RESUMO
Background: Nausea and vomiting are common side effects in parturients undergoing cesarean delivery performed under spinal anesthesia can be very unpleasant to the patients. The reported incidence of nausea and vomiting during cesarean performed under regional anesthesia varies from 50% to 80% when no prophylactic antiemetic is given. Therefore, use of prophylactic antiemetics in parturients undergoing cesarean delivery is recommended by some authors
Objective: In this study, alizapride was evaluated, as a D2 receptor antagonist, on the prevention of nausea and vomiting following Spinal Anesthesia in parturients undergoing elective cesarean section
Patients and Methods: The study was carried out in AL-Azhar University Hospitals, Obstetric and gynaecology department on 90 patients undergoing an elective, lower segment cesarean section [LSCS]. All patients were identified by code number to maintain the privacy of the patients. Any unexpected risks appeared during the course of the research was cleared to the participants and the ethical committee on time. A written informed consent was obtained from all patients. Patients were divided into 3 groups, 30 patients for each group. Group I [Alizapride 50 group]: Received intravenous [IV] Alizapride 50 mg diluted in 10 ml of normal saline over 1-5 minutes, immediately after clamping umbilical cord. Group II [Alizapride 100 group]: Received intravenous [IV] Alizapride 100 mg diluted in 10 ml of normal saline over 1-5 minutes, immediately after clamping umbilical cord. Group III [Saline group]: Received normal saline 10 ml, immediately after clamping umbilical cord
Results: The incidence of nausea and vomiting was significantly decreased in group 2 [Alizapride100 group] compared with group 1 [Alizapride 50 group] and both group was better than group 3 [control group]. The use of ondansetron and chlorpheniramine was significantly decreased in group 1 and 2 when compared with group 3
Conclusion: This study concluded that Alizapride 100 mg, given intravenously immediately after clamping umbilical cord would reduce PONV and pruritus in parturients undergoing an elective cesarean section under spinal anesthesia
RESUMO
Background: the role of the nucleosome in the induction of antibody response in lupus mediated tissue damage especially glomerulonephritis, may provide a new insight in the early diagnosis and alternative therapeutic developments in systemic lupus erythematosus [SLE]
Objectives: to evaluate the frequency and specificity of antinucleosome antibody expression in SLE patients in relation to disease activity. Also, to assess their predictive value in subclinical lupus nephritis
Methods: this study included 26 patients with SLE and 52 control subjects [26 were healthy and 26 had juvenile rheumatoid arthritis "JRA"]. Among lupus patients, 15 had clinical evidence of renal involvement. After clinical evaluation to calculate the SLE disease activity index [SLEDAI], measurements of urinary microalbumin and serum antinucleosome antibodies [antinucleosome specific, antihistone and anti ds-DNA antibodies by ELISA] were performed. Patients without clinical evidence of renal involvement were followed up for one year and measurement of urinary microalbumin was repeated at the end of the study period. Those who later developed microalbuminurea were categorized as patients with subclinical lupus nephritis
Results: the expression of the 3 studied antinucleosome antibodies was significantly higher among lupus patients as compared to JRA patients and healthy controls. Seropositivity for one or more antinucleosome antibodies was elicited in 84.5% of lupus patients. Serum levels of the 3 antinucleosome antibodies were significantly higher among lupus patients with clinical nephritis than those without nephritis. ANSAb had higher sensitivity, specificity and positive and negative predictive values for subclinical lupus nephritis [100%] than antihistone and anti ds-DNA antibodies [43%, 100%, 100% and 50% respectively for either antibodies]. All patients with lupus nephritis were seropositive for at least one of the antinucleosome antibodies, while those without clinical or subclinical nephritis were seronegative for the 3 antinucleosome antibodies. In 27.3% of patients with lupus nephritis, ANSAB was positive while both antihistone and ds-DNA antibodies were negative. Antinucleosome antibodies correlated positively with SLEDAI and cumulative steroid dose and negatively with corrected creatinine clearance
Conclusions: the observed sensitivity and specificity of antinucleosome specific antibodies as early indicators of subclinical lupus nephritis appear encouraging and deserve further analysis on a large scale in order to confirm their validity, especially in the anti ds-DNA seronegative lupus patients