[ effect of tranexamic acid on pregnancy outcome and vaginal post-parturition hemodynamics]

Tranexamic acid, as an anti-fibrinolytic agent, has been shown to reduce bleeding, but its use has been limited in the scope of vaginal delivery. The purpose of this study was to examine the effect of tranexamic acid on pregnancy outcome and vaginal post-parturition hemodynamics. In a randomized, double-blind clinical trial, 200 primgravida pregnants were divided into the two groups [case and control]. The case group received IV tranexamic acid immediately post-parturition and the control group IV glucose 5%. Hemoglobin [Hb] on admission and 24 hours post-parturition were measured and Hb level drop more than 10% was considered as postpartum hemorrhage. The Hb status was evaluated through measuring blood pressure and heart rate. The pregnancy outcome measures [e.g. changes in Hb level, need for the additional uterotonic drugs, blood transfusion and surgery] were evaluated. There was a significant difference between the two groups in Hb level drop within the first 24 hours post-parturition. Moreover, no severe bleeding, blood transfusion and misoprostol administration were reported in the case group, but 4 cases in the control group. Tranexamic acid administration can effectively reduce post-partum bleeding and therefore prevent a further decrease in maternal Hb levels

[Antibiotic sensitivity of isolated E.coli from pregnant women urine]

Urinary tract infection is the most common bacterial infection during pregnancy. The pregnant women seems to be at risk for pyelonephritis and untreated infection. Timely recognition and on-time appropriate treatment of urinary tract infection particularly in pregnant women reduce the related complications. This study was done to assesse Sensitivity of isolated E.coli from pregnant women urine to antibiotics. In this descriptive study E.coli isolated from 360 urine samples from pregnant women, were examined, using Eosin Methylene Blue, blood sugar method. Antibiogram diffusion disk Kirby-Bauer was performed to assess the antibiotic response. The persent of sensitivity of Escherichia coli to antibiotics were Co-amoxiclav [5.72%], Ampicillin [8.86%], Amoxicillin [11.87%], Cefazolin [32.12], Cephalexin [36.1%], Gentamicin [40.28%], Co-trimoxazole [48.15%], Nalidixic acid [55.3%], Nitrofurantoin [72.48%] and Ceftriaxone [80.78%]. This study showed that there is a high level of E.coli antibiotics resistance toward Amoxicillin and Ampicillin high sensevity is related to Ceftriaxone and Nitrofurantoin in this region

[Evaluation of genetic pattern of non-tuberculosis mycobacterium using VNTR method]

Epidemiological studies of Non-tuberculosis Mycobacterium is important because of the drug resistance pattern and worldwide dissemination of these organisms. One of genetic fingerprinting methods for epidemiological studies is VNTR [Variable Number Tandem Repeat]. In this study genetic pattern of atypical Mycobacterium was evaluated by VNTR method for epidemiologic studies. 48 pulmonary and non pulmonary specimens separated from patients with the symptoms of pulmonary tuberculosis [PTB] and identified as Non-tuberculosis Mycobacteriumby phenotypic and PCR-RFLP methods were selected for this study. Clinical samples and their standard strains were evaluated according to VNTR pattern using the 7 genetic loci including ETR-B. ETR-F. ETR-C. MPTR-A. ETR-A. ETR-E. ETR-D. The results of VNTR method showed that none of the 7 loci had any polymorphism in the standard strains of atypical mycobacterium. Some of these variable number tandem repeat in 42 clinical samples of non-tuberculosis Mycobacterium were polymorphic while the PCR product [for any loci] was not found in the remaining 6 specimens. Although the used genetic loci of this study were suitable for epidemiological studies of Mycobacterium tuberculosis, these loci were not able to determine the diversity of genetics of non-tuberculosis Mycobacterium Therefore, it seems necessary that other loci be studied using VNTR method

[ Survey the effect of planned program of health promotion on stress management in middle-aged women]

There are many physiological and psychological stresses in Middle-age, which can have significant effect on mortality and suffering from a disease in women. So considering stress management in the form of a program is very important. This study aims at investigating effect of planned program of health promotion on stress management in middle-aged women. This research was a semi-experimental study and done with two groups of case [50 people] and control [41 people] were selected by convenience sampling. planned program of health promotion was performed on three stages: identification and investigation, supportive planning and evaluation of programs performing and giving feedback. Tools used to data collection in this research included: demographic information questionnaire and health promotion lifestyle profile 2 [HPLP2] questionnaires which completed by the case and control groups before and one and a half months after intervention. The finding showed that before intervention ,no meaningful important statistical difference was observed average numbers of stress management and spiritual improvement between case and control groups [P>0.05]. While after intervention according to independent t-test showed that there is a meaningful statistical difference in average numbers [P<0.05]. This difference was also meaningful before and after intervention in case group. Performing planned program of health promotion has been effective on stress management in middle-aged women and is suggested as a good program in mental health of middle-aged women

Should post kidney transplantation hyperlipidemia considered a risk factor for graft function?

