فهرست مطالب

  • Volume:9 Issue: 3, 2008
  • تاریخ انتشار: 1387/04/15
  • تعداد عناوین: 8
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  • Davari Tanha F., Mohammad Pour J., Kaveh M., Shariat M Page 1
    Introduction
    The predominant etiologic theory of preeclampsia is that reduced uteroplacental perfusion is the unique pathogenic process in the development of preeclampsia. Maternal and fetal erythroblast counts are elevated in the peripheral blood of pregnant women with preeclampsia. The purpose of this study was to examine whether this elevation actually occurs before the clinical onset of the disorder.Study design: In a prospective cohort survey erythroblasts were enumerated in 599 maternal blood samples obtained in 19-26 weeks with singleton pregnancy. After complete blood count a peripheral blood smear was done and erythroblast was counted, and results were subsequently correlated with pregnancy outcomes. The data were analyzed by SPSS 13.0.Independent sample t-test and Fisher’s exact test was used. A p value of <0.05 was considered statistically significant.
    Results
    Significantly higher quantities of erythroblasts (mean 2.46±1.23 vs 0.44±0.55;p=0.009)were detected in blood samples obtained from women who later acquired preeclampsia (n=50) than in blood samples from the control Cohort (n=549). Intrauterine growth restriction was accompany by a similar rise in erythroblast count(mean NRBC 0.82±0.8 in preeclamptic group vs 0.59±0.85 in normotensive group;p=0.009). Mean gestational age was less in preeclamptic group(37.58±1.45 vs 39.07±0.94,p=0.009).On the basis of 1.5 erythroblast as point of convergence there was sensitivity =61.45, specificity=93.02,NPV=98.16, accuracy=91.65
    Conclusion
    Because a large proportion of the erythroblasts in maternal blood are fetal origin, our data suggest that fetal-maternal cell traffic is affected early in pregnancies that are later complicated by preeclampsia.
  • Jafari Javid M., Ghanbar M., Shahidi A., Golbabaii Sh, Atashkhoii S., Shahrokhi Sh Page 2
    Introduction
    Pre-emptive analgesia has been used widely and effectively for post operative pain relief. In this study Bupernorphine, a partial agonist of opioids has been compared to Morphine as preemptive analgesic with the aim to achieve better pain control and less post operative complications.Methods and Material: In this randomized double blind clinical trial, 60 patients were assigned in two equal groups of study (each group=30). Bupernorphine group received 4mcg/kg IV of the drug and morphine group received 0.1mg/kgIV of the drug, 10 minutes before induction of anesthesia. The average time of the first demand for post operative analgesic, the frequencies of demands and the total amount of administered analgesics were recorded. The incidence of post operative complications such as respiratory depression and postoperative nausea and vomiting (PONV) were recorded.
    Results
    The average time of the first demand for analgesic in Bupernorphine group (410±20minutes) was significantly longer than morphine group (240±25minutes), p<0.0001. The number of patients demanded analgesic were lower in Bupernorphine group (46.7%) than morphine group (90%), p<0.0001. The average increase in arterial paco2 was higher in Morphine group. No significant differences were noted between two groups in the incidence of post operative shivering and Nausea and vomiting.
    Conclusions
    Intravenous Bupernorphine before induction of anesthesia was more effective and had fewer side effects than morphine in post operative pain management.
  • Sakhavar N., Mirteimoori M., Teimoori B Page 3
    Introduction
    Preterm labor is defined as delivery before 37completed weeks of pregnancy. Since 10% of total labors are preterm and 70% of infants’ mortality is due to this problem, preterm labor is an important problem in obstetrics, midwifery and pediatrics. So that different treatments have been employed in order to suppress preterm labor from several years ago. Magnesium sulfate is often used as a first - line in suppressing of preterm labor, although its maternal and neonatal side effects are common, in best of conditions only 24-48 hours delays of labor, and randomized clinical trial studies have shown that in suppression of preterm labor it is as effective as placebo. On the other hand because of known ability of Human Chorionic Gonadotropin (HCG) in suppression of contractions in muscles detached from human myometer (in vitro), and safety of this drug in pregnancy, we take a decision that compare the ability of Magnesium Sulfate with HCG in suppression of preterm labor.
