Comparison between preoperative rectal diclofenac plus paracetamol and diclofenac alone for postoperative pain of hysterectomy

To detect whether the preoperative combined administration of rectal diclofenac and paracetamol is superior to placebo or rectal diclofenac alone for pain after abdominal hysterectomy. Ninety female patients [American Society of Anesthesiologists [ASA] physical status I-II], scheduled for abdominal hysterectomy were recruited to this double blind trial and were randomized to receive one of three modalities before surgery: rectal combination of diclofenac and paracetamol, rectal diclofenac alone or rectal placebo alone which were given as a suppository one hour prior to surgery. The primary outcomes were visual analogue pain scores measured at 0, 0.5, 2, 4, 8,16 and 24 hours after surgery and the time of first administration and also total amount of morphine used in the first 24 hour after surgery. A10 cm visual analog scale [VAS] was used to assess pain intensity at rest. In patients receiving the combination of diclofenac and paracetamol total dose of morphine used in the first 24 hour after surgery was significantly lower [13.9 +/- 2.7 mg] compared to diclofenac group [16.8 +/- 2.8 mg] and placebo group [20.1 +/- 3.6 mg] [p<0.05]. VAS pain score was significantly lower in combination group compared to other groups all time during first 24 hours [p<0.05]. There had been a significant difference between combination group and the two other groups in terms of the first request of morphine [p<0.05]. According to our study Patients who receive the rectal diclofenac-paracetamol combination experience significantly a lower pain scale in the first 24 hour after surgery compared with patients receiving diclofenac or placebo alone. Their need to supplementary analgesic is significantly later and lower compared to placebo and diclofenac alone

effects of healthy diet in pregnancy

To evaluate the importance of observing healthy habits by pregnant women that influences different aspects of mother and fetus health, we assessed the change in dietary behavior, and cigarette smoking after distributing the guidelines among 485 prenatal care patients. The subjects were pregnant women who enrolled in health care centers of Tehran University from September, 18, 2010 to July 21, 2012. At first the standard questionnaires including questions about socio demographic factors and also their dietary behavior, and cigarette smoking were filled out. Then we gave them the guideline. After 2 months the participants received the similar questionnaires. The change in their behavior was evaluated comparing the 2 series of questionnaires by SPSS-16 analysis methods. Totally 1.9% of participants met fruit and vegetable guidelines before education and 5.6% after that [3.7% rise] [p < 0.0001]. In studied group 99% met cigarette smoking guidelines before and 100% after education. There was a meaningful association between the amount of fruit and vegetables consumption before and after pregnancy [p < 0.0001]. According to the significant effect of education, we can apply it as an effective way of improving the healthy behaviors in our society. Furthermore, discovering related factors to healthy behavior can lead to addressing the most appropriate [needy, necessitous, deserving] group of population for education

effect of paternal age on preterm births; a survey of 281 cases

To determine the effect of paternal age on preterm births in Iranian neonates. From January 2005 to January 2006, two hundred eighty one preterm neonates born in Mirza Kuchakkhan Hospital enrolled in this cross-sectional study. A structured questionnaire was applied for recording following data: birth weight, sex, gestational age, maternal age and paternal age. The study was limited to neonates whose maternal age was between 20 and 30 years to eliminate its confounding effect. Near 50% of fathers were between 30-39 years old and more than half of neonates had gestational age between 35-37 weeks. There were no relation between either paternal age [p= 0.1] or birth weight [p=0.5] and neonatal gestational age. In women with parity one, there was not significant difference between gestational age among different paternal age levels [p= 0.6] as well as women with parity two and three [p=0.2, p=0.3]. Paternal age has no effect on gestational age and birth

Post dural puncture headache after cesarean section, a teaching hospital experience

This prospective study examined the frequency of Post-Dural Puncture Headache [PDPH] in 361 parturient women undergoing spinal anesthesia for cesarean section in a teaching hospital of Tehran University of Medical Sciences. Spinal anesthesia was performed using 25 gauge Quincke needles in all women. Patients were followed up to determine incidence of PDPH and then tried to compare those with or without PDPH using statistical methods to determine risk factors of PDPH. The overall incidence of PDPH was 10.8 percent in this study. In terms of probable risk factors which were compared between the two groups of patients, no statistically significant differences were found. The incidence of PDPH in our study was higher than studies which used pencil - tipped needles and we determined that the occurrence of PDPH is not associated to some factors like the previous history of nonspecific headache, Body Mass Index, age, type of local anesthetic, previous history of PDPH, experience of operator, history of habitual tea and coffee drinking

High plasma homocysteine and insulin resistance in patients with polycystic ovarian syndrome

Polycystic ovarian syndrome [PCOS] is a common disease among women in fertility ages and cause severe insulin resistance. Hyperhomocysteinaemia is said to be among the features of PCOS that could influence its outcome. This study aimed to investigate whether hyperhomocysteinaemia exists in PCOS and if it is related to insulin resistance in the affected patients. This prospective study was carried out in a university based fertility clinic. Sixty four PCOS patients and 50 normo ovulatory controls were reviewed for fasting glucose, insulin, homocysteine, luteinizing hormone [LH], and follicle-stimulating hormone [FSH] plasma levels in the blood sample of the 3[rd] day of their menstrual cycle. Insulin resistance was determined with the fasting glucose [mmol/L] to insulin [mIU/L] ratio and HOMA-IR [Homeostasis model assessment-Insulin resistance]. Independent-samples T-test and linear regression test were utilized to analyze the obtained data. Homocysteine levels compared between PCOS patients and control group showed a significant difference. PCOS group was divided into insulin resistant [IR] [LogHOMA-IR >/= 0.57] and non insulin resistant [NIR] patients. The IR group had significantly higher homocysteine [p-value=0.02], fasting insulin and glucose levels [p-value<0.001] rather than NIR group. PCOS patients have a leaning toward hyperhomocysteinaemia and insulin resistance. Insulin resistant patients are found to have higher homocysteine level

Neonatal ovarian cyst: a case report

Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts. Prenatal ultrasonography allows diagnosis of ovarian cysts and may suggest antenatal complications. The management of fetal ovarian cysts is still controversial despite the improvement in prenatal diagnosis with ultrasonography. Some studies suggest an aggressive management, while others plead for a conservative one. We report on the first successfully treated large neonatal ovarian cyst from Iran. She was a normal-term infant with respiratory distress due to the large size of the ovarian cyst diagnosed prenatally. We didn't find any other related anomaly in the neonate. Neonatal simple ovarian cysts are rare, but may cause complications. Most small simple cysts regress spontaneously; surgical intervention is reserved for complicated or large size ovarian cysts