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 study aimed to analyze the relationship between the internal public debt and the public budget deficit in Iraq during the period 2010–2020 using descriptive and analytical approaches to the data of the financial phenomenon. Furthermore, to track the development of public debt and the percentage of its contribution to the public budget of Iraq during the study period. The study showed that the origin of the debt with its benefits consumes a large proportion of oil revenues through what is deducted from these revenues to pay the principal debt with interest, which hinders the development process in the country. It has been shownthat although there was a surplus in some years of study, it was not
... Show MoreIntroduction & Aim: Long-term diabetes mellitus (DM) is known to have a deleterious impact on bone health, resulting in change in bone mineral density, bone turnover, and bone quality, all of which increase the risk of fractures. The aim of. this study was to link immunological and pro-inflammatory cytokine (I.L-6, I.L-1, and TNF-alpha) markers in patients.with type 1 diabetes to Their connection to bones formation (sPINP) and bone resorption parameters (sCTX). Materials & Methods: This study included 80 patients suffering from T1DM in the age range of 20-45 years. The patients were assayed for their biochemical (Vitamin D and HbA1c), Immunological (IL-6, IL-1 and TNF-alpha) parameters, as well as bone formation and resor
... Show MoreThe research aims to investigate the existence of a direct causal relationship between selected agricultural variables: agricultural output (as a representative of growth in the agricultural sector), agricultural terms of trade as a completely new variable in agricultural studies in recent years, agricultural labour which is an important part in the total workforce for Iraq, and finally, agricultural investment because of its importance and vital role in the production process, creating job opportunities, and then raising the level of employment, then it's role to achieving agricultural growth and development. For this purpose, the researchers used the Toda-Yamamoto causality methodology for a time series covering from 1990 to 2019. The res
... Show MoreRheumatoid arthritis is a chronic, progressive, inflammatory autoimmune disease of unidentified etiology, associated with articular, extra-articular and systemic manifestation that require long-standing treatment. Taking patient’s beliefs about the prescribed medication in consideration had been shown to be an essential factor that affects adherence of the patient in whom having positive beliefs is an essential for better adherence. The purpose of the current study was to measure beliefs about medicines among a sample of Iraqi patients with Rheumatoid arthritis and to determine possible association between this belief and some patient-certain factors. This study is a cross-sectional study carried out on 250 already diagnosed rheumatoid
... Show MoreBackground: Anti-oxidants are used as supplements to counteract the over production of free radicals in periodontal disease.Co-Q10 functions as an intercellular antioxidant by acting as a primary scavenger of free radicals (FRs) and reactive oxygen species (ROS), this study aimed to evaluate the effect of intra pocket application of perio Q gel (coenzyme Q10) alone and as adjunct to scaling and root planing on the periodontal clinical parameters in the treatment of patients with chronic periodontitis and compare the better improvement on the clinical periodontal parameters among different treatment modalities at 3 and 6 weeks. Materials and methods: A total of 323 sites with pocket depth (5-8) mm in patients with chronic periodontitis were
... Show MoreBackground: Acetabular retroversion has been proposed to contribute to the development of pain and osteoarthritis of the hip. Conventional anteroposterir (AP) pelvic radiographs may represent a reliable, easily available diagnostic modality.
Objective: To obtained a reproducible technique allowing the anterior and posterior acetabular rims to be visible for assessment
Method: This is a cross-sectional study conducted from December 2015 to March 2017 targeting patients with hip pain in orthopedic clinic of Al-Kindy teaching hospital. The study sample consisted of 100 patients with hip pain who were investigated with Antroposterior pelvic plain x-ray, which was done for all
... Show MoreChronic Kidney Disease (CKD) is a public health problem and many studies support the link between kidney dysfunction and cardiovascular events. Aldosterone has been shown for decades that a plasma aldosterone concentration is elevated in CKD. Whilst, Osteoprotegerin (OPG), after its capacity to protect bone, also osteoprotegerin is elevated in patients with chronic kidney disease (CKD), where it could predict the deterioration of kidney function, cardiovascular, vascular events and all-cause mortality. On the other hand, fibroblast growth factors (FGFs), in patients with CKD, its levels seem to increase progressively as kidney function worsens. The aim of the present study is to assess the correlations between serum osteoprotegerin
... Show MoreSARS-CoV-2 stands for severe acute respiratory syndrome coronavirus 2 which is the causative agent of spreading coronavirus disease 2019 that is known as COVID-19 pandemic, the disease leads to severe acute respiratory illness. Matrix metalloproteinases- 9 (MMP-9) plays several important physiological functions. This enzyme could also be implicated in the "cytokine storm" in some way, which may represent one of the possible scianrios during coronavirus infection, in addition to its role in the mechanism of lung fibrosis on molecular basis.. The tissue inhibitors of metalloproteinase (TIMPs) are well characterized for controlling the activity of MMPs in extracellular matrix remodeling. They also considered as signaling molecules anal
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