    Materials And Methods
    In this clinical trial study, 64 cases were chosen from pregnant women between the 24-34 weeks of pregnancy who were suffering from preterm contractions of uterus with intact amniotic sac and cervical dilatation of less than 4 cm. These women had referred to obstetric ward of Ali-Ebne-Abitalib Hospital, Zahedan, Iran during the years of 2004-6 and randomly were divided into two equal groups (32 cases in each group) In first group primarily 4 grams of Magnesium Sulfate (1 gram per minute) infused and then 2 grams per hour was continued. Whereas, in second group HCG was injected firstly 5000 units intramuscularly and then infused 20 units per minute. Treatments in both groups were continued to 12 hours after uterine contractions stoppage, during the treatments therapeutic effects as well as maternal conditions and complains were recorded in both groups. The results were analyzed by Chi square and T test with SPSS software, differentiation was regarded as significant if P value <0.05.
    Results
    The average duration between initiation of treatments and suppression of contractions of uterus in the first group who had received Magnesium Sulfate was 2.9±0.5 hours, while in the second group that had received HCG was 3.14±0.25 hours, so that differentiation of two groups from this point was non-significant (pv = 0.132). Average rate of labor within 48 hours after beginning of treatment, in the first group was 13% while in second group it was 15% (pv = 0.223), so that there was not significant differentiation between two group from this point too. Whereas, frequency of patients complaints due to side effects of medications in the first group was 100% while in second group was zero (pv <0.0001) which was significant.
    Conclusion
    HCG and Magnesium Sulfate in suppression of preterm labor have the same efficacy but since HCG has not any maternal and neonatal side effects, it is a good alternative in suppression of preterm labor.
  • Ohidullah M., Jamaluddin M Page 4
    The esophagus carries food from the mouth to the stomach. Continuous exposure to the refluxed stomach acid on the esophageal lining causes a burning sensation in the chest or throat known as heartburn. In this study an attempt has been made to investigate the evolution of the pH level over time, and how this evolution depends on the speed at which the stomach is emptied. In this study we used the Linear Mixed Model to handling the longitudinal data. We built our model considering random intercept and random slope with cubic trend of time reflected by the mean profile and variance structure. We found that all the components of cubic trend of time (hour, hour2 and hour3) are significant at 5% significance level. This also coincide the mean profile in exploratory data analysis, that is, cubic evolution of pH level over time exists. The study reveal that there is significant evolution of the pH level over cubic time effect, exists of the patients. The study also shows that the pH level significantly depends on the speed at which stomach is emptied.
  • Mohammadi Tofigh A., Rahmani Sh, Mozaffar M., Abdollahi Sm, Nemati Honar B Page 5
    Objective
    To report a case series of pancreatic pseudopapillary solid cystic tumor as a rare low grade malignant abdominal tumor, which is relatively frequent in young women, with a discussion about its presentations and management to carry out a review of literature.
    Materials And Methods
    We report a case series of 5 Solid pseudopapillary tumors of pancreas. Then all published series of this tumor since 1952 will be analyzed according to our series. The reviewed parameters included demographic data clinical manifestations, therapeutic modalities, and clinical outcomes.
    Results
    Eighty percent of patients were female with mean age of 22.4 years. Two were presented with acute abdominal signs following blunt trauma, 2 with mass sensation, and 2 were incidentally found. They were all diagnosed pre-operatively through computed tomographic (CT) scan and all tumors had benign characteristics. No abnormalities were found in the follow up period and control CT scans.
    Conclusion
    Solid pseudopapillary tumors of pancreas have benign behavior, and the treatment of choice consists of surgical resection. It may spread outside the pancreas, particularly in peritoneal cavity. Metastatic spread may be promoted by trauma, including tumor biopsies, which should never be performed. The outcome after surgical resection is excellent with 90% survival in the long term. Recurrence has been reported in approximately 10% of patients.
  • Shariat M., Sufian M Page 6
    Penile fracture is a rare urological emergency resulting from tear in the tunica albuginea of the penis due to forceful manipulation of an erect penis. We would like to report a case suspected of penile fracture presenting with large hematoma over the glans penis in which, ultrasound was used to confirm the diagnosis and correlate the ultrasound and intra operative findings.
  • Aflaki E., Nazarinia Ma, Habib Agahi Z., Shenavandeh S., Jahanbani Mr, Zahedi Kashkooli L., Rajaee A Page 7
    Relapsing polychondritis (RP) is an autoimmune disorder manifested by episodes of progressive inflammation and destruction of both articular and nonarticular cartilage1. Although RP has been shown to have an increased association with other autoimmune disorders, this disease has been found to coexist with systemic lupus erythematosus (SLE)2.We present a patient with SLE, who developed left auricular inflammation, polychondritis and ocular inflammation associated with hoarseness.
  • Mirsharifi R._Aminian A._Jafarian A._Kalhor M._Dashti H._Ali F. A H._Alibakhshi A._Tahvildary M._Heidari S._Tavakoli F. Page 8