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: psychiatric and behavioral side effects
are common in patients with epilepsy and it may
represent an intrinsic feature of the disease itself or a
side effect of the antiepileptic use. Our aim in the
present study is to assess the psychiatric side effects of
Sodium Valproate and Carbamazipine .as these drugs
are the most commonly used antiepileptic drugs in Iraq.
Methods: 80 patients with primary generalized
epilepsy on Carbamazipine and 50 patients on Sodium
Valproate were enrolled in the present study; all the
patients were assessed for any psychological
disturbances using semi-structural interview based on
the tenth edition of the international classification of
the diseases(ICD 10) ad
Objective: The present study aims to assess the stressful life events for patients with substance abuse in Baghdad city.
Methodology: A descriptive study was carried out at (Baghdad teaching hospital and Ibn-Rushed Psychiatric hospital).
Starting from 1
st of December 2012 to 3
rd of July 2013, A non-probability (purposive) sample of 64 patients that
diagnosed with substance abuse, the data were collected through the use of semi-structured interview by
questionnaire, which consists of three parts sociodemographic data, medical information, and Life events scale
consists of 49-items distributed to six domains including, family and social domain, health domain, security, legal and
criminal domain, work and school do
Background: Colonic cancer is a very common disease world-wide being fourth most common cancer characterized by abnormal proliferation of the inner wall of colon then taking full colon wall thickness then spreading to surrounding lymph nodes and tissues and finally distant metastasis. It is one of most complicated diseases with debilitating symptoms which becomes more sever , prominent and specific with advancing stage with high percent of fatality and relatively short survival if diagnosed late or if left untreated.Objective: To evaluate the efficacy of serum CEA & sAPRIL levels in the diagnosis and screening of colon cancer and their validity for this.Patients and methods: This study was applied on 35 patients with colonic can
... Show MoreObjectives: To determine the (QoL) for patients with permanent pacemaker and to find-out the relationship between
these patients’ (QoL) and their sociodemographic characteristics such as age, gender, level of education, and
occupation.
Methodology: ٨ purposive non-probability” sample of (62) patient with permanent pacemaker was involved in this
study. The developed questionnaire consists of (4) parts which include !.demographic data form, 2.disease-related
information form, 3.socioeconomic data form, and 4.Permanent pacemaker patient’s quality of life questionnaire data
form. The validity and reliability of the questionnaire were determined through the application of a pilot study. ٨
descriptive statistical a
Background: Patients with decompensated cirrhosis are often given therapeutic and prophylactic drugs. Polypharmacy raises both the likelihood of prescription errors and the complications associated with drugs. Clinical pharmacists are excellent at recognizing, addressing, and preventing clinically significant drug-related problems.
Objectives: Identification types of pharmacist interventions to address drug-related problems in patients with decompensated cirrhosis and assess the acceptance/implementation of these recommendations. And identify patient factors associated with accepting pharmacist recommend
... Show MoreBackground: Normal Left Ventricular systolic function is present in nearly 50% of patients with congestive heart failure, the majority of such patients have systemic hypertension. Recent studies have demonstrated Left Ventricular dyssynchrony among patients with heart failure and normal systolic function. The co-existence between Left Ventricular dyssynchrony and hypertension with normal systolic function (with no clinical evidence of heart failure) is less well understood.
Objective:
To assess the Left Ventricular dyssynchrony among hypertensive patients with normal systolic function by using Tissue doppler imaging.To find out the associations between the LV dyssynchrony and other global
... Show MoreBackground: Myasthenia gravis is an autoimmune disease of the neuromuscular junction that results in fluctuating muscle weakness as well as significant fatigue. Disease exacerbation is a critical condition, and the predisposing factors for it need to be identified to improve preventive measures.
Objectives: Our study aims to determine the predisposing factors for myasthenia gravis exacerbations in a group of Iraqi patients.
Subjects and Methods: A total number of 30 myasthenia gravis patients were admitted to the hospital with an exacerbation of their symptoms, determined as the development of functional disability, dysphagia, or respiratory fai
... Show MoreTo determine the seroprevalence of hepatitis B markers in chronic hepatitis B patients, 75 patients with chronic hepatitis B virus of ages (8-70) years have been investigated and compared with 50 apparently healthy individuals. All the studied groups were carried out to measure (HBsAg), (HBsAb), (HBeAg), (HBeAb), and (Total HBcAb) by Enzyme linked immunosorbent assay (ELISA) technique. The percentage distribution of HBsAg was (86.67%) and HBsAb was (1.33%) in sera of CHB patients and there were a highly significant differences (P<0.01) when compared between studied groups, while, the percentage distribution of HBeAg was (22.67%) in sera of CHB patients and the significant represent the difference in distribution of HBeAg as infection but no
... Show MoreThe objective of this study was to evaluate the alteration in levels of gonado trophins hormones i.e.,Leutizing (LH),Follicular(FSH) in sera of patients with thyroid disorders and molecular binding study of (LH ,FSH) with their antibodies The study was conducted at the specialized center for endocrinology and diabetes from January / 2009 to March / 2010.Two hundreds and twenty three Iraqi subjects, 109 patients with thyroid disorders at age range between (40-50) years and 114 healthy individuals as control group were included in this study.The majority of patients were female with hyperthyroidism and (49.54 % ) were at age range between(40 - 50) years. The levels of hormones(LH,FSH.tri iodothyronine(T3).thyroxine(T4), thy
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