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 concept of the separation worry is considered one of the common disorders in children. The causes and effects of this worry influence the child mental and cognitive ability and the child ability to communicate with others, has friendship and the ability of adaptive with the environment, peers and teachers and it also influences the child's academic and social performance.
The importance of this study is represented in handling the working memory, one of important subject in cognitive psychology. Many universal studies show that the working memory is very important in several daily functions such as continuous attention, followinstructions, implement instructions of many steps, the moment of information remembering and keep focusin
Background : It had been indentified by histological, histochemical and morphometrical studies that peganum harmala is a mammogenic herb and borage officinalis is a lactogenic one . To complete our investigation about these two herbs , we performed electron microscopical study . Materials and methods : Rats were grouped according to their physiological status into three groups . Each group was subdivided in to three subgroups : one control and two experimental . The two experimental group were treated daily; the 1st one with an aqueous extract of peganum harmala seeds and the 2nd with an aqueous extract of borage officinalis flowers . After two weeks of treatment , mammary glands were employed for electron microscopical study . Resu
... Show MoreIntroduction: Cerebral hydatid disease (CHD) is rare and the multiple-cystic variety is even rarer. In this paper, we report a case of multiple CHD and explore a possible link with a preceding spontaneous intracerebral haemorrhage (ICH). Case presentation: A 27-year old gentleman with a history of surgically-evacuated, spontaneous ICH presented with severe headache, left-sided weakness - Medical Research Council (MRC) grade II - and recurrent tonic-clonic seizures, while on a full dose of anti-epileptic medication. Brain magnetic resonance imaging (MRI) scans showed multiple intra-axial cystic lesions in the right hemisphere. The cysts were removed intact using Dowling’s technique through a large temporoparietal crani
... Show MoreThis study was set out to investigate factors affecting labor productivity on construction in the north of Iraq (Kurdistan) and to rank all the factors based on engineers, contractors, and designer’s opinions. 76 factors were analyzed based on previous literature and a pilot study. Next, by using online Google Form, a questionnaire form was created and sent to people who have experience in the construction industry. Afterward, the questionnaire form was sent to targeted people by email and social media apps. Factors were divided into nine groups “Management, Technical and Technology, Human and Workforce, Leadership, Motivation, Safety, Time, Material and Equipment, and External”. However, 202 respondents participated in this study,
... Show MoreBackground: Most primary hypothyroidism patients also experience inefficiency and irregularity. It is possible to understand the significance of myo-inositol in treating the thyroid gland by relating it to the synthesis of thyroid hormones. Study aimed to estimate serum of inositol 1,4,5-triphosphate (IP3) in primary hypothyroidism disorder and through that level it can shed light on whether it is accused of inactivity of the thyroid gland and at the same time open the doors for the use as a treatment.
Subject and Methods: The study was taken from the analytical cross-sectional design.120 subjects were divided into three groups, the first group included 40 healthy subjects, the s
... Show MoreChronic Hepatitis B(CHB) is a serious sequel after Hepatitis B Virus infection, although the rate of chronicity is inverse with age but it may be associated with a significant proportion of deaths related to cirrhosis and liver cancer. HBV serology and measurement of hepatocytic enzymes with viral load can predict disease prognosis and response to treatment. HBeAg refers to a high viral replication and associated with more infectivity to others. This study aimed to determine the impact of HBeAg status in chronically infected patients on various baseline tests. A total of 90 patients with CHB infection who were included in this study. Several standardized measures used for liver function tests, viral load and hepatitis B serological
... Show MoreInterleukin-38 (IL-38), an inflammatory cytokine discovered in recent years, has been implicated in the pathogenesis of systemic lupus erythematosus (SLE). IL-38 is encoded by the
The risk assessment for three pipelines belonging to the Basra Oil Company (X1, X2, X3), to develop an appropriate risk mitigation plan for each pipeline to address all high risks. Corrosion risks were assessed using a 5 * 5 matrix. Now, the risk assessment for X1 showed that the POF for internal corrosion is 5, which means that its risk is high due to salinity and the presence of CO, H2S and POF for external corrosion is 1 less than the corrosion, while for Flowline X2 the probability of internal corrosion is 4 and external is 4 because there is no Cathodic protection applied due to CO2, H2S and Flowline X3 have 8 leaks due to internal corrosion so the hazard rating was very high 5 and could be due to salinity, CO2, fluid flow rate
... Show Morethe shear strength parameters of the treated and untreated gypsum soil under the effect of four soaking and drying cycles has studied in this paper, moreover examined the effect of wetting and drying cycles on the collapse potential of the soil and comparing between the behavior of the treated and untreated gypsum soil under the effect of the two conditions. Gypsum soil sample brought from Sawa lake in Al Muthana governorate with the content of gypsum 65.5%, the polyurethane polymer (PP) was used with different percentages 3, 6, and 10% to enhance the mechanical properties of gypsum soil, model was prepared to achieve four soaking and drying cycle to the samples before testing, this model consists of an Aluminum plate base with dimensions 7
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