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 importance of the research lies in preparing an experimental curriculum according to a scientific method that will contribute to the development of the special strength(endurance the strength of arms) in order to contribute to the attempt to develop the basic skills of the national team players with the goal ball for the blind As for the research problem, it lies in the weakness of the strength endurance of the national team players with the goal ball for the blind, as the research problem is clearly evident in the last minutes of the match, as well as the former studies in the field of goal ball game for the blind at the country level The research aims to prepare special exercises for endurance of strength as well as t
... Show MoreBackground. The presence of black triangles around the dental implant-supported prosthesis and the failure to construct adequate papillae around them bothers dental implantologists. Peri-implant surgical soft tissue management will improve esthetics, function, and implant survival. Aim. To compare the effects of rolled and nonrolled U-shaped flaps combined with a temporary crown in enhancing the soft tissue around dental implants. Materials and Methods. Forty patients were included in this study; all patients were operated on by the same maxillofacial surgeon at Al-Iraq specialized dental clinics from January 2019 to January 2020. Patients were divided randomly into two groups: group A: at the second stage of implant surgery, a U-sh
... Show MoreThe objective of investigating some biochemical parameters like urea, creatinine, Hb and other parameters as CRP and leptin in the serum of ESRD patients on hemodialysis pre-dialysis. Method: Sample of 250 cases which consists of the patient with ESRD, their mean ages were 52.66 ± 12.55 years with ranged from 18-83. Moreover, under hemodialysis treatment not less than three months. Apparently, 20 healthy subjects were selected as (control) for comparison. Results: The results showed that there was a significant increase (p<0.01) in the serum urea, creatinine, CRP, and leptin. While, revealed significant (p< 0.05) decrease in the levels of uric acid, serum glucose, albumin, inorganic phosphorus, potassium, Hb and platelet in patien
... Show MoreThe use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 fro
... Show MoreThe use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 from Al-
... Show MoreMigraine affects more than one billion individuals each year across the world, and is one of the most common neurologic disorders, with a high prevalence and morbidity, especially among young adults and females. Migraine is associated with a wide range of comorbidities, which range from stress and sleep disturbances to suicide. The complex and largely unclear mechanisms of migraine development have resulted in the proposal of various social and biological risk factors, such as hormonal imbalances, genetic and epigenetic influences, as well as cardiovascular, neurological, and autoimmune diseases. Experimental findings suggest an involvement of neuroinflammatory mechanisms in the pathophysiology of migraine. Specifically, preclinical
... Show MoreChronic myeloid leukemia (CML) is a myeloproliferative disorders characterized by formation of Philadelphia chromosome. After disease development, several events may associate with the reduction of anti-tumor immunity. The present study was designed to investigate the immunological profile of innate and adaptive immune response in Iraqi patients with CML. Patients were grouped into untreated (UT), treated (T) with chemotherapy, while another apparently healthy individuals were recruited to represent the control (C) group. Methods: ELISA technique was used to estimate serum levels of GM-CSF, IL-1a, IL-8, IL2, INF-?, IL-4, and IL-10 while SRID was used to estimate serum levels of C4, IgM, IgA, and IgG. Results: Regarding to innate immune resp
... Show MoreAzo dyes like methyl orange (MO) are very toxic components due to their recalcitrant properties which makes their removal from wastewater of textile industries a significant issue. The present study aimed to study their removal by utilizing aluminum and Ni foam (NiF) as anodes besides Fe foam electrodes as cathodes in an electrocoagulation (EC) system. Primary experiments were conducted using two Al anodes, two NiF anodes, or Al-NiF anodes to predict their advantages and drawbacks. It was concluded that the Al-NiF anodes were very effective in removing MO dye without long time of treatment or Ni leaching at in the case of adopting the Al-Al or NiF-NiF anodes, respectively. The structure and surface morphology of the NiF electrode were inves
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