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.
There were many ideas and opinions on the linkage between growth and economic reform in both developed and developing countries. The relationship is, of course, existed. Therefore, this research comes to analyses it in the Iraqi economy. This study is based on a hypothesis that the economic reformation in Iraq leads to lag level of growth with the of high rates of inflation. However, the study is designed to be included five sections. It found a positive relationship between the economic reformation and slowing of economic growth, in which the specified hypothesis is not fit to the economic reality in Iraq after 2003 &
... Show MoreBackground: Diabetes mellitus is a metabolic disorder affecting people worldwide, which require constant monitoring of their glucose levels. Commonly employed procedures include collection of blood or urine samples causing discomfort to the patients. Necessity arises to find alternative non invasive technique is required to monitor glucose levels. Saliva is one of most abundant secretions in the human body and its collection is easy, noninvasive and painless technique. Objective: The aim of this study was to determine the efficacy of saliva as a diagnostic tool by study the correlation between blood and salivary glucose levels and glycosylated hemoglobin (HbA1c%) in diabetes and non diabetes, and the comparison of salivary glucose level
... Show MoreBackground: Juvenile idiopathic arthritis (JIA) is a chronic disease of childhood. Increased prevalence of periodontal disease and dental caries in juvenile idiopathic arthritis is due to difficulties in executing good oral hygiene. This study was conducted to assess oral health status in patients with Juvenile idiopathic arthritis according to age and duration of illness. Materials and methods: A research was conducted among Juvenile idiopathic arthritis patients attending Baghdad Teaching Hospital with different age and both gender, underwent a clinical evaluation of their dental and oral condition. Diagnosis of dental caries was done according to the criteria of WHO (1997). Dental plaque, gingival condition, calculus were assessed by PI/
... Show MoreBackground:Parkinson’disease(PD) is a neurodegenerative disorder of the central nervous system characterized by resting tremor, bradykinesia, cogwheel rigidity, and impairment of postural reflexes; the frequency of PD increases with aging.Clinically Parkinson's disease characterized by two groups of symptoms: motor and non-motor symptoms.Non-motor symptoms can be categorized as autonomic, cognitive/psychiatric (may include depression, dementia, anxiety, hallucinations), sensory and rapid eye movements (REM) sleep behavior disorder (RBD).
Objectives:The objectives of this study are to find out the frequency of the non-motor symptoms of idiopathic Parkinson disease in a group of patients in Baghd
... Show MoreCeliac disease (CD) is an inflammatory small intestinal disorder that can lead to severe villous atrophy, and malabsorption . Since the measurement of α-amylase activity is the most widely used biochemical test for the diagnosis of pancreatic and non pancreatic disease , therefore serum α-amylase were studied in the present study in an attempt to evaluate the usefulness of this enzyme in the diagnosis of celiac disease and its relationship with anti gliadin IgA and IgG and serum glucose . Thirty one patients with celiac disease were studied and compared with twenty four healthy individuals . Significant elevation of α-amylase activity , glucose and anti gliadin IgA and IgG were observed in the sera of patients with celiac diseas
... Show MoreBackground: The styloid process is a cylindrical bone (protrusion). It situated above the common carotid artery between the external and internal branches immediately proximal to the internal jugular vein and facial nerves. The styloid process varies in length also it may be absent as well as elongated. Classically, an elongated styloid process and calcified of stylohyoid ligament causes Eagle’s syndrome. The aim of this study was to examine the styloid process using 3 dimensional multi-detector computed tomography (3D-MDCT) to detect the presence of Eagle’s syndrome that causes severe headache and migraine. Materials and methods: One hundred patients with severe headache and migraine were exposed to 3D- multi-detector CT with special
... Show MoreIntroduction: Cutaneous leishmaniasis is considered a parasitic contagion resulting from the flagellated parasite belonging to the genus of Leishmania. Also, cutaneous leishmaniasis is a zoonotic ailment transmitted through the bloodsucking sand-flies bite (belonging to the Phlebotomus genus). The disease's reservoirs included wild or semi-domesticated animals, in general rodents and dogs. Tissue inhibitor metalloproteinase-1 (TIMP-1) is one of the extracellular matrix proteins that have a role in vessel wall degeneration and aneurysm development. In addition, it belongs to the zinc-dependent endopeptidases family that are involved in the degradation of connective tissues proteins which are included in vascular integrity maintenance. The Ge
... Show MoreIn Iraq, more than 1031 school projects have been halted due to disputes and claims resulting from financial, contractual, or other issues. This research aims to identify, prioritize, and allocate the most critical risk factors that threaten these projects’ success for the duration (2017-2022). Based on a multi-step methodology developed through systematic literature reviews, realistic case studies, and semi-structured interviews, 47 risk factors were identified. Based on 153 verified responses, the survey reveals that the top-ranked risk factors are corruption and bribery, delaying the payments of the financial dues to the contractors or sub-contractors, absence of risk management strategy, multiple change orders due
... Show MoreBackground: Chronic suppurative otitis media (CSOM) is the result of an initial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation for at least 2 weeks duration. It is an important cause of preventable hearing loss, particularly in the developing world.Objective: To get an overview on the bacterial ear infection profile in general and to assess the antibiotic resistance of Pseudomonal infection (PS) particularly since it is usually the commonest infection to cause otitis media and the most difficult to treat due to the problem of multi drug resistance..Methods: A cross sectional study was done which included 405 patients of CSOM patients, 196 (48%) case were mal
... Show MoreBackground: Indeterminate colitis (IC), a term
originated by pathologists to characterize confounding
histopathlogic appearance of resected mucosa, has
become catch phrase for cases in which diagnostic
criteria at all levels elude classification as Crohn's
disease (CD) or ulcerative colitis (UC).
OBJECTIVES: evaluate the prevalence of pANCA
expression in the sera and its isotypes.
Patients and methods: PATIENTS GROUP
consisted of 60 patients (40 males and 20 females)
with indeterminate colitis and their age range was (19-
84 years). CONTROL GROUP consisted of 30 (15
males and 15 females) healthy volunteers and their
age range was (20- 66 years).
Antineutrophil cytoplasmic ( pANCA and cANCA)
te