[Comparison between effects of intravenous labetalol and hydralazine on control of hypertension and maternal and neonatal outcomes in severe preeclamptic patients: a randomized clinical trial]

Severe preeclampsia and eclampsia are responsible for 25% of maternal mortality, especially in developing countries. Considering the importance of this complication, the present study aimed to compare between effects of labetalol and hydralazine on control of hypertension and the maternal and neonatal outcomes in severe preeclamptic patients. This clinical trial study was conducted on 190 severe preeclamptic patients classified into two groups [95 subjects in each group]. Two groups were randomly received hydralazine [5 mg intravenously, every 20 minutes, up to a maximum of five doses] or labetalol [at first 20 mg intravenously, and if not effective, 40, 80, 80, 80 mg respectively, every 20 minutes, up to a maximum of five doses]. In both groups, blood pressure and heart rate were recorded 20 minutes after drug administration. Blood pressure control, as well as the maternal and neonatal outcomes, compared between two groups. Maternal and neonatal outcomes were compared using chi-square, Fisher's exact, Mann-Whitney, and t tests. All significant differences were at p<0.05. Demographic characteristics and blood pressure control were similar in both groups, only five women in the hydralazine group and four women in labetalol group had persistent severe hypertension after maximum of five doses. Hypotension was not observed in both groups. Maternal tachycardia was similar in two groups. Others maternal and neonatal outcomes had no significant differences between two groups. According to the results of this study, the effect of labetalol and hydralazin is similar in the control of hypertension in severe preeclamptic patients and there isn't significant different in maternal and neonatal outcome in two groups

[Evaluating the diagnostic value of transvaginal ultrasonography for endometrial abnormalities in premenopausal women with abnormal uterine bleeding]

Abnormal uterine bleeding [AUB] is a common and serious problem in women of late reproductive age and an indication for endometrial biopsy as an invasive method. On assessing AUB, in some cases, even with the observation of normal thicker endometrium in ultrasonography, abnormal biopsy is reported. Thus, this study was carried out to assess the role of measuring endometrial thickness by transvaginal ultrasonography as a screening tool for premenopausal women with abnormal uterine bleeding. In this diagnostic study, 154 premenopausal women with AUB referred to Naghavi Clinic of Kashan University of medical sciences during 2010-11. Transvaginal ultrasonography was performed to assess endometrial thickness before the Pipelle endometrial biopsy at the first day of menstruation. The biopsies were then sent to a pathologist unaware of the results of transvaginal ultrasonography and finally, the Roc curve was utilized to determine the best cut-point. Forty-eight out of 154 cases [31.2%] had abnormal endometrium [hyperplasia 23.2%; polyps 3.9%; and asynchronous 3.9%]. The reported thickness of endometrium with the sensitiveity and specificity of 76.2% and 41.1% [PPV=33.6%, NPV=82.1%, LR+=1.29 and LR- =0.58] was 7 mm. Although endometrial thickness of

[Influence of closure and non-closure of the visceral and parietal peritoneum on post cesarean morbidity]

One of the most important issues in promoting mother and child health is reducing the morbidity rate after cesarean section. The aim of this study was to investigate the influence of closure and non-closure of the visceral and parietal peritoneum on post cesarean morbidity in women attending Shabihkhani Maternity Hospital in Kashan, Iran. This study was conducted with a single blind randomized clinical trial method on 100 parturient women that underwent emergency or elective cesarean section. Patients with previous cesarean section and or abdominal surgery, diseases such as hypertension, diabetes mellitus and premature rupture of membrane and pre operative bleeding, were excluded from this study. Then, the participants were randomly divided into two groups: in one group both peritoneal layers were closed while in the other group, they were not closed. Post operative morbidity including fever, bleeding, post operative pain, analgesic consumption and time of operation were assessed. Data were analyzed with t-tests, and chi2 and a P<0.05 were considered significant. In this study, there were no significant differences between the two groups with respect to age, gestational age, the reason for caesarean section and gravidity, nor were there any differences with respect to the incidence of fever or bleeding and was similar between the two groups, but there was a significant difference between the two groups regarding to feeling of severe pain [P=0.0003], analgesic consumption [P=0.0003] and time of operation [P=0.004]. In the non-closure group, dose of analgesic drugs, pain severity and time of operation were less than those of the other group. The Findings showed that non-closure of peritoneal layers as a shorter and simpler procedure has no influence on increasing post cesarean morbidity. Therefore, due to maternal health promotion and early neonatal breastfeeding, non closure of peritoneal layers is recommended

[ comparative study on the adequacy of liquid-based thin layer papanicolaou and conventional smears]

Background: considering the significance of early diagnosis of cervical cancer and low sensitivity of conventional pap smear tests, this study was carried out to evaluate the adequacy of papanicolaou smear taken by liquid-based thin layer method compared to the conventional methods for women referring to obs/gynecological clinics of Kashan [March to October 2008]

Materials and Methods: this cross-sectional descriptive study was done on pap smear specimens [n=400] of women referring to gynecological clinics. Randomly for half of samples, Pap smear was prepared by manual liquid-based thin layer [direct to vial] method and the conventional method for half of the samples. Samples were prepared using cytobrush and interpreted based on Bethesda [2001] criteria. In each of sampling methods both satisfactory and unsatisfactory cases were identified and analyzed using Chi-square test

Results: in both methods, the number of satisfactory and unsatisfactory smears were 191 [% 95.5] and 9 [% 4/5] respectively, signifying no difference between methods. The factors for unsatisfactory smear in conventional smear were exudates [8 cases [[88.9%]]; blood [1 case [11.1%]] and in liquid based samples the lower cellularity [9 cases [100%]]

Conclusion: the number of satisfactory cases in liquid-based thin layer method was the same as the conventional method

Effects of oral iron supplement on breath-holding spells in children

Breath holding spells are one of the most frequent and important diagnostic challenges in pediatrics. The aim of this study, conducted on pediatric patients referring to the pediatric neurology clinic in Hormozgan province, was to evaluate therapeutic effects of iron on breath holding spells 35 children [19 males and 16 females], aged between 3 to 60 months, with a history of breath-holding spells, were included in the trial. To obtain all relevant data a specifically designed questionnaire requiring information on sex, age, age of onset of spells, type of spells, frequency of attacks before and after treatment with oral iron supplement, and determinants of body iron stores was completed for all the patients, based on the mother's statements. The patients were treated by an oral iron preparation for three months. The age of onset of spells ranged between 6 to 24 months. The cyanotic type of spell was detected in 31 children, the pallid type in 3, and the mixed type in one child. There were 14 children with iron deficiency anemia and 20 children with reduced iron stores. Just one child had a normal iron profile. Complete therapeutic response was documented in 24 children, good response in 9, and poor response in one and in one child no change in frequency of spells was seen. Although no significant therapeutic difference was seen in the different response groups, it seems that iron supplement may play an important role in reducing breath holding spells in children