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.
Inflammatory response had a role in cancer progression, presence of noticeable inflammation within the tumor and its margin may play an important prognostic role in colorectal carcinoma.
Acromegaly is ametabolic disorder characterized by an acquired progressive somatic disfigurement, mainly involving the face, extremities and many other organs, that are associated with systemic manifestations, caused by excessive secretion of growth hormone and a resultant persistent elevation of insulin-like growth factor-I concentrations. In more than 90% of cases originates from a monoclonal benign pituitary adenoma. Aim of this study to assess the level of insulin-like growth factor-I (IGF-I) in saliva of acromegalic patients, and to compare it with the basal levels of serum IGF-I. Sixty specimens of serum and saliva collected from two groups of subjects (forty acromegalic patients and twenty healthy persons). The specimens were
... Show MoreBackground: Several studies linked the development of steroid-resistant nephrotic syndrome (SRNS) to genetic variations in the multidrug resistance 1 (MDR1) gene, though a disparity in findings was underlined among children with different ethnic origins. Objective: This study examined the relationship between MDR1 variants (rs2032582 and rs2032583) and the risk of developing SRNS in Iraqi patients with idiopathic nephrotic syndrome (INS). Methods: This case-control study included children with steroid-sensitive INS (SSNS; n=30) and SRNS (n=30) from the Babylon Hospital for Maternity and Pediatrics. Sanger sequencing was used to determine the participants’ genotypes. Results: The rs2032582 genotypes and alleles were not associated
... Show MoreAn experimental and numerical study has been carried out to investigate the heat transfer by natural convection and radiation in a two dimensional annulus enclosure filled with porous media (glass beads) between two horizontal concentric cylinders. The outer cylinders are of (100, 82 and70mm) outside diameters and the inner cylinder of 27 mm outside diameter with (or without) annular fins attached to it. Under steady state condition; the inner cylinder surface is maintained at a high temperature by applying a uniform heat flux and the outer cylinder surface at a low temperature inside a freezer. The experiments were carried out for an annulus filled with
glass beads at a range of modified Rayleigh number (4.9 ≤ Ra≤ 69), radiation
In this paper, the Magnetohydrodynamic (MHD) for Williamson fluid with varying temperature and concentration in an inclined channel with variable viscosity has been examined. The perturbation technique in terms of the Weissenberg number to obtain explicit forms for the velocity field has been used. All the solutions of physical parameters of the Darcy parameter , Reynolds number , Peclet number and Magnetic parameter are discussed under the different values as shown in plots.
Background: Adenoiditis is a common cause of otitis media with effusion (OME) in children & perhaps OME is one of the most common diseases leads to hearing impairment in children with subsequent impairment of speech development & learning difficulties , however, treatment remains controversial. Objectives: To evaluate if there is a significant advantage of tympanostomy tube insertion in association with adenoidectomy over adenoidectomy in association with myringotomy alone in treatment of children with OMEType of the study: This is a prospective study. Patients & methods: The study consisted from 63 children diagnosed as cases of bilateral OME & variable degrees of adenoid hypertrophy. The patients were divided randomly i
... Show MoreThe present study has been carried out to estimate heavy metals mobility, bioconcentration and transfer from polluted soil to roots tissues and from roots tissues to aerial parts using bioconcentration factor and translocation factor. Soil samples and the biomass of the eight vegetable species have been collected during summer season, 2019 from four different sites in Wadi Al-Arg, Taif Governorate, KSA. In general, heavy metals content of soil samples in site III and IV have recorded elevated values compared with those of site I and II. The soil from site IV has shown the highest concentration of Mn, Ni, Cr, Pb, Cu, and Cd amounted 31.63, 14.05, 13.56, 22.79, 31.02 and 2.98 mg/kg dry soil respectively, while the soil from site III has sh
... Show MoreWater one of the most important sources Which is no doubt essential for life surviving, water is vital in many sectors of life e.g. ( agriculture, industrial, power and so many things can’t be restricted on the mentioned items, water has become major problem facing the world today. Competition over water resources between nations has made it as a vital commodity and a justification for waging wars against its neighbor’s countries, there are currently 263 rivers that either cross or demarcate international political boundaries. Geographically, Europe has the largest number of international basins (69), followed by Africa (59), Asia (57), North America (40), and South America (38).The absolute numbers of international basins, as well as t
... 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
... Show MoreAcute decompensated heart failure (ADHF) is a leading cause of hospital admission and many factors are known to precipitate decompensation. We aimed to assess the decompensating factors of heart failure and the management of patients admitted to the emergency department (ED). A total of 107 patients were examined, all diagnosed with ADHF in the ED of the Baghdad Teaching Hospital, from June 2017 to December 2017, and presenting with decom¬pensation (pulmonary oedema, peripheral oedema, and fatigue). The mean patient age was 62.5 ± 9.8 years (range: 43–85 years); the majority of them were in their 7th decade (37.4%), and men were slightly more than women. Hy¬pertension was the most commonly associated comorbidity (68.2%), follow
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