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: Multiple myeloma (MM) is characterized by clonal proliferation of malignant plasma cells within the bone marrow. In most patients, monoclonal immunoglobulin heavy chains or light chains are produced and are associated with organ dysfunction. The growth factor B-cell activating factor (BAFF) plays an important role in the pathogenesis of multiple myeloma due to its ability to promote B-cell survival, expansion, and differentiation. Objective: to measure the circulatory level of B-cell activating factor in multiple myeloma patients in relapsed and remission states and explore its possible correlations with the clinical staging, β2-microglobulin, and interleukin-6. Methods: This cross-sectional study was performed on 60
... 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
... 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: The rapidly growing knowledge regarding factors controlling tumour growth, with the new modalities of therapy acting on the biological activity of the tumours draw the attention of most cancer researches nowadays and represent a major focus for clinical oncology practice. For the detection of HER2/neu protein overexpression and gene amplification, immunohistochemistry (IHC) and in-situ hybridisation (ISH) is the recommended techniques, respectively, with high concordance between the two techniques. The current United Kingdom recommendations for HER2/neu testing are either for a two-tier system using IHC with reflex ISH testing in equivocal positive cases, or a one-tier ISH strategy. AIM: To compare the results of HER2/neu gene s
... Show MoreBackground: Recurrent laryngeal nerve injury is
an important post-thyroidectomy complication for
which different modalities of treatment were
practiced to lower its incidence.
Objectives: To estimate the incidence of
recurrent laryngeal nerve injury in thyroid surgeries
in relation to type of surgery, type of gland diseases
& nerve identification.
Methods: Different types of goiters prepared
preoperatively by indirect laryngoscopy, operated
upon with different types of surgeries, postoperative
direct laryngoscopy by the anaesthetist were done
and indirect laryngoscopy done as needed.
Results: Of of 200 patients, the overall incidence
of recurrent laryngeal nerve injury was 9
Patients (4.5%
Certain bacterial and viral infectious agents may play a role in the activation of inflammation in atherosclerosis lesions. Epidemiological studies indicate that infectious agents may predispose patients to atherosclerosis as Infections have been associated with an increased risk of this disease. Moreover, a positive antibody status has been detected against some infectious organisms associated with atherosclerotic rupture. Infectious agents found in human atheroma, which may directly cause or accelerate atherosclerosis , include many pathogens but the present study focused on Helicobacter pylori, hepatitis B virus surface antigen and C. In order to evaluate the possible association between H. pylori, HBV, and HCV infections and the risk of
... Show MoreAbstract
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 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 MoreTo determine the relationship between herpes simplex virus 1, 2 and neurological disorders, sixty samples from patients with neurological diseases were collected (40 patients with Multiple sclerosis and 20 patients with Parkinson’s disease) all of whom attended both the Neurological science Hospital as well as the Neuropathology consultation Department in Baghdad Hospital In Iraq. The samples were collected in the time frame between November 2017 and April 2018. The ages of the patients that were investigated were between (17-76) years and compared to a control group consisting of 25 samples collected from apparently healthy individuals. All the studied groups were subjected to the measurement of anti-HSV 1, 2 IgG antibodies by the means
... Show MoreObjective: To compare the radiological and functional outcomes of patients of Comminuted intraarticular distal radius fractures treated with or without bone marrow injection along with external fixator ligamentotaxis. Methodology: This prospective comparative study on 41 patients with comminuted intra-articular lower end radius fractures distributed patients randomly into two groups depending on whether an aspirate of bone marrow was injected at the fracture site two weeks after fracture management with external fixation ligamentotaxis. Results: The mean age was 35.8 years, with male predominance. The radiological parameters (radial height, radial inclination, and volar tilt) at the 6th month follow up were lower in the group who did not re
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