مجله دانشکده پزشکی اصفهان
پیاپی 701 (هفته اول اسفند 1401)

Platelet transfusion is one of the main treatments for thrombocytopenia to reduce severity and frequency of bleeding. Inadequate increase in platelets following platelet transfusion is known as platelet refractoriness. The aim of this study is to investigate the prevalence, as well as predictive factors, of platelet refractoriness.

In a cross sectional study, 73 patients suffering from severe thrombocytopenia due to leukemia or aplastic anemia, hospitalized at the hematology-oncology ward of two main referral hospitals in Mashhad, were evaluated. Platelet transfusion was done in patients with platelets count less than 10,000 per microliter or less than 20,000 per microliter and fever more than 38° C. Platelet count was measured before and 60 minutes after platelet transfusion, and after calculating body surface area (m2), corrected count increment (CCI) was calculated. If CCI is more than 10,000 per microliter, no platelet refractoriness was considered.

55 patients (75.3%) had platelet refractoriness. Higher platelet refractoriness was seen in the group that received more platelet units and patients who received apheresis units had less refractoriness.

Platelet transfusion should be done only if necessary and transfusion of apheresis units must be considered in patients who need regular platelet transfusion.

Dilatation and curettage (D&C) has been the method of choice for obtaining endometrial sample but there is a challenge about the D&C’s accuracy and reliability compared to other diagnostic methods. The aim of this study was to investigate the concordance between endometrial histopathological diagnosis from D&C and hysterectomy samples.

In this retrospective study, histopathological results of D&C samples of 136 women who suffered from abnormal uterine bleeding between 2015 to 2018 and underwent hysterectomy were investigated and compared with pathologic reports of hysterectomy.

The mean ± standard deviation (SD) of age of patients was 52.6 ± 11.3 years in the range of 33-80 years. According to the findings of D&C in comparison with the standard method of hysterectomy, the specificity and negative predictive values were substantial in premalignant samples. Beside, D&C findings revealed the specificity and the positive predictive values as likely as 100% for diagnosing malignant samples. In the other hand, D&C revealed significant the sensitivity and the positive predictive values for diagnosing normal and benign samples. In the premalignant pathologies that were diagnosed with D&C, the risk of an undetected malignancy in the atypical hyperplasia was 16.7%.

No malignant pathology was encountered in patient with a diagnosis of normal tissue or a benign pathology on the D&C samples. In addition, both the specificity and the positive predictive values following D&C was 100% in diagnosing endometrial malignancy.

The World Health Organization emphasizes the importance of quality of married life throughout a person's life, the aim of this study was to investigate the quality of marital life and its demographic predictors in the elderly.

This is a cross-sectional study on 200 elderly people over 60 years’ old who referred to Isfahan health care centers. The data of this study were collected by Fletcher Quality of Marital Life Questionnaire (2000). Then the relationship between quality of marital life and its dimentions with demographic factors was analyzed by logistic regression.

In 46% of the elderly, the quality of marital life was favorable. The highest utility was in the dimension of commitment (63%) and the lowest utility was in the dimension of sexual arousal (31%). The Adjusted Odds Ratio of favorable quality of marital life in people with higher incomes than lower income people were 2.14 and this relationship was in dimensions of satisfaction, commitment, intimacy and sexual arousal. The adjusted odds ratio of favorable sexual arousal in people under 70 compared to those over 70 was 3.90. Gender, education, and occupation did not predict the quality of married life.

The quality of married life is unfavorable in more than half of the elderly in Isfahan, and it becomes less favorable with increasing age and lower income.