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.
Lipid disorders and cardiovascular disease (CVD) risk are known to be increased in patients with diabetes mellitus. The effects of statins on serum lipid levels are well known; however, previous studies did not compare the effects of statins on serum lipid levels in diabetic patients with non-diabetic patients. To investigate the effects of Atorvastatin on serum lipid profiles in hyperlipidemic patients with type 2 diabetes mellitus in comparison with hyperlipidemic patients without diabetes.This study was conducted on 33 type 2 diabetic patients & 34 non-diabetic patients; their age range was 40-80 years, all of them were hyperlipidemic, who had been administered 10, 20, & 40 mg daily of Atorvastatin and completed a 6-month foll
... Show MoreThe research aims to show the effect of some short-term debt instruments (central treasury transfers, cash credit granted to the government by commercial banks) on the production of the wheat crop in Iraq, through its effect on money supply during the period (1990-2018), As the study includes two models according to the statistical program (Eviews9), the first model included measuring the effect of short-term debt instruments on money supply, and the second measuring the extent of the money supply's impact on Wheat crop production, as the results of the standard analysis showed that the short-term debt instruments used in the model were Significant effect on wheat crop production indirectly through its effect on money supply, As
... Show MorePurpose: This research seeks to provide a point of view based on the creation of sustainable value to the customer of the banks in the context of total quality management and relationship marketing. It aims to develop a model to measure the value of sustainable customer peduncular under total quality management PAL (administrative leadership, involvement of employees, continuous improvement, process improvement, staff training), through the mediation of relationship marketing and objective dimensions (administrative leadership, involvement of employees, continuous improvement, improving processes , staff training), and to explore any of the variables and dimensions more influential in the creation of sustainable value to the cust
... Show MoreMixed Kirkuk and Sharki-Baghdad crude oils were distilled into narrow fractions. The range of these narrow fractions were 10oC, starting from IBP to 350oC. The total distillates from mixed Kirkuk and Sharki-Baghdad crude oils were 58.25 vol % and 44.65 vol %, respectively.The hydrocarbons compositions (paraffin, naphthene, aromatic) in light fractions starting from IBP to 250oC were determined by using PONA analysis method. The results show that the paraffin content decreases with increasing mid percent boiling point of the fraction, while the naphthene, and aromatic increase with the increase of mid percent boiling point of mixed Kirkuk and Sharki-Baghdad crude oils. Three groups of empirical equations were developed for the prediction
... Show MoreHenrik Ibsen is considered one of the greatest writers on society and its problems in the modern era, as his works deal with society in all its forms in a realistic way, in which he presents the motives and consequences of social problems and their impact on society to study these problems through them to and propose solutions through theatre. Most of his writings were very serious about addressing these social issues. The method of collecting information in the study came through reviewing a group of sources related to realistic theater and social theory, then reading the plays covered in a critical and analytical reading. Based on that, the method of writing this study came and used a group of sources that directly relate to the s
... Show MoreBackground: Diabetic mellitus type ? is a metabolic disorder of diverse etiological factors, characterized by hyperglycemia resulting from an absolute deficiency of insulin affected childhood and adolescent. Some of these patients seek an orthodontic care .The orthodontist who is treating these medically compromised patients should have a working knowledge of the multitude of medically complex problems. This information will support and enable for delivery of high standards of dental care in general and orthodontic care in particular. The aim of this study was to analyze serum IgG levels and salivary secretory IgA (sIgA) levels in human dentine extract (HDE) before (T0) and 6 months after (T6) orthodontic treatment and to correlate anti-HDE
... Show MoreType 2 daibetes mellitus (T2DM) is a global concern boosted by both population growth and ageing, the majority of affected people are aged between (40- 59 year). The objective of this research was to estimate the impact of age and gender on glycaemic control parameters: Fasting blood glucose (FBC), glycated hemoglobin (HbA1C), insulin, insulin resistance (IR) and insulin sensitivity (IS), renal function parameters: urea, creatinine and oxidative stress parameters: total antioxidant capacity (TAC) and reactive oxygen species (ROS). Eighty-one random samples of T2DM patients (35 men and 46 women) were included in this study, their average age was 52.75±9.63 year. Current study found that FBG, HbA1C and IR were highly significant (P<0.01) inc
... Show MoreFibroblast growth factor-23, play an important role in atherosclerosis, endothelial dysfunction and vascular calcification. Sevelamer can improve vascular calcification, serum uric acid, low-density lipoprotein-cholesterol and Fibroblast growth factor-23. Aim of study Assessment the effect of sevelamer as phosphate binder against calcium carbonate on Fibroblast growth factor-23. Methods A prospective open-labelled study that included patients on hemodialysis. A total of 72 patients were screened, only 53 patients completed the 10 week period. Adults patients with serum phosphate as> 5.5 mg/dl were included. There were Group1: Includes 28 patients (19 males and 9 females receiving sevelamer carbonate (Renvela) tablet. Group 2: Include 25pati
... Show MoreObjectives The gold standard in the field of periodontal research currently is to find a valid biomarker that can reliably be used for diagnosing periodontal diseases. Given the limitations of the current diagnostic tools that stall to predict susceptible individuals and determine whether active tissue destruction is occurring, there is an increased urge to develop alternative diagnostic techniques that would compensate for the problems inherited in these available methods, such as measuring levels of biomarkers present in oral fluids such as saliva; so the aim of this study was to determine the diagnostic potential of interleukin-17 (IL-17) and IL-10 to differentiate periodontal health