Seroprevalence of Bordetella pertussis antibody in pregnant women in Iran

The increasing incidence of pertussis among adolescents and adults in recent years is an alarming factor in transmission of the infection to non-immune infants and children. Vaccination of pregnant women, immediately after delivery and before being discharged from the hospital may help to protect mothers and their newborns against the disease. Decision making process, regarding maternal immunization, requires credible information and knowledge about seroepidemiology of the infection in pregnant women. The aim of this study was to determine the seroprevalence of Bordetella pertussis antibody among admitted pregnant women in Hamadan, western Iran. In this cross-sectional study, 288 pregnant women admitted to the Fatemiyeh Hospital, Hamadan, western Iran, were enrolled into the study. After obtaining consent from every patient, serum samples were taken from patients and were kept frozen until testing. Serum level of B. pertussis antibody was measured using ELISA. Level of antibody higher than 24 U/ml was considered positive. The obtained data were analyzed using the statistical software SPSS. From 288 pregnant women, 126 [43.8%] were in their second trimester. Serological results in 103 patients [35.8%] were positive. The mean age of mothers with positive serology was 27.5 +/- 6 years old. Thirty-five percent of patients had a valid immunization record, and 1.57% of those with no vaccination record had a positive serology. The level of immunity against B. pertussis in pregnant women was low. Immunization before or during pregnancy can stimulate newborn's immune response and gives them required protection against pertussis infection

Effects of ascorbic acid on serum level of unconjugated estriol and its relationship with preterm premature rupture of membrane: a double-blind randomized controlled clinical trial

Background: Vitamin C is a water-soluble antioxidant that not only stimulates and protects collagen synthesis but also plays an important role in maintaining cellular integrity in a normal pregnancy. This study surveyed the effects of ascorbic acid on the serum level of unconjugated estriol and the relationship between unconjugated estriol and preterm premature rupture of membrane [PPROM]

Methods: This double-blind, randomized clinical trial recruited 60 patients with predisposing factors to PPROM. The women were randomly divided into two groups of intervention and control and received vitamin C and placebo, respectively. The intervention group received 250 mg vitamin C twice a day and the controls received the placebo only. Unconjugated estriol was measured using the ELISA. All data were extracted and recorded in a checklist and compared using descriptive statistics as well as the chi[2], Fisher exact, and t tests

Results: The demographic data showed no difference between the two groups. The mean level of serum unconjugated estriol was significantly lower in the intervention group than in the control group [P=0.044]. Also, the frequency of PPROM was lower in the intervention group, but the difference was not significant [P>0.05]. Unconjugated estriol levels were not significantly different between the healthy women and the PPROM patients

Conclusion: This study demonstrated that vitamin C administration decreased unconjugated estriol levels in the patients with PPROM. The findings of this study also indicated that administration of ascorbic acid was a safe and effective method to reduce the incidence of PPROM. Alteration in unconjugated estriol is an active mediator for this effect

Therapeutic effect of vitex agnus castus in patients with premenstrual syndrome

Medical therapies have been widely used for premenstrual syndrome [PMS], but in all of them side effects are predominant. Herbal remedies rarely have side effects and people have more tendencies toward them than chemical therapies. In this study the therapeutic effect of Vitex agnus castus on women who had the PMS, in comparison with placebo, were investigated. In this randomized, placebo-controlled, double-blind study, from134 selected patients 128 women suffered from PMS were evaluated [active 62, placebo 66]. All patients answered to a self assessment questionnaire about their headache, anger, irritability, depression, breast fullness and bloating and tympani during the premenstrual period before the study. Forty drops of Vitex agnus extract or matching placebo, administrated for 6 days before menses for 6 consecutive cycles. Patients answered the self-assessment questionnaires after 6 menstrual cycles, again. Each item rated using a visual analogue scale [VAS]. The mean age was 30.77 [SD=4.37] years in the active group and 30.89 [SD=4.02] years in the placebo group. Rank of variables had significantly difference in active and placebo group before and after the study [P<0.0001] also we noticed significant differences on the use of Vitex agnus in comparison with placebo [P<0.0001]. Vitex agnus can be considered as an effective and well tolerated treatment for the relief of symptoms of mild and moderate PMS

Hydrosalpinx with adnexal torsion in a virgin patient

We present a case of 28-years-old female, presenting with acute right lower abdominal pain. She wasn't sexually active and in the absence of infection and hormonal treatment, with right side adnexal torsion due to hydrosalpinx

Umbilical endometriosis associated with umbilical hernia

Abdominal wall endometriosis is defined as endometrial tissue superficial to the peritoneum. Cutaneous endometriosis is a well known but rare phenomenon. We present a case of spontaneous umbilical endometriosis

[Comparison of hemoglobin concentration, after cesarean .section, between two methods: general anesthesia and spinal anesthesia]

The use of halogenated agents during balanced general anesthesia may result in an increase in blood loss associated with cesarean section but in some studies this result rejected. The aim of this study was. Comparison of hemoglobin concentration, after cesarean section between two methods: general anesthesia and spinal anesthesia. This clinical trial study comprised 170 pregnant women, who were elective cesarean section candidates for the second time. This study was approved by the local committee of medical ethics. Patients were randomly divided into two groups, each with 85 members. Exclusion criteria were: cardiac diseases, coagulate disorders, anemia, preeclampsia, abruptio placenta, emergent cesarean section cases, atonia [polyhydramnius ....], birth weight more than 4kg, and long duration of the operation [more than 90']. Patients of the first group underwent general anesthesia and spinal anesthesia was applied for the second group. There was no significant difference between both groups regarding the mean age, operation, and anesthesia durations [p>0.05]. The mean hemoglobin [HP] and hematocrit [Hct] levels were significantly lower in both groups post operatively compared with the same values pre operatively [p<0.05]. Post operative, Hb.Hct reduction rate [preoperative Hb.Hct minus post operative Hct] was significantly higher in general anesthesia group [p<0.05]. If duration of operation time was longer than one hour, Hct significantly decreased. Results of the present study showed that postoperative Hct reduction rate in cesaeran section was higher in patients who received general anesthesia in comparison with spinal anesthesia

Diagnostic accuracy of C-reactive protein and erythrocyte sedimentation rate in patients with acute scrotum

Our aim was to investigate the diagnostic efficacy of C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR] in patients with acute scrotum. One hundred and twenty patients with an acute scrotum were evaluated and assigned into 3 groups: 46 had acute epididymitis [group 1], 23 had spermatic cord torsion [group 2], and 51 had other noninflammatory causes of acute scrotum. Serum samples of all patients taken at the time of admission were tested for CRP levels and ESR. An at least 4-fold increase in the serum CRP levels was seen in 44 patients [95.6%] in group 1 [mean, 67.77 +/- 47.80 mg/L]. In contrast, only 1 patient in group 2 had a significant increase in serum CRP level [mean, 9.0 +/- 4.90 mg/L]. The patients in group 3 did not experience any significant increase of CRP levels [mean, 7.0 +/- 2.2 mg/L]. The patients with epididymitis had higher CRP and ESR values than others [P <.001; P <.001]. The best cutoffs were 24 mg/L for CRP and 15.5 mm/h for ESR to differentiate between epididymitis and noninflammatory causes of acute scrotum. The sensitivity and specificity were 93.4% and 100% for CRP and 95.6% and 85.1% for ESR, respectively. Based on our findings, serum levels of CRP and ESR can provide helpful information easily and rapidly for differentiation between epididymitis and other causes of acute scrotum. We suggest CRP and ESR be measured before making a decision of surgical exploration