[ effect of intra abdominal wall infiltration with bupivacaine in reducing postoperative diclofenac need in elective cesarean sections]

Considering the side-effects of opiums and NSIADS drugs such as respiratory depression, apnea and GI effects, today it has been paid more attention to intra abdominal wall infiltration of local anesthetics for this purpose. The aim of this study is to determine the effect of intra abdominal wall infiltration with bupivacaine to reduce post operative diclofenac need in elective cesarean sections. In this double- blind, placebo-controlled trial, 60 healthy women with single term pregnancy underwent spinal anesthesia were randomized into two groups. Patients, then received a combination of 30cc of bupivacaine with 1.5cc of epinephrine as intra abdominal wall infiltration or equal volume of saline in cesarean section at the time of abdominal closure. Pain was assessed using a visual analogue scale 1, 2, 3, 4,8 and 12 h after the operation. Also mean diclofenac consumption was assessed during 12 h after the operation. The final analysis was done with statistical tests by SPSS [P<0.05 was considered significant]. Mean pain scores at 1 and 2 h after the operation was significantly lower in bupivacaine group than placebo [p<0.05]. Mean diclofenac consumption was lesser in bupivacaine group than placebo [p<0.05]. Also the time we prescribed diclofenac in bupivacaine group was later [p<0.05]. Intra abdominal wall infiltration with 30cc of 0.25% bupivacaine leads to less paid and less diclofenac consumption at the first hours after cesarean section

[Relative frequency of gonococcal endocervisitis and some associated factors in reproductive age women]

Introduction: Gonorrhoeae is one of the sexual transmitted diseases. It is often asymptomatic in women and can cause a variety of complications and sequelaes, if it is left untreated

Objective: The goal of this study was to determine the relative frequency of gonococcal endocervisitis and some associated factors in women in reproductive age referring to Alzahra hospital in Rasht from 2002 to 2003

Materials and Methods: This is a cross-sectional study. In this study, all the women who referred to Alzahra maternity hospital for family planning and gynecologic disease in 2002-3 were assessed with sequential non-probability sampling .All of the women, who had inclusion criteria, were examined for cervical mucus assessment [for kind and amount]. Culture of cervical mucus is a standard method for diagnosis of gonorrhea infection. So they were referred to a specific laboratory for providing samples of cervical mucus to culture in Thayer-Martin medium. After this procedure, one pathologist evaluated smears. Data gathering form included demographics variables like age, education and …also cause of referring ,kind of vaginal discharge, history of vaginal infection and treatment, contraceptive methods and results of culture. Analysis carried out with chi–square test by spss.10 software

Results: In this study, 1951 women were enrolled. Most of patients 1488 [76.3%] were 21-40 years old. The first coitus age in majority of cases was 20-34 years old. 1136 cases [58.2%] had a history of vaginal infection, 1167 women [59.8%]were in middle class socio-economic status. Neisseria gonorrhea revealed in 11 cases [0.6%] of cultures. There weren't significant correlation between variations like age, first coitus age, parity, education level, socio- economic level, contraceptive methods and gonococcal infection. There was a significant statistical difference between muco-purulent vaginal discharge and gonococcal infection [P<0.004]

Conclusion: Nevertheless, culture of the samples have sensitive, frequency of gonorrhea was similar to research that was carried out in Tehran [diagnosed with smear]. In comparison with the prevalence of gonococcal infection in Asia, it was 4% and was limited to 0.6% in our study. It appears that the condition of cultural values in sexual relations, rate of gonococcal infection had decreased