anti-pruritic effect of ondansetron after epidural morphine

Pruritus is a common and difficult to treatsideeffectafterneuraxialopioidadministration. We investigated ninety [90]patients with pruritus [more than '4' onvisual analog scale on which '0' representsno pruritus and '10' represents the worstimaginable pruritus] after 3mgepiduralmorphine in a randomized, double- blindand placebo-controlled study. The patientswere divided into two groups [45 patientseach] according to the drug given to treatpruritus: group"O" given 8mg ondansetronin 100 ml of 0.9%Nacl [ondansetron group]and group"C" given 100 ml of 0.9%Naclonly [control group]. A decrease in pruritusscore more than '4' points on visual analogscale [VAS], within 60min. after starting thetest infusion, was considered a treatmentsuccess. Hemodynamicchanges[arterialblood pressureandheartrate],arterialoxygen saturation [SaO2], changes in thelevel of pain andsedation and other sideeffects were checked regularly during thestudy period [24hrs]. Residual pruritus orrecurrence ofpruriticsymptomswerereportedduring24hrsfollowingthetreatment. We found a significantly highertreatmentsuccessrateingroup"O"comparedtogroup"C"[75%and%respectively],[p<0.05].Also,therecurrence rate of pruritus within 24hrs afterneatment was significantly lower in group"O" than group "C" [9%and40% respectively][P<0.05]. There was no significant difference [p>0.05] between the two groups regarding: the severity of pruritus, hemodynamic effects, pain and sedation scores or in the side effects. Among the successfully treated patients, none complained of residual pruritus 24hrs after treatment. So, 8mg ondansetron given by intravenous infusion is an effective treatment of pruritus associated with epidural morphine. It is safe and well tolerated in this clinical situation

role of calcium, magnesium, and trace elements zinc and copper in preterm labour and prelabour spontaneous rupture of membranes

This work was conducted on 60 pregnant women. Twenty full term normal pregnant women without premature rupture of membranes and with true labour pains [as a control group], 20 pregnant women with preterm labour and 20 full term pregnant women with prelabour spontaneous rupture of membranes. This work was done to study the relationship and role of calcium. magnesium and the trace elements, zinc and copper in pregnant women with preterm labour and those with premature spontaneous rupture of membranes. Maternal serum levels of calcium, magnesium, zinc and copper were measured in the three groups. In addition, their levels were also measured in the foetal membrane in cases with prelabour spontaneous rupture of membranes and the control group. The maternal serum levels of calcium, magnesium, zinc and copper, were statistically significantly decreased in cases with prelabour spontaneous rupture of membranes compared with the control group. Also a significant decrease in maternal serum levels of calcium, magnesium and zinc was found in cases with preterm labour compared with the control group, but there was no statistical significant change in the serum copper levels. The foetal membrane levels of calcium, magnesium and copper, were significantly decreased in cases with prelabour spontaneous rupture of membranes compared with the control group, but the foetal membrane zinc showed no significant decrease

Intrauterine insemination [IUI] using swim-up technique or percoll gradient technique versus timed intercourse in the management of unexplained infertility

Forty-eight patients with unexplained infertility were subjected to 3 treatment protocols. They were randomly divided into 3 groups. Group I comprised 13 patients who were treated by induction of superovulation and timed intercourse through 17 treatment cycles. Group II included 16 patients who were treated by induction of superovulation and IUI using husbands washed sperm prepared by the swim-up technique through 19 treatment cycles. Group III. on the other hand, included 19 patients who were similarly treated but with IUI utilizing Percoll gradient technique, through 23 treatment cycles. The clinical pregnancy rates/treated cycles were 5.9% in the first group, 10.5% in the second group and 13% in the third group. Induction of superovulation and IUI with husbands capacitated sperm especially using Percoll gradient technique may he beneficial for treatment of patients with unexplained infertility