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:
Objectives: To assess nurses' attitude toward end of life phase. To find out relationships between nurses attitude and socio demographic data (age, gender, level of education, years of experience).
Methodology: A descriptive cross-sectional study design is carried out to assess the attitude on nurses concerning patient at the end of life phase at critical care units, from the period of (1nd November 2021) to (1th February 2022). A probability sample random sampling technique used. Then, the number of participants in Baquba Teaching Hospital and general al khalis hospital were determined by using rando
... Show MoreObjective: To assess the nutritional status of hemodialysis patients.
Methodology: A descriptive quantitative cross sectional study was effectuated in hemodialysis centers from
February 2011 to September 2011. A purposive "non-probability" sample of (70) male and female hemodialysis
patients in al-Najaf al-Ashraf Governorate from those who have spent more than six months on maintenance
hemodialysis schedule. Data collected through using of a well-designed questionnaire consist of five parts, part
one consists of sociodemographic contain (9) items, and part two consists of medical data contain (8) items, and
part three consists of health and nutrition behavior contain (12) items plus (8) items of anthropometric
measur
Herpes simplex virus (HSV) is a common human pathogen that causes severe infections in newborns and immunocompromised patients. Conjunctivitis or corneal epithelial keratitis is caused by HSV type 1 all over the world and at all times of the year. The present study was aimed at detecting HSV in patients suffering from conjunctivitis. One hundred and ten (110) clinical samples (90 patients and 20 controls, both males and females) of eye conjunctiva swabs were collected from patients of different ages. The samples were analyzed using qPCR and ELISA techniques. The qPCR results revealed that HSV was present in 47 (52.2%) of the 90 patients who were infected. Of these patients, 25 (48.0%) were males and 22 (57.8%) were females, indicati
... Show MoreObjective(s): To assess nurses' practices for neurological unconscious patients in intensive care units.
Methodology: A descriptive study was conducted that included (50) nurse who are working in intensive care
units in hospitals and departments of the nervous system in (4) hospitals (neuroscience hospital, teaching
neurosurgical hospital, surgical specialist hospital, and sheck zaied hospital) in Baghdad city from March, 30th
,
2009 to July, 30th 2009 for the purpose of assessing their skills towards unconscious patients. A purposive "nonprobability
sample" was selected that consisted of (50) nurse who are working in intensive care units. A
questionnaire format and observational checklist were used which consist of
The aim of this study is to determine serum IL-33 levels and atherogenic index of plasma (AIP) .Forty patients with moderate activity of rheumatoid arthritis (RA) and forty healthy individuals as control group were enrolled in this study, age (25-45) years. Disease activity was assessed in patients by erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) and rheumatoid factor(RF) .Also lipid profile(cholesterol TC, triglyceride TG, low density lipoprotein LDL-C, very low density lipoprotein VLDL and high density lipoprotein HDL-C), AIP, and IL-33 were determined in all subjects. The results revealed a significant increase in ESR,CRP and RF , TG, VLDL,AIP and IL-33,while is a significant decrease in HDL concentration in patients gr
... Show MoreBackground: Anti-vascular endothelial growth factors commonly used intravitreally for treatment of variable retinal disease worldwide, which help to regulate the upregulation of vascular endothelial growth factors due to ischemia or/and other retinal insult.
Objective: To review all cases of intravitreal bevacizumab given in the retinal unit of the Eye Specialty Private Hospital in Iraq from December 2015 to June 2016, pointing out the common indications.
Methods: A retrospective study including all cases of intravitreal injections of bevacizumab recorded at the Eye Specialty Private Hospital from December 2015 to June 2016 were retrieved. Age, sex, laterality, diagnosis
... Show MoreBackground: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.
Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/Iraq
Material and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.
The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)
Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).
Results: Primary glomerulonephrit