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 question about the existence of correlation between the parameters A and m of the Paris function is re-examined theoretically for brittle material such as alumina ceramic (Al2O3) with different grain size. Investigation about existence of the exponential function which fit a good approximation to the majority of experimental data of crack velocity versus stress intensity factor diagram. The rate theory of crack growth was applied for data of alumina ceramics samples in region I and making use of the values of the exponential function parameters the crack growth rate theory parameters were estimated.
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 MoreThe relationship between blood group antigens and peptic ulcer disease has been widely evaluated in the past, but only one study relating H pylori seroprevalence to ABO blood groups among Iraqi patients with peptic ulcer disease is available. We aimed to evaluate the frequency of peptic ulcer disease among different ABO blood groups in Iraqi patients, and we thought it was worthwhile to try to determine whether these components take some part in disease etiology. One hundred and six patients with peptic ulcer disease (PUD) (43 male and 63 female; mean age: 48 ± 18 years) who attended Baghdad teaching hospital and Al- Yarmouk teaching hospital endoscopy centers were enrolled , and 238 control Subjects. Fing
... Show MoreAlopecia areata is a common disorder, hypothesized to be autoimmune in etiology. Cortisone taken orally may stimulate new hair growth. Prednisone (orally administered steroid (has proved effective for patients with alopecia areata, but its potential side effects include weight gain, metabolic abnormalities, acne and menstrual problems.
This clinical study was designed to assess the clinical significance of the nutrient antioxidants (vitamin A, vitamin E and vitamin C) in reducing the dose of corticosteroids (prednisolone), and as a consequence, their side effects in patient with alopecia. The results of this study reveal the potential clinical significance of the therapy for two months with these antioxidants in reducing the dose
... Show MoreBackground: Understanding the morphological characteristics between the floor of the maxillary sinus and the tips of the maxillary posterior roots is crucial in orthodontics involving diagnosis and treatment planning. The aim of this study was to evaluate the distances from the maxillary posterior root apices to the inferior wall of the maxillary sinus, thickness and density of maxillary sinus floor using cone-beam computed tomography images and the relationships between roots and maxillary sinus according to gonial angle and skeletal pattern. Materials and methods: Three-dimensional images of each root were checked, and the distances were measured along the true vertical axis from the apex of the root to the sinus floor, and the thickne
... 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
Since June 2020, an explosion in number of new COVID-19 patients has been reported in Iraq with a steady increment in new daily reported cases over the next 3 months. The limited number of PCR kits in the country and the increment in the number of new COVID-19 cases makes the role of CT scan examinations rising and becoming essential in aiding the health institutions in diagnosing and isolating infected patients and those in close contacts. This study will review the spectrum of CT pulmonary changes due to COVID-19 infection and estimate the CT severity score index and its relation to age, sex, and PCR test results
The international reporting auditor witness rapidly developed over the past years, where profession began give attention to the development of auditor reporting and improve its informational report through the issuance and amendment of some relevant international auditing standards. The reality of the situation refers to the failure to inform the auditor in Iraq in many areas, including: Clearly defined management responsibility for the preparation of financial and auditor's responsibility to express an opinion on these statements and Amendment of opinion when the financial statements as a whole is free from material misstatement based on the evidence is sufficient and appropriate audit, or not to build the auditor's ability to obt
... Show MoreA survey of haemoproteids among the eight species of Iraq rallids were carried out in the
middle, south, and west of Iraq. Two haemoproteods were recorded, Haeomproteus porzanae
(Galli-Valerio, 1907) as a new record for Iraq and the new species H. baghdadensis described
from Fulica atra L. collected in the middle of Iraq.