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.
Abstract
Natural gas is characterized by features that made from it a fuel and a raw material for many industries. Deepening its position as a favorite fossil supplier between other types of fossil fuel is the efficiency, diversity of its uses, low costs and compatibility with the environment which leads to increasing of its uses then increased global demand. So, the natural gas must take its place as an important resource in Iraq and participate the oil in the economic development process of building and financing of the general budget.
Iraq is planning to continue of increasing the export capacity of raw oil to meet ambitious production targets emanating from the mai
... Show MoreNumerous physiological and biochemical changes are linked to menopause. The current study was intended to examine the transforms linked to anthropometric measurements and bone-related factors. In this study of 80 women which included; they comprised 40 premenopausal women and 40 postmenopausal women. waist circumference (WC), body mass index (BMI), hip circumference (HC), moreover waist to hip ratio are among the anthropometric measurements (W-HR) recorded by standard procedures. The plasma samples were tested for the following biochemical parameters: bone-related parameters [calcium (Ca), phosphorus (P), uric acid (UA), alkaline phosphatase (ALP), and erythrocyte sedimentation rate (ESR)] and serological agglutination tests [rheumat
... Show MoreAbstract The success of the system of government in any country needs to have a handle on the amount of power efficiency , capacity , capability and wisdom, Iraq has gone through since its inception through several stages of time, namely: The first stage: which ran from August 23, 1921 until July 14, 1958 and was ruling monarchy (rule of the royal family) and punishing power of political elites both of them and works access to power without taking into consideration the laws and principles of the Constitution, and as a result of the inability of civilian powers and political parties access to power to grant that army officers regulatory and disciplinary specifications as well as possessing arms and overthrow the rule of the minority coup
... Show MoreIt was aimed to understand the interleukin-4 (IL-4) role in etio-pathogenesis of rheumatoid arthritis (RA). Two approaches were adopted. In the first one, a quantitative expression of IL4 gene was assessed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and such findings were correlated with some demographic, clinical and laboratory parameters, which included gender, duration of disease, disease activity score (DAS-28), rheumatoid factors (RFs), C-reactive protein (CRP) and anti-cyclic citrullinated peptide (ACCP) antibodies. In the second approach, a single nucleotide polymorphism (SNP) of IL4 gene (rs2243250) was inspected by DNA sequencing using specific primers. Fifty-one Iraqi RA patients (22 males and 29 fem
... Show MoreKE Sharquie, AA Noaimi, AM Oweid, JSSDDS, 2009 - Cited by 2
Abstract: The aim of this study is to assess the effectiveness of 940 nm diode laser in comparison to Endoactivator in elimination of smear layer in terms of radicular dentin permeability and ultra-structural changes of root canal walls by SEM evaluation. Twenty-eight single-rooted extracted lower premolars were instrumented up to size X4 (protaper Next, Dentsaply) and divided into two experimental groups according to the irrigation system, G1; activated by EndoActivator and G2; activated by Diode laser 940 nm, CW mode, 1.7 W. Afterward, the roots were made externally impermeable, filled with 2%methylene blue dye, divided horizontally into three segments representing the apical, middle, and coronal thirds then examined under stereo- micr
... Show MoreIn diabetes, impaired wound healing and other tissue abnormalities are considered major concerns. Many factorsaffect the time and quality of wound healing. One of the purposes of medical sciences is wound healing in a short time withreduced side effects. The herbal products are more precious in both prophylaxis as well as curative in delayed diabetic woundhealing activity when compared to synthetic drugs.A wide range of evidence has shown that capers plant possesses differentbiological effects, including antioxidant, anticancer and antibacterial effects. Phytochemical analysis shows thatC. spinosahashigh quantities of bioactive constituents, including polyphenolic compounds, which are responsible for its health-promotingeffects. The healing
... Show MoreAbstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. O
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