SUMMARYDiabetes mellitus still represents an important medical problem during pregnancy, causing perinatal morbidity and mortality. Despite improved outcome reflected by a steep decline in perinatal mortality over the past few decades, controversy still exists regarding the care of the pregnant woman with both pre-existing and gestational Diabetes Mellitus. Doppler ultrasound is especially valuable during pregnancy because fetal maternal and placental circulations can be studied.The aim of this work was to study the vascular changes in the uteroplacental and fetoplacental circulations, and to correlate these findings with histopathology of the placenta and placental bed, which may occur in association with diabetic pregnancies.The study was carried out on 100 pregnant women of comparable age and parity. They were divided into 2 groups. The control group comprising 20 normal non-diabetic pregnant women and the normotensive diabetic group comprising 80 pregnant diabetic women. All were singleton pregnancies of 34 weeks or more and were delivered by C.S the control and the study cases were subjected to history taking and thorough physical examination. They were also subjected to ultrasonographic examination for fetal biometric parameters and for Doppler examination. Doppler examination included umbilical artery, uterine arteries fetal middle cerebral artery. At the time of C.S the placenta and placental bed biopsy was obtained. After delivery, the Apgar Score of the newborn was assessed at 1 and 5 minutes, the body weight was measured and the fetus was followed up for any complications.There was a positive correlation between the umbilical artery PI and the mean blood glucose levels indicating that poor diabetic control is probably associated with increased umbilical artery PI. However there was no significant difference between the mean value of the umbilical artery PI in the diabetic and control groups.The uterine arteries Doppler indices showed no significant findings between the diabetic and the control groups. Neither did the uterine arteries Doppler indices show a correlation with the mean blood glucose levels.- 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.RecommendationThe current study recommends• Further studies needed to prove the exact role of QRSD and its relationship with LVSF• Further studies to be done on LV systolic dysfunction as EF dose not accurately reflect the left ventricular systolic performance.• Value of biventricular bacing could be assessed and predicted using QRSD rather than QRSd as QRSd does not reflect closely interventricular inhomoegecity.• Larger scale of patients is recommended in further studies to evaluate QRSD