الفهرس 
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Abstract
Perinatal asphyxia is one of the major causes of neonatal mortality in developing countries. Perinatal asphyxia is characterised by impaired gas exchange which leads to hypoxemia, hypercarbia and metabolic acidosis.
Impaired gas exchange and insufficient perfusion to vital organs leads to severe neurological insult resulting in death and long term disability.
The molecular mechanism behind the neurological deficit is not fully evaluated. Two mechanisms of the DNA damage have been suggested. It is envisaged that H2O2 which crosses the biological membrane easily can penetrate the nucleus and react with ions of iron or copper to form hydroxyl radical (OH.). Other explanation is the ability of oxidative stress to cause DNA damage by triggering a series of metabolic events within the cell that lead to the elevation of nuclease enzymes which cleave the DNA backbone.
The intracellular free Ca+ interact with Ca+ dependent endonuclease leading to fragmentation of DNA, resembling the mechanism that of apoptosis(programmed cell death).
The present study was designed to assess DNA damage in full-term asphyxiated newborns and to relate it to different clinical features of the
patients. This was done through evaluation of (50) full-term newborns thirty(30) patients were newborns with different grades of hypoxic ischemic encephalopathy admitted at NICU, Menoufia University. Twenty (20) age and sex-matched healthy full-term newborn were included in the study as controls. All the neonates in this study subjected to detailed history taking clinical examination including Apgar score, gestational age , complete physical examination of all systems with special consideration to neurological examination and routine Laboratory investigations.
Estimation of DNA damage in peripheral leucocytes by DNA fragmentation assay was done by the means of DNA extraction and then Gel electrophoresis.
In our study, there was no difference between patients and controls regarding mode of delivery. Also there was no statistically significant between patients and control regarding parity of mothers and mother age but there was significant incidence of delivery complications in patients compared to control.
In our study, a significant lower Apgar score at 1 and 10 minutes was detected in cases when compared to controls. All organs can be affected by perinatal asphyxia. HIE is the most widely studied, as it has the most serious sequelae. In this study clinical examination of patients central nervous system shows a significant high incidence of seizures, flaccidity and hypotonia and non-elicited reflexes.