Hyperlipidemia is a common problem after kidney transplantation.To uncover the real impact of post kidney transplantation hyperlipidemia on graft function and survival, and to determine whether it is just a biochemical phenomenon after using immunosuppressant or a part of disease pathology. 330 kidney transplants were managed in Sina Hospital Kidney Transplantation Unit affiliated to Tehran University of Medical Sciences, Tehran, Iran from September 1994 till February 2010. The demographic characteristics of the patients, causes of chronic kidney diseases, history of pretransplantation dialysis, pretransplantation comorbidities [e.g., hypertension, diabetes mellitus [DM], hyperlipidemia and coronary artery disease], rejection episodes, status of infection with cytomegalous virus [CMV], post-transplantation DM, hyperlipidemia, ischemic heart disease [IHD], and graft and patient survival were recorded. A serum creatinine level >2 mg/dL was considered as "graft deterioration," and return to dialysis as "graft loss." According to the presence or absence of post kidney transplantation hypercholesterolemia [>200 mg/dL] or hypertriglyceridemia [>200 mg/dL], the patients were classified into "hyperlipidemic" or "non-hyperlipidemic." The presence of clinical or paraclinical coronary artery disease was also determined in both groups.The incidence of hyperlipidemia elevated from 8% to 50% before and after transplantation. 2.7% developed clinical IHD. 13% of hyperlipidemics and 22% of non-hyperlipidemics developed graft deterioration. Among hyperlipidemics with deteriorated grafts 40% had premorbid diseases, 68% had CMV infection and 82% had hypertension. Only 22% had previous acute rejection and 27% received deceased kidney transplant.Post-kidney transplantation hyperlipidemia is just an associated phenomenon secondary to the use of immunosuppressant medications, which have no obvious impact on renal graft function and can be easily controlled by instituting dietary modifications and use of modern antilipid medications. Post kidney transplantation CMV infection and hypertension are considered as the main threatening risk for renal graft-even more dangerous than acute or chronic rejections

[Comparison of one and two visit treatment of open apices with Mineral Trioxide Aggregate plug]

Mineral trioxide aggregate [MTA] usually produces moisture by paper cone for at least 4 hours with regard to some studies that the moisture of periapical tissues is enough to set the MTA. The aim of this study was comparison of one-visit apexification with two-visit apexification using MTA plug. In this experimental study 70 extracted single-rooted human teeth were selected. The crowns and 2mm of apices were cut. Canal preparation was performed to ISO size No.100 in the apical portion. The teeth were randomly divided into 2 experimental groups of 25 and 2 control groups of 10 teeth. The canals in group one were obturated immediately after MTA plug placed. In group two after placing MTA plug, a moist paper point was placed inside the canal, and after 24 hours, canals were obturated. The roots were covered with two layers of nail polish in the designed system and were transferred in a sterile BHI [Brain Heart Broth] culture. A fresh solution of Enterococcus faecalis was injected to the system every 3 days. For 90 days, the time of culture contamination was registered. Survival analysis with Kaplan-Meier method and Log Rank test were used to analyze the data. Mean and 95% CI of survival time in one visit group was 12.77 [0-25.69] days and in two visit group was 4.160.3-7.01] days. There was no significant difference in survival curve between the two groups. Results showed that apexification in one visit by placing an apical pug of MTA is a predictable and reproducible clinical procedure

[Abetalipoproteinemia: report of two cases]

Abetalipoproteinemia is a rare disorder of lipoprotein metabolism, which causes low levels of cholesterol and absence or very low levels of LDL and VLDL. This rare autosomal recessive disorder is characterized by lipid malabsorption, spinocerebellar degeneration, acanthocytosis and retinopathy. In this study two cases of this disorder presented with severe malabsorption and abdominal distention, which mimicked celiac and fibrocystic diseases were reported

Frequency of macroprolactinemia in hyperprolactinemic patients with simple polyethylene glycol precipitation test

Hyperprolactinemia is seen not only in pregnancy but also in several pathological conditions, However, some patients with hyperprolactinemia are diagnosed as idiopathic, because the causes are unknown. They are subjected to repeated radiological examinations to find a microadenoma, to a long term treatment with bromocriptine, and even to a surgical intervention. There is evidence that macroprolactinemia, in which most circulating PRL form large protein complexes [>150 KDa], is a major cause of idiopathic hyperprolactinemia. Macroprolactinemic patients are clinically characterized by lack of or less hyperprolactinemia - related symptoms. The objective of this study was to assess the prevalence of macroprolactinemia in hyperprolactinemic patients. Prolactin was measured before and after precipitation of macroprolactin by polyethylene glycole in 113 hyperprolactinemic [PRL>28 micro g/L patients. In 23% of the patients, macroprolactinemia was found. Considering the high prevalence of macroprolactinemia and to avoid diagnostic and therapeutic pitfalls, the screening for macroprolactinemia in all hyperprolactinemic patients is recommended

comparative study on the effect of lidocaine and furosemide on urinary output and graft function after renal transplantation

Renal transplantation is an ideal treatment for patients with chronic renal failure. It was demonstrated that despite the adhesion to surgical and anesthetic principles, urinary output is not satisfactory after transplantation. It seems that microvascular spasm of renal vasculature is responsible for this phenomenon. We designed a study to investigate whether lidocaine injection into renal artery can relieve vasospasm and subsequently improve output and graft function better than furosemide. In a randomized clinical trial, from July 2002 to November 2003, 100 consecutive patients who were referred to our center for kidney transplantation were recruited in this study. After obtaining written informed consent, they were divided blindly into two groups. In group 1, lidocaine was injected into renal artery, before arterial anastomosis, and group 2 received furosemide as the conventional intervention. Urine volume within 1, 4, and 24 postoperative hours and serum creatinine levels in the first three weeks were recorded and compared between the two groups. Urine volumes at 1, 4, and 24 hours after transplantation were higher significantly in lidocaine group [P<0.001]. Serum creatinine levels were lower significantly in the first postoperative day and also 21 days after transplantation in group 1 [P<0.001]. Comparing to furosemide, it seems that lidocaine can cause a more effective vasodilation in renal arteries of kidney allograft, resulting in a better diuresis. This may have a role in the betterment of graft function