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 Introduction: MMP3 plays a crucial role in the process of bone erosion in the pathomechanism of rheumatoid arthritis (RA). It acts by removing the outer osteoid layer, which allows the osteoclasts to tightly connect and carry out the subsequent damage to the underlying bone. MMP3 can trigger the production of other MMPs like MMP-1, MMP-7, and MMP-9, it plays a pivotal role in the remodeling of connective tissues. Aim of the study: to assess the influence of MMP-3 serum levels and single-nucleotide polymorphisms of rs679620 in the rheumatoid arthritis patients' group in comparison to the control group. Subjects: eighty eight samples, 45 rheumatoid arthritis patients after being referred by their treating physician for regular RA
... Show MoreThe role of the public sector- Investment customizations- economic embargo - The role of the private sector - Coexistence between the public and private sectors - Ratio of growth
Tuberculosis is caused by Mycobacterium tuberculosis; it is considered as one of the most common, infectious diseases and major causes of morbidity and mortality worldwide. A prospective study was conducted to obtain more clarification about the impact of causative agent and its treatment to enhance autoantibodies production such as ANCA and BPI which used as diagnostic markers for several diseases, and to provide further insight into the classical risk factors (age and sex).Seventy patients with tuberculosis involved in this study, 35 of them were untreated and 35 with treatment administration these patients were attending to directorate of general health national reference laboratory in Baghdad during the period between November/ 2012 and
... 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
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 MoreThe 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
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