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: Coronary artery disease (CAD) is a major contributor to morbidity and mortality worldwide. Early-onset CAD, also known as PCAD, is a severe form of CAD associated with high mortality and a poor prognosis. Early diagnosis is crucial to reducing complications. While hsCRP is an established biomarker for CAD, kalirin is a potential novel biomarker due to its role in promoting smooth muscle proliferation and endothelial dysfunction. Objective: To evaluate the relationship between serum kalirin and hsCRP levels with the presence and severity of PCAD and to compare the diagnostic value of both biomarkers. Method: The study recruited 92 participants into two groups: the PCAD group (46) included patients with confirmed CAD by an
... Show MoreThe objective review is to inspect the involvement of Interleukin-6 (IL-6) in rheumatoid arthritis (RA) and to highlight the role of IL-6 and its variants in the pathogenesis of RA and response to anti-IL-6 agents. Several genetic and environmental risk factors and infectious agents contributed to the development of RA. Interleukin-6 is engaged in self-targeted immunity by modifying the equilibrium between T regulatory (T-reg) and T helper-17 (Th-17) cells. The evidences reported that IL-6 parti
Multiplesclerosis(MS)isachronic,inflammatory,immune-mediateddiseaseof the central nervous system (CNS). More than 2 million people worldwidehave MS. The goal of the present study was to compare Iraqi patients' treat-ment satisfaction with three different disease-modifying therapies (DMTs),administeredorally,subcutaneously,andbyslowinfusion;namely,fin-golimod, interferon beta-1b (IFNβ-1b), and natalizumab, respectively. Aswell as to assess the individual differences among these therapies about theireffectiveness, convenience and global satisfaction also to assess the role ofcertain predictors on treatment satisfaction. Patient satisfaction with medi-cation assessed by the Treatment Satisfaction Questi
... Show MoreBackground: Oral mucositis is regarded as one of the major complications of radiation therapy especially in patients with head and neck cancer. The aim of this study was to evaluate the efficacy of glutamine in preventing or minimizing the development of mucositis of the oral cavity. Subjects and methods: Forty-six participants were randomly selected amongst those who were planned to receive radiation therapy for head and neck region cancers. They were randomly divided into two groups of 23 subjects, one group received glutamine and the second group received a placebo. Results: Glutamine had a statistically significant effect in reducing the occurrence and/or severity of oral mucositis in the treated patients compared to patients in the con
... Show MoreThe trade balance is considered as a way to join the national economy with the world, So it is the mirror that reflect the economic center of the country and it is point to competitive ability of it, The tariff and the exchange rate perform a great role to motivate the domestic production and improve the trade balance if we direct them to achieve the same purpose. The Iraqi economic has trade balance which achieve overabundant during the years of studying because of the oil exports, while the other exports represent a small percentage it is hardly remember, and expansion in imports from other side causes exhaustion in oil revenues, and this make the trade balance in permanent
... Show MoreThis research aims to study and analyze the reality of monetary policy and financial sustainability in Iraq through either a descriptive or analytical approach by trying to link and coordinate between monetary policy and fiscal policy to enhance economic sustainability. The research is based on the hypothesis that the monetary policy of Iraq contributes to achieving financial stability, which improves economic sustainability by providing aid and assistance to the state to reduce the budget deficit and exacerbate indebtedness. The author used the monetary policy indicators, the re-deduction of Treasury transfers by the central bank and the money supply, and financial sustainability indicators, including the public debt indicators and the
... Show MoreAbstract
The common types of movement disorders are ; dystonia which is a syndrome of repetitive muscle contractions. While , Huntington disease is autosomal dominant progressive neurodegenerative disorder, which is characterized by involuntary movements (“chorea”).
Tetrabenazine therapy has been shown to effectively control this movements compared with placebo.
Design the proper dosing approach for patients treated with tetrabenazine with genotype polymorphisms and their hepatic effect on patients.
A prospective case controlled study was carried on 50 patients whom divided into 2 groups :first group involved 25 patients who had cho
... Show MoreThyroid hormones, triiodothyronine (T3) and thyroxin (T4) play an important role in growth, development, and physiology of the kidney. The kidney has a central role in metabolism and clearance of these hormones as well as thyroid – stimulating hormone (TSH). Chronic renal failure (CRF) is a state of irreversible deceleration in renal function results in alterations in internal milieu, which affects the synthesis and secretory rate of hormones. To evaluate the thyroid hormone levels in non-dialyzed patients with chronic renal failure (CRF); 24 patients with CRF aged 30-70 years, mean±S.d. (48.458 ± 13.569) and 48 healthy volunteers who served as controls aged 30-70 years (43.104 ± 12.387) were studied for their thyroid function status u
... Show More