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 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 MoreThe present study was set to demonstrate the prevalence of toxoplasmosis infection and its effects on patients with systemic lupus erythematosus (SLE) through determining their serum levels of anti-dsDNA and IL-18 antibodies. For this purpose, the sera from 132 SLE and/or toxoplasmosis patients and 30 healthy women, were collected. The study sample was divided into four groups of SLE, toxoplasmosis, SLE coinfected with toxoplasmosis, and healthy control. Anti-Toxoplasma IgG antibodies were examined for all the samples using ELISA kit. The results showed a high mean level of anti-Toxoplasma IgG among SLE patients coinfected with toxoplasmosis (104.8792±12.31585pg/ml) in comparison to that in toxoplasmosis patients (91.1705±12.577
... Show MoreAim and Objectives: The objective of this study was to illustrate the link between periodontitis (PO) and endothelial dysfunction in hypertensive patients. Materials and Methods: This cross‑sectional study involved 53 hypertensive patients with or without PO compared with 28 healthy controls. On the basis of the study protocol, the participants were divided into three groups: Group (1): 24 patients with hypertension only, Group (2): 29 patients with hypertension and PO, and Group (3): 28 healthy controls. Lipid profile, endothelin‑1 (ET‑1), and high‑sensitivity C‑reactive protein (hs‑CRP) were measured. Blood pressure and body mass index (BMI) were evaluated. Diagnostic criteria of severe PO periodontal indices including plaque
... Show MoreRecently, Systemic lupus erythematosus (SLE) was considered as one of the autoimmune diseases that the genetic and environmental factors contributed in the disease etiological profile. According to the environmental factors, infectious agents have been concluded to have a role in the etiology and pathogenesis of SLE. Chlamydia pneumoniae and Mycoplasma pneumoniae are among these infectious agents that have been suggested to be involved in the etiology of SLE. Accordingly, the current study was designed to assess the anti-C. pneumoniae and anti-M. pneumoniae IgG antibody status by enzyme linked immunosorbent assay (ELISA) in the sera of 64 Iraqi SLE females' patients and 32 Iraqi healthy females as controls. The patients' group were distribu
... Show MoreAIM: The aim of this study was to measure the prevalence of myeloproliferative disorders in a sample of Iraqi patients and to measure the changes in patients’ blood parameters. BACKGROUND: Myeloproliferative disorders are a group of neoplasms affecting the bone marrow progenitor cells characterized by excess cells with a risk of transforming to acute leukemia. There is a gap in knowledge about the prevalence of Iraqi population. Thus, we investigated the prevalence and distribution of different types of myeloproliferative disorders in a sample of Iraqi patients. MATERIALS AND METHODS: Cross-sectional study is done at the National Center of Hematology from November 2019 till March 2020 on 75 patients who were diagnosed
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