Genetics of ischemic stroke

Stroke is the third leading cause of death and a major cause of disability worldwide. Most cases of ischemic stroke are attributable to hypertension and other risk factors, but in over 20% of cases, the cause is unknown. Recent research has implicated some novel genes in the etiology of ischemic stroke, including genes for soluble epoxide hydrolase [sHE], 5-lipoxygenase activating protein [FLAP] and phosphodiesterase 4D [PDE4D]. Moreover, thrombophilic states such as prothrombin G20210A mutation and factor V Leiden are now known to cause arterial stroke as well as venous thrombosis. Meanwhile, the recent availability of enzyme replacement therapy for Fabry disease and the proven benefits of regular blood transfusion in certain patients with sickle cell disease have greatly altered the outlook of these devastating inherited disorders. Thus, our understanding of the role of genetic factors in stroke raises the prospects for accurate assessment of future stroke risk among susceptible individuals, in whom early preventive measures may be life-saving. Further research into the genetics of stroke will clearly compliment ongoing national and international efforts to reduce the global burden of stroke

Maternal, neonatal mortality and morbidity due to obstetrical procedures

Obstetrical procedure is the intervention which is done by the obstetrician to correct the advance of delivery in order to assure a healthy mother and newborn. The obstetrician can intervene by one of the following ways: 1. External and internal version. 2. Vacuum extractor. 3. Delivery forceps. 4., Cesarean session. Bleeding is the most common complication in the delivery without procedure 55.2%.. Pretermission is the most common complication after the delivery without procedure 36%. The bleeding is the most common complication 7.4% after procedure by vacuum extractor. Asphyxia is the most common complication at newborns 8.3% after delivery by vacuum extractor. Mother's morbidity percentage after delivery by forceps is 36%. Newborns' morbidity percentage after delivery by forceps is 18%. Mother's morbidity percentage after internal version of second twin is 17.5%. Newborns' morbidity percentage after internal version of second twin is 54% and the pretermission is the most common complication. Mothers' morbidity percentage after cesarean session is 17.4% and the bleeding is the most common complication. Newborns' morbidity percentage after cesarean session is 19.2% and the pretermission is the most common complication. By this study we conclude that delivery without procedure is the least morbidity for mothers and the forceps is the most morbidity for them, and the cesarean session is the most common reason for bleeding, and the internal version of second twin is the most morbidity and mortality for newborns. Therefore, obstetrician has to adhere the conditions of procedure and choose the right indication due to decrees the morbidity of mothers and newborns