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 angiotensin converting enzyme (ACE) I\D gene polymorphism influences the blood ACE enzyme activity. Renoprotective effect of ACE inhibitors (ACEIs) varies among patients due to genetic variation, particularly in Renin-Angiotensin-Aldosterone System genes. This study investigates the genetic variations of ACE I\D and AGT1RA1166C gene polymorphisms in the antiproteinuric effect of ACEI therapy in type 2 diabetes mellitus (T2DM) patients. This is a cross-sectional study that included 76 T2DM patients who are ACEI users, divided into two groups: T2DM without diabetic kidney disease (DKD) included 31 patients, and T2DM with DKD included 45 patients. Urine samples were taken for measurement of urine albumin and creatinine, then calcul
... Show MoreThe acute phase response is a major pathophysiologic phenomenon that accompanies inflammation whether acute or chronic. Complement (C3 and C4) and C - reactive protein (CRP) are positive acute phase proteins (+ ve APPs ). Their production takes place in hepatocyte and the blood concentration of these parameters are increased in osteoarthritis (OA). Chloroquine (CQ) is a diprotic weak base traditionally used to treat malaria. Recently the phosphate salt of CQ is used to decrease this type of (+ve APPs) . In this study, patients who suffered from knee osteoarthritis (KOA) are treated with oral dosage form of chloroquine phosphate (CQP) for one month, twice daily. Our results demonstrate that CQP improves the patient status by decreas
... Show MoreRheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition,
... Show MoreRheumatoid arthritis is an inflammatory chronic disease with an autoimmune pathogenesis. To determine the role of Helicobacter pylori as a trigger agent, twenty five patients with rheumatoid arthritis of ages (15-47) years have been investigated and compared with twenty healthy individuals. All the studied groups were carried out to measure the rheumatoid arthritis (RA) IgM, anti-CCP antibody IgG and IgA by ELISA test and by measured anti-IgG antibody level of H. pylori by using ELISA and IFAT techniques. The present study showed significant differences (P< 0.05) of anti-H. Pylori in sera of RA patients than control group, this lead to suggest that H. pylori had a role in pathogenesis of RA.
This study included 46 patients with liver hydatid cyst diagnosed clinically and surgically. Control group consist of 22 healthy volunteers. The patients were divided according to the size of the cysts into more and less than 5 cm diameter size, 33 and 13, respectively. Also they were divided into primary and secondary hydatid cyst infection, 30 and 16, respectively. Significant increase of GOT, GPT and ALP levels were recorded due to hydatid cyst infection and had direct effect on the liver function, beside an increase in total bilirubin in patients serum compared with the control, also the same occurred in the secondary infection compared with primary infection, patients with> 5 cm showed significant increase in the above levels compared
... Show MoreBack ground: Oral lichen planus is a chronic inflammatory disease that affects the mucous membrane of the mouth. Several researchers suggest that oxidative stress is implicated in the pathogenesis of this disorder. It has been hypothesized that melatonin is powerful anti-oxidants and can easily cross the cell membrane and is considered a free radical scavenger of Hydroxid, Oxygen and Nitrogen dioxide, cortisol as a stress hormone and the immunoglobulin A as first line of defense and protection to the mucous membrane of the mouth are interrelated factors for the emergence of oral lichen planus. Aim of this study was to evaluate the level of melatonin, Cortisol and IgA in saliva of patients with oral lichen planus lesions in comparison with p
... Show MoreThis research dealt with the subject of auditing bank credit risks in accordance with international auditing standards and aims to develop procedures and design a credit risk audit program in accordance with international auditing standards and demonstrate their impact on the truth, truthfulness and fairness of financial statements and on their overall performance and continuity in the banking sector Its importance lies in relying on international auditing standards to assess and measure bank credit risk and its impact on the financial situation as well as the ability to predict financial failure. A set of conclusions have been reached, the most important of which is that the bank faces difficulties in measuring credit risk in accordance
... Show MoreBackground: Atherosclerosis is well known related to age and certain cardiovascular diseases. Aging is one reason of arteries function deterioration which can cause loss of compliance and plaque accumulation, this effect increases by the presence of certain diseases such as hypertension and diabetes disease. Aim: To investigate the reduction of blood supply to the brain in patients with diabetes and hypertension with age and the role of resistive index in the diagnosis of reduced blood flow. Method: Patients with both diseases diabetic and hypertension were classified according to their age to identify the progression of the disease and factors influencing the carotid artery blood flow. By using ultrasound and standard Doppler techniq
... Show MoreIn this paper, some relations between the flows and the Enveloping Semi-group were studied. It allows to associate some properties on the topological compactification to any pointed flows. These relations enable us to study a number of the properties of the principles of flows corresponding with using algebric properties. Also in this paper proofs to some theorems of these relations are given.
Foreign trade receives a good deal of economists' attention for its active contribution to economic growth, and imports of goods and services that could not be produced locally constitute an important share of the local economy. Agricultural imports constitute an important share of the total imports due to their role in fulfilling the needs of local markets; however, the agricultural sector in Iraq contributes no more than a limited share of the country's need, which has encouraged the import of a variety of fruits, vegetables and strategic crops and different types of red and white meat. For the sake of identifying the factors affecting the demand on agricultural imports in Iraq, the following factors has been analyzed: th
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