Traitement endovasculaire de l'accident vasculaire cérébral

Ischemic stroke (IS) is an acute pathology that requires an urgent treatment and a complex organization for the health care systems. IS is the second mortality reason around the world and the third one in industrialized countries based on World Health Organization database. IV thrombolysis started in 1996 as a treatment for IS with the administration of reteplase or Rt-PA up to 4h30 after symptoms beginning with 30 to 40% of efficacy. Mechanical thrombectomy (MT) allows to expand therapeutic window further than IV thrombolysis and higher efficacy. Therapeutic decision is multidisciplinary with senior doctors and appropriate materials: stroke unity composed by interventional neuroradiologists, angio-room, department of Neurosurgery, Intensive Care and imaging equipments to perform neuroradiological examens. MT is considered the gold standard treatment for IS if Aspect Score is > to 5 and symptoms started not more 6 hours before endovascular treatment. Randomized studies showed the superiority of MT + IV thrombolysis over IV thrombolysis only. Endovascular treatment by MT requires financial support from health care systems, but the price is justified by the lower number of disabled patients because morbidity, functional impacts and quality of life at 90 days

Prevalence of bacterial vaginosis in antenatal women.

Bacterial vaginosis is an established risk factor in pregnant women for premature rupture of membranes and preterm delivery. This study was carried out to find out the prevalence of Bacterial Vaginosis (BV) in antenatal women with vaginal discharge and the effect of treatment with Metronidazole gel on pregnancy outcome. One hundred and fifty symptomatic and fifty asymptomatic women in second trimester of pregnancy in the age group of 20-30 years were included in the study. Gram stained smears of vaginal discharge were examined for evidence of BV with a scoring system by Nugent et al and was found to be positive in 38.5% in symptomatic antenatal women. Intravaginal metronidazole gel application was found to be an effective therapeutic option. Incidence of preterm labour was more in untreated cases.