Study of relationship between g894t variant of endothelial Nitric oxide synthase gene and acute ischemic stroke

Background: cerebral stroke [CS] is considered as one of the major causes of death and disability worldwide. Ischemic stroke is the most common type of stroke in Egypt, as in other countries, accounting for 43% to 79% of all stroke types .There are some traditional factors that increase the risk of ischemic stroke such as hypertension and smoking, but genetic risk factors, suggested by evidence from inheritance-based studies, might contribute to predisposition to ischemic stroke. Among investigated genetic variations of eNOS is G894T polymorphism that leads to a change of glutamate to aspartate at site 298 and is said to have increased susceptibility to cleavage of eNOS enzyme which contribute to the development of stroke

Patients and methods: the study was conducted on a group of thirty [30] Egyptian patients admitted to the Neurology Department and Stroke Units of Ain Shams University hospitals [Al-Demerdash hospital].They were presented with acute ischemic stroke in the first 48 hours and diagnosed according to clinical neurological and radiological examinations. Oral informed consents were obtained either from the patients or their relatives before enrollment in the study according to the Ethical Committee of Faculty of Medicine, Ain Shams University. In addition, ten [10] Egyptian apparently healthy, age and sex- matched subjects were investigated as control group. All individuals included in this study were subjected to full history taking, thorough general, neurological and radiological assessment. The laboratory investigations included complete blood count, coagulation profile, and blood glucose level assay. Furthermore, eNOS G894T gene polymorphism was assessed by PCR- RFLP

Results: in this study, we couldn't find a significant association between eNOS G894Tgene polymorphism and acute stroke Egyptian patient

Pre-anesthesia evaluation leading to a diagnosis of long QT syndrome - a case study

Long QT Syndrome is a rare disorder characterized by prolongation of QT interval on an ECG. Patients with this disorder have an increased risk of developing life-threatening arrhythmias such as torsades de pointes, and occasionally sudden cardiac arrest. We present this case of undiagnosed Long QT Syndrome in a 7 years old boy, who presented to our service for incision and drainage of an abscess in the left axilla under general anesthesia. This case highlights the importance of proper and meticulous preanesthesia evaluation, even in low risk patients, so that potentially harmful medical conditions are diagnosed well in time and managed accordingly

Emergency obstetric hysterectomy in Elywia Maternity Teaching Hospital Baghdad

Background: Emergency obstetric hysterectomy is a life saving procedure in severe obstetrical hemorrhage

Objective: To review frequency, indications, associated risk factors and maternal morbidity and mortality associated with emergency obstetric hysterectomy done in Al- Elwiya maternity teaching hospital-Baghdad

Patients and Methods: A prospective study carried out from January the 1st 2010, to December 31st 2010.Maternal parameters analyzed were age, parity, booking status, setting, anemia and pre existing diseases, history of traditional birth attendants interference, mode of delivery, history of caesarean section, time of arrival to hospital and postpartum state of on arrival, frequency ,indications of emergency obstetric hysterectomy, associated maternal morbidity and mortality

Results: During the study period; 200 cases developed postpartum hemorrhage out of 17150 deliveries. Thirty-one cases ended by emergency obestetric hysterectomy and 169 cases were conservatively managed medically or surgically, giving an incidence of 1.8/1000 deliveries.Emergency obestetric hysterectomy following vaginal delivery was 0.11% and following cesearean section was 0.27%. Majority of patients were un booked 77.41% and their age group 25-42 years. Common parity was 3 and 4. Morbidly adherent placenta was commonest indication of emergency obestetric hysterectomy ; 51.61%, rupture uterus 22.60%, atony of uterus 12.90%, broad ligament heamatoma 9.67% .Out of 31 cases; 15 cases had traditional birth attendant interference 48.38%.All cases required blood transfusion and admission to intensive care unit. Out of 31 cases; 2 maternal deaths 6.45%.Total hysterectomy performed in 20 patients, and subtotal in 11

Conclusion: Emergency obstetric hysterectomy is a life saving, surgical procedure to arrest intractable obstetric hemorrhage. It brings down maternal mortality when performed in selected cases at appropriate time. Identification of risk group, planned delivery and timely referral of risk parturient; can minimize its performance