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: the coronavirus leads to upper respiratory tract-associated manifestations like nasal congestion, sore throat, and smell disorder
Objectives: To reveal the impact of COVID-19 pandemic on otolaryngology symptoms using our daily medical practice.
Subject and Methods: A cross-sectional study that was carried on in the isolation wards at Al-Kindy and Al-Nu’man Teaching Hospitals during three months from the 1st of Jun. till the end of Aug. 2020. It included 1270 patients who were diagnosed with COVID-19 infection seen in the ENT consultation clinic and admitted to the isolation wards.
Results: Otolaryngological manifestations were shown
... Show MoreBackground: The estimation of ferritin and related variables by complete serum iron profile, for Iraqi hashimoto’s patients to see the effect of thyroid hormone insufficiency, which may lead to deficiency of ferritin iron stores, this may be quite useful during the diagnosis and treatment of hashimoto’s patients. Patients and Method: The study was performed at National Center of Teaching laboratories of Medical city institute in Baghdad. Fifty newly diagnosed patients with hashimoto’s and forty apparently healthy controls. Diagnosis based on thyroid profile analysis including:Thyroid Stimulating Hormone (TSH), Thyroxine (totalT4) and Triiodothyronine (total T3), estimation of antibodies against thyroperoxidase, iron profile including:
... Show MoreAbstract:
Objectives: This study aims to (1) find out the association between patients' age, years of getting the disease, and their spiritual coping ability, and (2) investigate the differences in illness perception and spiritual coping ability between gender groups, level of education groups, monthly income groups, residence groups and satisfaction with health services groups.
Methodology
A descriptive correlational design is used in this study. The study sample includes a convenience sample of (158) patients with chronic kidney failure.
The study instrument consists of two parts; the first one focuses on participants’ sociodemographic characteristics, and the second part deals with participants’ spiritual coping by us
Abstract
Sovereign wealth funds are an important tool for achieving economic stability and avoiding the local economy from external shocks, including the shocks of international oil prices. The spread of these funds is the result of large current account surpluses in many Asian and oil-exporting economies. These surpluses are due to higher commodity prices Has led to a rapid accumulation of foreign assets in central banks. Many countries with rent economies face the problem of their dependence on non-renewable natural resources, especially the oil countries, including Iraq. Oil revenues are more than 97% of oil exports, so they suffer from structural imbal
... Show MoreEach Intensity Modulated Radiation Therapy (IMRT) plan needs to be tested and verified before any treatment to check its quality. Octavius 4D-1500 phantom detector is a modern and qualified device for quality assurance procedure. This study aims to compare the common dosimetric criteria 3%/3 mm with 2%/2 mm for H&N plans for the IMRT technique. Twenty-five patients with head and neck (H&N) tumor were with 6MV x-ray photon beam using Monaco 5.1 treatment planning software and exported to Elekta synergy linear accelerator then tested for pretreatment verification study using Octavius 4D-1500 phantom detector. The difference between planned and measured dose were assessed by using local and global gamma index (GI) analysis method at
... Show MoreThe imbalances and economic problems which it face the countries, it is a result of international economic developments or changes or global crises such as deterioration in trade, sharp changes in oil prices, increasing global indebtedness, sharp changes in foreign exchange rates and other changes, all that, they affect the economic features of any country. and These influences vary from one country to another according to the rigidity of its economy and its potential in maneuvering with economic plans and actions that would reduce the impact or avoidance with minimal damage. Therefore, the countries that suffer from accumulated economic problems as a result of mismanagement and poor planning or suffe
... Show MoreBackground: EBV infection in tissue micro-environment is challenged by the precisely regulated survivaland apoptosis mechanisms. Abnormal bcl-2 proto-oncogene expression in colonic carcinomas allowsaccumulation and propagation of these genetically altered cells.Objective: To analyze the relevant concordance of BCL-2 gene , EBNA1 s and LMP-1-EBV expression inissues from a group of Iraqi patients with colonic adenocarcinomas.Patients and Methods: One hundred (100) tissue biopsies, belonged to (40) patients with colorectalcancers, (40) patients with benign colon tumors, and (20) apparently normal colorectal control tissues,were enrolled in this study. The detection of EBNA1 s and LMP-1-EBV as well as BCL-2 was done byimmunohistochemist
... Show MoreThe study aims detection teaching modalities adopted relationship in Jerash University exactly the classroom, and to achieve the goal of the study was to develop a questionnaire consisting of (39) items, and was achieving validity and reliability have, then sent to a sample of professors made up the university from (122) university professor of the total (172) professor, and they study population.
Study found a relationship between the teaching methods of the four their strategies with classroom management, and as a result the overall average level, while Hspt critical thinking at the highest correlation with classroom discipline management relationship strategy, while the relatio
... Show MoreImage quality has been estimated and predicted using the signal to noise ratio (SNR). The purpose of this study is to investigate the relationships between body mass index (BMI) and SNR measurements in PET imaging using patient studies with liver cancer. Three groups of 59 patients (24 males and 35 females) were divided according to BMI. After intravenous injection of 0.1 mCi of 18F-FDG per kilogram of body weight, PET emission scans were acquired for (1, 1.5, and 3) min/bed position according to the weight of patient. Because liver is an organ of homogenous metabolism, five region of interest (ROI) were made at the same location, five successive slices of the PET/CT scans to determine the mean uptake (signal) values and its standard deviat
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