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.
Left bundle branch block (LBBB) is a common finding in electrocardiography, there are many causes of LBBB.
The aim of this study is to discuss the true prevalence of coronary artery disease (CAD) in patients with LBBB and associated risk factors in the form of hypertension and diabetes mellitus.
Patients with LBBB were admitted to the Iraqi heart center for cardiac disea
Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the presence Philadelphia chromosome (Ph) which was created by a reciprocal translocation between chromosomes 9 and 22 (t [9;22] [q34;q11]. The approval of the 2nd generation TKI ( Nilotinib) takes the treatment of CML patients into new erea with more efficiency and mild to moderate adverse effects. This study was aimed at evaluation of molecular cytogenetic response by (FISH) for Nilotinib in Iraqi patients with assessment for electrolytes disturbances of Nilotinb by measuring a panel of electrolyte (Na+, K+, Ca++, PO4--- and Mg++) , where thirty Iraqi patients with CML who have resistance or no response to Imatinib treatment, attending to Baghdad Teaching Ho
... Show MoreIntroduction: The association between acute stroke and
renal function is well known. The aim of this study is to
know which group of patients with acute stroke is more
likely to have undiagnosed Chronic Kidney Disease and
which risk factors are more likely to be associated with.
Methods:We studied 77 patients who were diagnosed to
have an acute stroke.Patients were selected between
April2011andJune 2011 using the " 4-variable
Modification of
Diet in Renal Disease Formula " which estimates
Glomerular Filtration Rate using four variables :serum
creatinine ,age ,race and gender.
Results :The study included 38 male and 39 females
patients ,aged (35-95) years. Glomerular Filtration Rate in
patients wi
Present investigation aimed to study plasma BNP hormone estimation as predictor of brain stroke and neurocognitive in relative with other limitations in CKD patient. The case control experimental study was conducted on CKD patient at Yarmuk Hospital at Baghdad Province, Iraq from February to April 2020. The results showed that there were significant variances (P< 0.05) between CKD patients and control group, there was significant increase in BNP hormone and cystatin-C levels at patient, while ihematological parameters were significantly decreased. The parameters of lipid profile were significantly increased (P<0.05). The result revealed that there was relationship between BNP hormone level and CKD. This support that BNP level is related wit
... Show MoreThe figure of personality modes determines its privileged style in the use of modern and advanced technological tools in the process of changing and developing in order to keep up with that. The proses of selection and choosing administrators in the appropriate places are the most important functions of senior management because it is easy to adopt factory buildings or establishments But this is a human world as that of machines world. So it is required to have people in the process of changing those who have a time, Knowledge, skill, ability and strong administrative personal skills, those people (leaders) should to put a clear vision for the selection and application of the change efforts and to create the necessary climate and
... Show MoreAbstract
Objectives: To assess patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention, and to find out the relationship between patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention
Methodology: A descriptive design was carried out at Al- Nasiriyah Heart Center in Thi-Qar Governorate for the period between May 19th, 2022 to October 25th, 2022. A non-probability sampling was used among (50) patients after their Percutaneous Coronary Intervention. The study instrument that used to collect data was composed of three parts namely: sociodemographic charac
... Show MoreMetabolic dysregulation and obesity are associated with many metabolic alterations, including impairment of insulin sensitivity and dyslipidemia. Recent studies highlight the key role of phosphatidylinositol 3,4,5-triphosphate-dependent Rac exchange proteins (PREX proteins) in the pathogenesis of obesity, advocating further elucidation of their potential therapeutic implications. The present study aimed to estimate the serum level of PREX proteins and its potential association with insulin resistance markers and plasma lipids level in obese and overweight non-diabetic patients. The study included 30 persons classified as obese, 30 as overweight, and 30 healthy individuals of similar age and gender. The levels of PREX1 and PREX2 were
... Show MoreBACKGROUND: Hepatocyte growth factor (HGF) is a proangiogenic factor that exerts different effects over stem cell survival growth, apoptosis, and adhesion. Its impact on leukemogenesis has been established by many studies. AIM: This study aimed to determine the effect of plasma HGF activity on acute myeloid leukemia (AML) patients at presentation and after remission. PATIENTS AND METHODS: This was a cross-sectional prospective study of 30 newly-diagnosed, adult, and AML patients. All patients received the 7+3 treatment protocol. Patients’ clinical data were taken at presentation, and patients were followed up for 6 months to evaluate the clinical status. Plasma HGF levels were estimated by ELISA based methods in the pa
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