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: BACKGROUND: Left ventricular hypertrophy is a significant risk factor for cardiovascular complications such as ischemic heart disease, heart failure, sudden death, atrial fibrillation, and stroke. A proper non-expensive tool is required for detection of this pathology. Different electrocardiographic (ECG) criteria were investigated; however, the results were conflicting regarding the accuracy of these criteria. OBJECTIVE: To assess the accuracy of three electrocardiographic criteria in diagnosis of left ventricular hypertrophy in adult patients with hypertension using echocardiography as a reference test. PATIENTS AND METHODS: This is a hospital-based cross sectional observational study which included 340 adult patients with a his
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Background: The overproduction of thyroid hormones is known as hyperthyroidism. Increased susceptibility to caries and periodontal disease are two potential oral symptoms. The interleukin-6 (IL-6) was observed to significantly increased in the hyperthyroid group. According to multiple research, IL-6 dysregulation has been linked to a number of oral disorders, including periodontal diseases. The study aimed to evaluate periodontal health status in relation to IL6 among hyperthyroidism patients. Subjects and Methods: The sample was composed of 90 female patients aged 25-45 years attending endocrine disorder |
Thoudy sustainable development attention of researchers and scholars at various orientations intellectual economies were or Ssayasn, or others as gaining the process of paramount importance in the light of major developments and unprecedented in the modern world at the levels of all and which turned the world sprawling into something like a global village is small, being aimed at elimination of backwardness and development branches of the national economy and raise the level of economic performance, and what was the province of Kurdistan-Iraq from areas with privacy clear and meets the elements of economic development has seen the movement of economic development and social with special features de facto geographical, political a
... Show Moreالعلاقة بين تعبير المعلمات المناعية ل (P53) وعدم استقرار الساتل الميكروي (MSI) مع العوامل السريرية المرضية لسرطان المعدة الغدي باستخدام الكيمياء النسيجية المناعية. الخلاصة الخلفية: يحدث سرطان المعدة الغدي بسبب عدم استقرار الكروموسومات، وطفرات TP53، واختلال الصيغة الصبغية، والانتقالات، والجينات الورمية الأولية، والتغيرات الجينية المثبطة للورم.عدم استقرار الساتل الميكروي(MSI) يسبب فشل إصلاح عدم تطابق الحم
... Show MoreThe aim of the research is to prepare motor sense exercises for developing motor and physiological abilities of backstroke and forward stroke service skill in badminton and investigated their effect. The research is adopted the experimental method with two groups design. The sample of the research is 8 players (13-15 years). The sample is divided into two groups of 4 players for each group. Both groups are exposed to pre and post tests, after the experimented were finished, the results are statically analyzed. The results have showed that there are positive developing abilities of motor and physiological of service skill in badminton. Finally, these prepared exercises are recommended for developing players’ abilities in badminton.
Coronavirus disease 2019 (COVID-19) is a flu-like infection caused by a novel virus known as Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). After the widespread around the world, it was announced by the World Health Organization (WHO) as a global pandemic. The symptoms of COVID-19 may arise within 2 weeks and the severity ranged from mild with signs of respiratory infection to severe cases of organ failure and even death. Management of COVID-19 patients includes supportive treatment and pharmacological medications expected to be effective with no definitive cure of the disease. The aims of this study are highlighting the management protocol and supportive therapy especially vitamin D and manifesting the clinical symptoms b
... Show MoreSeven leafhoppers (Cicadeilidae). and one plantboppei (Delpbacidae), Homoptera were identified from a one year operated light trap at the College of Agiculture farm in Abu¬Ghraib. The leafhoppers were: Balclutha hortensis Lind.; B. rufaofasciata Merine.; psammctettix alien us Dahlbem.; P. striatus L.; Extianus capicola.; Neoaliturus haematoceps H. R.; and Orozius albicnctus Dist. The planthopper was Sogatella vibix Haupt. one year records of their populations, indicated that B. rufofasciata occured during the fall from October 10 until December 18; E. capicola from October 24 until November 21 and again in the summer from March to October. The others occured only during the summer, from the end of March and early April until Mid-Septemb
... Show MoreIn this study the Sub family of Nomiinae Robertson,1904 (Hyminoptera: Halictidae) was revised There were five species registered in our investigation: