CORONARY ARTERY DISEASE AS

Faculty Medicine Year: 2005
Type of Publication: Theses Pages: 201
Authors:
BibID 3218545
Keywords : Cardiology    
Abstract:
SummaryStrokes are a major public health problem where carotid artery stenosis accounts for 20 to 30% of all cases. Also, patients with concomitant critical carotid and coronary artery disease are at risk of major neurological events specially during coronary artery bypass grafting.Cardiologists often underestimate the prevalence of renal artery stenosis in their cardiac patients, and there are no specific guidelines that address the timing or indications to perform renal angiography in patients undergoing coronary angiography.To evaluate the prevalence of carotid and renal artery stenosis in patients with documented coronary artery disease and the role of predisposing risk factors for such affection in Egyptian patients, we prospectively studied 100 patients. Who were subjected to coronary angiography and were with significant stenosis (> 70% stenosis) of at least one vessel, and/or > 50% in the left main coronary artery.In the same setting, these patients were subjected to both carotid and renal angiography, either selective or nonselective. Where significant carotid or renal artery stenosis was considered if stenosis > 50%.Risk factors for atherosclerosis were evaluated for all our patients including, patients age, gender, smoking history, hypertension, diabetes mellitus and dyslipidemia. Also, renal function tests (blood urea and serum creatinine) were evaluated.All patients were classified into three groups according to the presence or absence of significant carotid and renal artery stenosis:Group I: Patients with positive coronary artery disease and normal carotid and renal arteries bilateral.Group II: Patients with positive coronary artery disease and with either significant carotid artery stenosis [group IIa], or with significant renal artery stenosis [group IIb].Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Endometrial thickness greater than 13 mm , which is hypoechoic or inhomogenous with presence of intratumoral blood vessels with RISUMMARYEndomtrial carcinoma is the commonest invasive malignancy of the female genital tract in both the united kingdom and united states of America . It is the fourth commonest cancer in women and the most curable of the 10 most common cancers in women.Recents reports have investigated the role of transvaginal color Doppler ultrasonography as a means of detecteding gynecologic malignancies. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, depth of myometrial invasion and presence of lymph node metastasis in patients with endometrial carcinoma .In this study , two groups of patient were included. Non malignant group comprised 60 patients and malignant group comprised 15 patients.All the patients in both groups were subjected to through history , through clinical examination and then TVS with color flow and pulsed Doppler study and finally from every patient endometrial biopsy was taken which was subjected to:- Routine histopathological examination .The results were statistically analyzed and diagnostic accuracy of Doppler ultrasonography in the prediction, diagnosis and prognosis of endometrial carcinoma are calculated .In this study , 75 patients included presented by abnormal uterine bleeding . Histological examination reveals that 15 cases (20%) proved to be endometrial carcinoma , 46 cases (61%) endometrial hyperplasia , 2 cases (3%) secretory endometrium , 5 cases (7%) proliferative endometrium , 6 cases (8%) atrophic endometrium , and only 1 case (1%) proved to be endometrial polyp . The sonographic finding in cases of endometrial carcinoma were charecterized by an endometrial thickness more than 10 mm . Non of the cases of endometrial carcinoma had endometrial thickness less than 10 mm , while all cases of atrophic endometrium had endometrial thickness less than 5mm . 32.6 % of cases of endometrial hyperplasia had endometrial thickness 5-10 mm , while 67.4 % more than 10 mm . The mean endometrial thickness of non malignant group was 11.23 + 6.04 while in malignant group was 20.67 + 6.58 and this was statistically significant (p< 0.001)Non histological markers of hepatic fibrosis in liver disease are still holly grill in hepatology. Currently liver biopsy is the gold standard for diagnosis and treatment of liver disease and required speciment to be more than 20 mm in length and contain 11 portal tract to be able to assess stages and grades of hepatic fibrosis probably. Histological examination of liver tissue biopsy, is recommended prior to the initiation of antiviral therapy (EASL International Consensus Conference on hepatitis C, 1999). It is vital for monitoring fibrosis progression. Unfortunately, this procedure is invasive, prone to complications, including hemorrhage and death (Poynard et al., 2000) and has a high risk of sampling error (Maharaj et al., 1986).In this study, 4 biochemical markers of hepatic fibrosis (alpha 2 macroglobulin, haptoglobin, apolipoprotien A1, GGT) used together with routine fiver function test were of an excellent predictor of hepatic fibrosis when compared with liver biopsy.This biochemical markers in prediction of hepatic fibrosis mostly in stage 2, 3, 4 according to METAVIR scoring system.This fact increase the need for non histological markers for hepatic fibrosis alone or in combination with liver biopsy. Biochemical markers for liver fibrosis and necroinflammatory features are an alternative to liver biopsy, in patients with chronic hepatitis C (Poynard et al., 2002).For detection of liver fibrosis by non invasive technique study of some serum biochemical markers in patients infected with HCV.