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 aims of study is to detect the inhibitory effect of Saccharomyces boulardii and Lactobacillus acidophilus on Escherichia coli that has been isolated from recurrent urinary tract infection in women. The sensitivity of E.coli isolates to antibiotics had been studied and the most resistant E.coli isolate to antibiotics had been studied .The cup assay was used on nutrient agar and Muller-Hinton agar to detect the inhibitory activity for each S.boulardii yeast grown on YEGP media and L.acidophilus grown on MRS media in which the result showed a high inhibition activity for each of them .Also in this study the adhesion property of E.coli had been evaluated in the presence of S.boulardii at concentration of 1×109 and L.acidophilus at conc
... Show MoreBackground: To evaluate the bony supports of the teeth adjacent to the area of cleft in patient with unilateral cleft lip and palate and to compare these measurements with the measurements of the same teeth in non-cleft side by using CBCT. Materials and methods: The CBCT scans of 30 patients having cleft lip( unilateral) and palate(unilateral), were analyzed and the measurements of the alveolar bony support for teeth that are adjacent to the cleft area were measured with those teeth located on opposite side (non- clef) side. For each tooth, the measurements will taken for the distance between the( cementoenamel junction) (CEJ) and the bony crest (AC) at the( buccal area) was measured and the thickness of the buccal plate At zero, one, tw
... Show MoreAim: To determine the expression of tissue inhibitors of metalloproteinases (TIMP-2) in oral squamous cell carcinoma (OSCC) and the difference in its expression level between positive and negative HPV-16 (human papilloma virus- 16) OSCC patients. Methods: This study was conducted on 33 biopsies obtained from patients with OSCC and 10 normal oral mucosa as controls. In situ hybridization (ISH) was used to investigate the presence of HPV-16, while immunohistochemistry (IHC) was used to estimate the expression level of TIMP-2. Results: The TIMP-2 was expressed in 27 (81.8%) of OSCC sections with no significant difference between its expression level in HPV-16 positive and HPV-16 negative OSCC cases (p=0.058). TIMP-2 was found to be hig
... Show MoreAbstract :
The Aims of this research is to describe the concept of risk, its type and method of measurement, and to clarify the impact of these risks on the expected cash flow statement and the preparation of the target cash flow statement that takes these risks into consideration. Because the local economic environment is exposed to many risks, Therefore, this list will be predictive, which will help the economic unit to make administrative decisions, especially decisions related to operational, investment and financing activities. Therefore, the research problem is based on the fact that most of the local economic units are the list of flows According to the actual basis and not according to the discretionary basis (bud
... Show MoreCore decompression is one of the commonest used techniques in the handling of osteonecrosis of the pre-collapsed head of the femur. Core decompression had succeeded in preserving the hip joint and delaying the requisite for total hip replacement, but it had failed in the induction of osteogenesis in the necrotic area, thus augmenting core decompression with biological agents to induce osteogenic activity. To assess the effects of platelet-rich plasma in non-traumatic avascular necrosis of the hip joint (early stage) after core decompression. Interventional comparative study for twenty-four patients (32 hip joints) with AVN of the head of the femur was involved in this prospective study, and they were separated into two groups of 16
... Show MoreBackground: Polymorphisms in the TNF-α gene affect the development and progression of rheumatoid arthritis. Objective: To investigate the associations between (-806 T/C) and (-857 T/C) SNPs with rheumatoid arthritis severity and susceptibility in a sample of Iraqi patients. Methods: A case-control study was conducted in Baghdad, Iraq. Twenty healthy controls and 63 patients confirmed to be newly diagnosed with rheumatoid arthritis were included. Those are divided into two groups (patients and controls), and the patients were further subdivided into severe and mild-moderate groups. Samples from those participants were analyzed for clinical and inflammatory parameter measurements. Genotyping by the Sanger method was performed to stu
... Show MoreObjective: Atorvastatin therapy is now recommended for reduction of cardiovascular risk in type 2 diabetic patients (T2DM), based on convincing evidence of reductions in mortality and vascular events in major clinical outcome trials. The aim is to evaluate the effects of atorvastatin on proinflammatory markers (TNF-α, IL-6), HbA1c andleptin in obese patients with type 2 diabetes. Methods: Sixty fivenewly diagnosed T2DM patients were randomly allocated into 2 groups; group I treated with metformin only; in group II atorvastatin was added with metformin. Twenty healthy subjects were enrolled as control group. While maintaining their usual eating habits, fasting blood samples were collected at baseline and after 12 weeks of treatment. Results
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