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.
Thyroid hormones, triiodothyronine (T3) and thyroxin (T4) play an important role in growth, development, and physiology of the kidney. The kidney has a central role in metabolism and clearance of these hormones as well as thyroid – stimulating hormone (TSH). Chronic renal failure (CRF) is a state of irreversible deceleration in renal function results in alterations in internal milieu, which affects the synthesis and secretory rate of hormones. To evaluate the thyroid hormone levels in non-dialyzed patients with chronic renal failure (CRF); 24 patients with CRF aged 30-70 years, mean±S.d. (48.458 ± 13.569) and 48 healthy volunteers who served as controls aged 30-70 years (43.104 ± 12.387) were studied for their thyroid function status u
... Show MoreABSTRACT: BACKGROUND: Left ventricular hypertrophy is a significant risk factor for cardiovascular complications such as ischemic heart disease, heart failure, sudden death, atrial fibrillation, and stroke. A proper non-expensive tool is required for detection of this pathology. Different electrocardiographic (ECG) criteria were investigated; however, the results were conflicting regarding the accuracy of these criteria. OBJECTIVE: To assess the accuracy of three electrocardiographic criteria in diagnosis of left ventricular hypertrophy in adult patients with hypertension using echocardiography as a reference test. PATIENTS AND METHODS: This is a hospital-based cross sectional observational study which included 340 adult patients with a his
... Show MoreIn this research the Empirical Bayes method is used to Estimate the affiliation parameter in the clinical trials and then we compare this with the Moment Estimates for this parameter using Monte Carlo stimulation , we assumed that the distribution of the observation is binomial distribution while the distribution with the unknown random parameters is beta distribution ,finally we conclude that the Empirical bayes method for the random affiliation parameter is efficient using Mean Squares Error (MSE) and for different Sample size .
MK Al-Janabi, NA Nasir, RK Jaber, AO Oleiwe, Iraqi Postgraduate Medical Journal, 2018 - Cited by 7
Objectives: To determine the contributing risk factors to adult nephrolithiasis patients.
Methodology: A descriptive study was conducted to determine the contributing risk factors to
Adults nephrolithiasis starting from December 2007 to September 2008. A purposive "nonprobability"
sample of (100) patients with nephrolithiasis was selected of those who were
admitted to the hospitals, attending the Urology Consultation Clinic and Extracorporeal Shock
Wave Lithotripsy Department. The study instrument consists of two parts. The first part is
related to the patients' demographic variables and the second part is constructed to serve the
purpose of the study. The total number of items in the questionnaire was (85) ones.
Background. 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 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 MoreAbstract
The common types of movement disorders are ; dystonia which is a syndrome of repetitive muscle contractions. While , Huntington disease is autosomal dominant progressive neurodegenerative disorder, which is characterized by involuntary movements (“chorea”).
Tetrabenazine therapy has been shown to effectively control this movements compared with placebo.
Design the proper dosing approach for patients treated with tetrabenazine with genotype polymorphisms and their hepatic effect on patients.
A prospective case controlled study was carried on 50 patients whom divided into 2 groups :first group involved 25 patients who had cho
... Show MoreEnvironmental factors that damage plant cells by dehydrating them, such cold, drought, and high salinity, are the most common environmental stresses that have an impact on plant growth, development, and productivity in cultivated regions around the world. Several types of plants have several drought, salinity, and cold inducible genes that make them tolerant to environmental challenges. The purpose of this study was to investigate several species in
Coronavirus disease 2019 (COVID-19) is a flu-like infection caused by a novel virus known as Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). After the widespread around the world, it was announced by the World Health Organization (WHO) as a global pandemic. The symptoms of COVID-19 may arise within 2 weeks and the severity ranged from mild with signs of respiratory infection to severe cases of organ failure and even death. Management of COVID-19 patients includes supportive treatment and pharmacological medications expected to be effective with no definitive cure of the disease. The aims of this study are highlighting the management protocol and supportive therapy especially vitamin D and manifesting the clinical symptoms b
... Show More