Dexamethasone for the prevention of nausea and vomiting after dilatation and curretage: a randomized controlled trial

Postoperative nausea a and Vomiting [PONV][1] are common complications after surgery. Propofol based nesthesia is a effective technique for decreasing of PONV. Most study are formed to evaluate efficacy of Dexamethasone in preventing of PONV, but there have been no reports to evaluate the efficacy of dexamethasone for preventing PONV in propofol -based anesthesia for D and C[1]. In a prospective, randomized double - masked, placebo controlled trial, 202 women received placebo or dexamethasone intravenously at doses of 4 mg, 8mg,.or 16mg immediately before Induction of anesthesia. Propofol based general anesthesia was used. Emetic episodes and safety assessments were performed to estimate sufficient sample size using chi- squar test with confidence interval 95% [alpha= 0.05 and beta=0.2]. The rate of patients who were emesis free [no nausea or vomiting] 0-24 hours after anesthesia was 78.4 in placebo, 81.1% in dexamethasone 4 mg, 90.0% in dexamethasone 8 mg and 95% in dexamethasone 16 mg. No clinically important adverse events were observed in any of the groups. Dexamethasone 8 mg is an effective antiemetic durg for prevention of postoperative nousea and vomiting 0-24 hours after anesthesia in women undergoing propofol based general anesthesia for termination of pregnancy. Increasing the dose to 16mg provided no additional benefit. In regard to cost, Dexamethasone is prefer to other drugs

Evaluation of laboratoary and clinical ressistance to parentral ampicillin in acute pyelonephritis during pregnancy

Acute pyelonephritis is one of the most common cause of hospitalization in pregnant women. It's a long time that Ampicillin has used as the first step of treatment, but now we encounter resistant species of bacteria against it. The purpose of this study was a survey of clinical and laboratory resistance to intravenous Ampicillin in pregnant women with acute pyelonephritis. This survey was done on 74 pregnant women who have been admitted to the obstetric center of Emam Reza Hospital with diagnosis of acute pyelonephritis for a period of one year [l378-79]. All of the patients were prescribed intravenous Ampieillin [lgr Qid] after taking urine culture and analysis. Clinical response was assessed after 72 hours and compared with the first urine culture. The most common pathogen was E.coli [79.4%]. Ampicillin resistance rate regarding antibiogram was common [88.2%], but clinically 43.2% of patients taking Ampicillin were resistant. There was a significant difference between laboratoary and clinical resistant in this study [P=0.03]. At last like other studies and of course with more emphasis, we can say that Ampicillin alone for empirical treatment of pregnancy acute pyelonephritis is not effective. So we propose that an aminoglycoside should be added to Ampicillin regimen for acute pyelonephritis of pregnancy