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:Group A: with TIAs of less than 15 minutes.Group B: with TIAs from 16 minutes to 30 minutes.Group C: with TIAs form 30 minutes to 60 minutes .All patients were subjected to the following:1- Detailed history taking.2- Complete general and neurological examination.3- Laboratory investigations:4- ECG (electrocardiography)5- Brain computed tomograhpy6- Transcranial Doppler7- Extracranial carotid DopplerThe results showed that:- Ther was male predomenence over females in both groups.- The prevalence of stroke risk factors were more common in group I than that of groupII.- The Canadian neurological scale was slightly higher in-group II with a higher scores among group A.- Among the patients of group II the outcome was favorable more than that of the first group according to Barthel index, the most favorable outcome was seen in subgroup A.- Favorable outcome was the best in patients with one week elapse time between the previous TIA and the onset of stroke.- Favorable outcome was better in patients who had 2 or 3 TIAs before their stroke.- Group II patients had smaller sized infarcts in CT than in group I patients.- -The mean cerebral blood flow velocities was lower on the affected side than the non affected side.In conclusion we do not state that TIA prevents ischemic stroke but if TIA occurs in the same vascular territory within a time window (4-14 days) and for short periods (less than 30 minutes) the clinical picture may become less severe and the outcome better after an ischemic stroke.RecommendationThis study like some other studies lead us to pay more attention to all risk factors of ischemic stroke and those with history of TIA to be fully investigated to identify the cause of TIA and to manage them and to be followed up to avoid evolving of cerebral infarction and these results may lead in the future to preventive medicine that target certain genes, drugs and/or combination therapy of ischemic stroke to create a neuroprotective effect against ischemic strokeSUMMARY AND CONCLUSIONOur study was done to show the effect of previous TIA in patients after their ischemic stroke in the anterior circulation and to clarify the neuroprotective effect of TIA through comparing the severity of clinical picture on admission and the outcome of stroke in patients with and without previous TIA.50 stroke patients was studied during the period from December 2003 to November 2004. There age range from 43 to 75 with mean age of (m ± SD = 60.8 ± 4.80).According to the presence or absence of previous TIA, our patients were divided into two groups:(Group I): (25 patients) with no past history of TIA (25 patients)(Group II): (25 patients) with previous one or more TIAs in the anterior circulation. We subdivided this group into:? Therapeutic options for clomiphene – resistance cases ( no response) are either parenteral gonadotropin therapy or laparoscopic ovarian drilling.? Therapeutic option for clomiphene failure cases ( ovulate but no conception) are reasses and possibly change to one of the assisted conception treatment.o Gonadotropin It should be given in lowest possible does to achieve unifollicular ovulations .Criteria employed before the administration HCG as the ovulatory trigger .o Insulin Sensitizers Metformin is the first line treatment of anovulation induction . It increases ovulation success and restor menstrual cycle . Metformin also has been used succesfully as an adjuctive agent with both CC and gonadotrophene it decrease long –team complcations of insulin resustance and hyperinsulinemia .It is given by mouth 500 mg three times daily after meals.o Ovarian Surgery:LOD is the substitute for wedge resection. LOD may be recommended only for women who have not responded to weight loss and fertility medication .The drill should be followed by ovarian stimulation, because the effect of the drill would not last long.• Menstrual Abnormalitis in women not attempting to conceive should be given long–term management of PCOS must involves the use of low does oral contraceptive or medroxyprogesterone acetate (depo or intemettent oral therapy ) , in addition to insulin sensitizers .• Hirsutism Treatment : is often palliative rather curative . It include cosmetic and medical therapy . Agents that have been used include oral contraceptives , antiandrogen drugs and insulin sensitizers.Conclusions• The diagnosis of PCOS needs ultrasound in addition to laboratory assays.• The treatment cycle should be carefully monitored by hormonal assays and ultrasonic folliculometry to prove the occurrence or failure of ovulation and in turn failure of the treatment protocol.• CC is the first line of treatment.• High Insulin level is a good marker for the poor prognosis of any treatment protocol.• Metformin should be added to the treatment protocol especially for hyperinsulinemic and obese patients.• Rec-FSH is the Gonadotropin of choice.• The addition of GnRh-a is not recommended.• Ovarian drill by laparoscopy should be carefully used on selective scale.Recommendations• Ultrasound may be useful to confirm the diagnosis of PCOS , it is not used as the only medical test for PCOS .• Watchful waiting is not appropriate when PCOS suspected – early diagnosis and treatment may help prevent future complications such as reproductive , metabolic or cardiovascular problem .• All anovulatory women ,especially when obese and /or hyperandrogenic , should be assessed for insulin resistance and glucose tolerance .• The decision to perform an endometrial biopsy should not be influenced by the patients age . It is the duration of exposure to unopposed estrogen that is critical .• In women who continue to manifest this disorder , periodic (once or twice a year) surveillance is necessary , especially women who continue to be obese .• Screening of first degree relatives of patients with PCOS , because they may by at high risk for diabetes , insulin resistance and high androgen levels . 
   
     
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