[ 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

[Survey relationship between the severity of hyperemesis gravidarum and fetus sexuality]

Hyperemesis Gravidarum [HG] is the extreme amount of nausea and vomiting during pregnancy. The incidence of this problem is between 0.3- 2%. HG is multifactorial disorder which fetal sexuality is one of them and some studies indicated the relation between HG and female fetus. Survey the relationship between the severity of hyperemesis gravidarum and fetus sexuality. All medical cases of pregnant women who referred to Alzahra hospital from 1997 to 2007 were considered as a descriptive- analytical study. Known cases of HG were selected [separated] between them. Variables such as fetal sexuality, duration of hospitalization, age, parity, pregnancy trimester, biochemical tests were extracted and analyzed with SPSS 14 and Fisher exact test. Among 197 cases, 150 cases [76.14%] were selected because of their full information 80.2% of women with female fetus, stayed >/= 4 days at the hospital. This amount was 33.9% in women with male fetus [p< 0.0001]. Ketonuria >/= 3+ [P0.016], Hyponatremia [P0.035], Hyperuremia [P0.045] were 16.5%, 41.8%, 62.6% in the first group and this amount were 3.4%, 23.7%, and 3.61% in the second group. 84.6% of women with female fetus and 64.4% of women with male fetus hospitalized in their first trimester [p=0.006]. HG was sever in 79.1% of women with female fetus and 61% of women with male fetus [p= 0.025]. This study showed statistical relationship between fetus Sexuality and severity of HG. The severity of this problem get raised with ketonuria, Hyperurmia, Hypernatermia and hospitalization in the first trimester