Evaluation the cooling gelpad and ice pack on wound healing and intensity perineal pain after episiotomy in primparous women

Episiotomy occuring during delivery can be a source of serious short and long term morbidity. So a delay in healing can also increase the duration of perineal pain. Nowadays attention has recently focused on maternal morbidity and improving diagnosis and treatment of perineal injury following childbirth. So, this study was done to evaluate the effectiveness of cold therapy in two patient groups [gel pad and ice pack] and compare them with control group in term of wound healing and intensity perineal pain after episiotomy in primparous women who gave birth at Hazrat Ommolbanin University Maternity Hospital in Mashhad-Iran from October 2005 to February 2006. In this randomized controlled trial, 121 healthy primparous women with include and exclude criteria which underwent normal delivery with episiotomy were chosen in the two cold therapy groups [gel pad and ice pack] and one control group. Evaluation of wound healing with REEDA scale and evaluation of intensity pain with numeric scale [NRS] [0-10] during the first 4 hours and on 1[st], 2[nd], 5[th], 10[th] days after episiotomy and evaluation of satisfaction of women from analgesia at 10th day were conducted. Data were analysed by statistic methods with chi-square, Kruskal Wallis, Mann-Withney u, Jonckheere trepstra, analysis variance and exact tests with software spss. The results showed a statistically significant difference in the wound healing in 2[nd] day [P<0.001], 5[th] day [P<0.001] and 10th day [P<0.001] and intensity perineal pain in 3 the groups at first 4 hours [P=0.003] and 10[th] day [P=0.044] after episiotomy. Also satisfactory was in favor of the maternity gel pad group. Using to maternity gelpad is effective in reducing perineal morbidity. So it suggested as a complementary treatment in clinical services and is a comfirmation to the correct and invasive treatment and can be an acheivement in promoting health level and also, women's satisfaction

[Side effects of Sodium Valproate in epileptic patients]

One of the most important problems in the treatment of epileptic patients is the drug effects. Na Valproate is a widely used drug for the treatment of epilepsy. The side effects of the drug include digestive disorders, increasing liver enzymes, fatal hepatitis, cognitive disorder, behavior disorder, insomnia, hyperactivity, tremor, stupor and coma, metabolic disorders, hair waving, curling, thinning and loss, pancreatitis, blood effects, fetal hydatoine syndrome irregular menstruation and secondary amenorrhea in this descriptive study 170 patients with epilepsy were evaluated. These patients were referred to Ncurologic clinic of Imam Reza Hospital over a period of 3 years from September 1996, and treated with Na Valproate. Sixty-five percent of patients were male due to the fact that females avoid Na Valproate during the fertility period. Our study was done to determine complications of Na Valproate, and the following complications developed in our patients transient neutropenia as the most common complication, 12 cases [7%], weight increasing, 7 cases [4%] diminished appetite, 4 cases [2.5%], tremor, 1 case, abdominal pain 1 case, and ALP increasing 1 case. Regarding to the limited side effects of Na Valproate and its good therapeutic effects in controlling different types of epilepsy, it is suggested that this drug is very effective in treatment of epilepsy except of children aged less than 2 years and women who are in the fertile ages