective: To evaluate the role of M.R.I. finding not only for diagnosis of disc herniation at lumbar region but also for localization the level of herniationMethods: A prospective study on seventy five symptomatic low backache and MRI confirmed prolapsed intervertebral disc patients at lumbo-sacral region were o
... Show MoreBackground: Prolapsed intervertebral disc is an important and common cause of low backache. MRI has now become universally accepted investigation for prolapsed intervertebral disc. We, however, regularly come across situations, when MRI shows diffuse disc bulges, even at multiple levels, which cannot be correlated clinically and when such cases are operated, no significant disc prolapse is found resulting in negative exploration. Objective: To evaluate the role of M.R.I. finding not only for diagnosis of disc herniation at lumbar region but also for localization the level of herniation Methods: A prospective study on seventy five symptomatic low backache and MRI confirmed prolapsed intervertebral disc patients at lumbo-sacral region were op
... Show MoreCoronary heart disease (CHD) is the leading cause of death in United State (U.S.). Controlling of modifiable risk factors such as smoking, hypertension (HT), diabetes mellitus (D.M.), dyslipidemia, physical inactivity & obesity will prevent other serious cardiovascular complications
The aim of this study was to evaluate the risk factors that influence the perforation, regardless of the presence of H. pylori infection, in a sample of Iraqi patients with peptic ulcers, admitted to Al-Kindy Teaching Hospital. A total of 90 patients who had perforated peptic ulcer participated in this study. The diagnosis was based on history, clinical examination, laboratory and radiological investigations and was confirmed intraoperatively. A number of probable risk factors for perforation were investigated. Eighty participants were males and 10 were females (male to female ratio 8:1). About 42.2% of patients were in their fifth decade of life. Forty-nine (54.4%) patients were asymptomatic be
Breast cancer is the most prevalent malignancy among women worldwide, in Iraq it ranks the first among the population and the leading cause of cancer related female mortality. This study is designed to investigate the correlations between serum and tissue markers in order to clarify their role in progression or regression breast cancer. Tumor Markers are groups of substances, mainly proteins, produced from cancer cell or from other cells in the body in response to tumor. The study was carried out from April 2018 to April 2019 with total number of 60 breast cancer women. The blood samples were collected from breast cancer women in postoperative and pretherapeutic who attended teaching oncology hospital of the medical city in Baghdad and
... Show MoreBackground: Cystatin C is recently considered to be a good predictor of cardiovascular morbidity and mortality in patients with coronary artery disease (CAD)Objectives: Correlation between cystatin and ischemic heart disease.Methods :One hundred forty patients (140) with ischemic heart disease admitted to thin study at Baghdad teaching hospital from the period June. 2011 to Jan. 2012. Those patients was categorized into three groups.Group (A): patients with ischemic heart failure.Group (B): Patients with myocardial infarction.Group (C) patients with unstable angina.All these groups were in comparison to fifty (50) healthy controls. Fasting serum citation (C) were measured in all patients and control in addition to all other routine inves
... Show MoreBackground: Ischemic heart disease is a major cause of the diastolic heart failure. Risk of heart failures was increased with microvascular coronary disease, which is characterized by left ventricular stiffness with impaired relaxation and reduced compliance. Aim of this study is to estimate the effect of the severity of myocardium ischemia on the left ventricle ejection fraction and left ventricular volume using SPECT with 99mTc MIBI and to compare the results with the echocardiography. The study included 117 subjects with ischemic heart disease were examined using SPECT and echocardiography techniques. The following
... Show MoreThis study was performed to assess the correlation of serum interleukins (ILs) levels with anthropometric data and lipid profile status in blood samples obtained from 100 Iraqi obese women with polycystic ovary syndrome PCOS. Obese non PCOS healthy women (n=75) matching in age (19-38 years) and body mass index(29.9-33.4kg/m2) served as a control group. The samples were collected from Kamal Al-Samurai Teaching hospital during the period of December 2017- June 2018.ELISA kits were used to measure serum levels of IL-6,IL-10,IL-18, IL-29,IL-33,tumor necrotic factor (TNF-α),high sensitive C-reactive protein (hsCRP), insulin, total testosterone, and sex hormone binding globulin(SHBG).The biochemical measure
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