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.
Background: Fractures of the humeral shaft accounting for approximately 3% of all fractures. There is a wide array of good options for their treatment and controversy over the best methods. Although good techniques of osteosynthesis are available, the aim of this article is toemphasize on the benefit and good outcome of conservative treatment for properly selected cases to decrease the cost and avoid the complications of surgery. Method : During the period from February 2011 to June 2012 fifty-five fractures of humeral shaft were treated at orthopedicdepartment in the ALKindyteaching hospital. 22 fractures considered suitable for the study. The patients treatedconservatively by using the‘U’ shaped coaptation slab. Then we shift to POP c
... Show MoreBackground: Fractures of the humeral shaft
accounting for approximately 3% of all
fractures. There is a wide array of good
options for their treatment and controversy
over the best methods. Although good
techniques of osteosynthesis are available, the
aim of this article is toemphasize on the benefit
and good outcome of conservative treatment
for properly selected cases to decrease the cost
and avoid the complications of surgery.
Background: Acromegaly is an uncommon, chronic, debilitating condition characterized by hyperinsulinism, insulin resistance, diabetes and prediabetes. One possibility for managing acromegaly's questionable influence on glucose homeostasis is the somatostatin analogues. Aim: To analyze the frequency and risk factors for impaired glucose homeostasis in acromegaly patients treated with depot long-acting octreotide (octreotide LAR), as well as the relationship between risk and treatment duration. Methods: The study included 52 Iraqi adults with acromegaly receiving octreotide LAR. Demographic, anthropometric, and clinical data were collected, as well as the duration of Octreotide LAR administration. Growth hormone, IGF-1, and adenoma si
... Show MoreBackground: The COVID-19 infection is a more recent pandemic disease all over the world and studying the pulmonary findings on survivors of this disease has lately commenced.
Objective: We aimed to estimate the cumulative percentage of whole radiological resolution after 3 months from recovery and to define the residual chest CT findings and exploring the relevant affecting factors.
Subjects and Methods: Patients who had been previously diagnosed with COVID-19 pneumonia confirmed by RT-PCR test and had radiological evidence of pulmonary involvement by Chest CT during the acute illness were included in the present study. The radiol
... Show MoreBackground : The aim of this work is to study the clinical features and causative fungi of tinea pedis in diabetic and non-diabetic patients. Result : Tinea pedis was estimated to be the second most common skin disease in the United States, after acne. Up to 15% of the U.S., population may have tinea pedis. Across Europe and East Asia, prevalence rates reach 20 %. Methods: The Complete history taking regarding: age, sex, occupation, residency, history of diabetes and diabetic profile (fasting blood sugar and post prandial).and Clinical examination of the feet Aim of the study : The aim of this work was to study the clinical features and causative fungi of tinea pedis in diabetic and non-diabetic patients Conclusion : Tinea pedis is more
... Show MoreTemporomandibular disorders (TMDs) were investigated in 143 pretreatment orthodontic patients (43 males and 102 females) whose age ranged between 10-25 years at the College of Dentistry, University of Baghdad, Iraq. The study was undertaken to elucidate the prevalence and severity of TMDs in malocclusion patients and to defme the relationships between malocclusion and TMDs. The clinical signs and subjective symptoms were recorded according to the principles introduced by Helkimo (1974b). Subjective symptoms were reported by 65.7% of the patients with 22.40/0 described as severe, and the most common symptoms were TMJ sounds and feeling offatigue. Clinical signs were observed in 81.8% of the sample with 22.4 and 6.3% described as moderate and
... Show MoreBackground: Gallstone disease (GSD) is a significant global health burden with variable prevalence influenced by metabolic, genetic, and infectious factors. Increasing evidence suggests that Gram-positive bacteria, particularly Staphylococcus aureus and Enterococcus species, contribute to gallstone pathogenesis through enzymatic activity and biofilm formation. Objectives: To characterize Gram-positive bacteria within gallstones from Iraqi patients, evaluate their biofilm-forming capacity, and analyze the relationship between bacterial colonization, gallstone type, and cholesterol levels. Methods: A total of 100 gallstones were obtained from patients undergoing elective cholecystectomy between October 2024 and March 2025. Stones were
... Show MoreBackground: study the effect of various risk factors on reperfusion success after thrombolysis by measuring ST resolution.
Objectives: Early patency of the infarct-related artery is associated with reduced mortality. Thrombolytic therapy is frequently followed by rapid recanalization lead to reduction of infarct size, improve left ventricular function and increase survival by reopening of coronary artery . The reduction in ST-segment elevation on the standard 12 lead electrocardiogram 1-4 h after initiation of thrombolysis may be the simplest and most useful clinical tool to test the effectiveness of thrombolytic therapy.
Methods: Seventy patients with acute ST elevation myocardial infarction admitted to alkindy teaching hospital C
Objectives: The aim of this study was to assess the possible the association between +3061 (G>A, rs1143676) missense mutation in exon 24 of the integrin α-4 subunit (ITGA-4) gene and the response to natalizumab in a sample of Iraqi multiple sclerosis patients. Methods: A sample of 59 patients with multiple sclerosis (16 males and 43 females; mean age of 32 years; age range of 15 to 52 years) receiving natalizumab for at least 12 consecutive months were involved in the study between March and August/ 2022. The sample was categorized into two groups according to their response to natalizumab treatment (responders and non-responders). Polymerase chain reaction and Sanger’s sequencing for the extracted deoxyribonucleic acid was pe
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