Comparison of fetal and maternal complication in twin and singleton pregnancies

Reflecting the wide variability of assisted reproduction technologies, the incidence of twin and higher order multiple gestation is increased which associated with complications and prenatal and maternal morbidity and mortality. The purpose of this study was to compare fetal and maternal complication in twin and singleton pregnancies. This prospective study was performed on 108 twin pregnant women [case group] and 201 singleton pregnant women who referred to Babol Yahyanejad hospital during 2001-2003. Data related to patients were recorded in a questionnaire and the complication rate in both groups was compared. T-test and fishers exact test were used when appropriated. Frequency of twin pregnancy was 1.4%. Preterm delivery was 60.2% in twin and 2.7% in singleton [p<0.05]. Low birth weight and growth retardation was in 45.8% and 38.4% of twin and 7.5% and 10% of singleton, respectively. It was statistically significant [p<0.05]. Frequency of placental abruption, previa, preeclampsia, fetal anomaly and death were not statistically significant. Results show that fetal complications such as preterm delivery, growth retardation and low birth weight were seen with higher frequency in twin pregnancies compared to singleton pregnancies. Since, this may cause high prenatal morbidity and mortality, therefore more attention is required to reduce complication

role of hygienic behavior in incidence of urinary tract infection among pregnant women referred to health center [Babol; 2002-2004]

The urinary tract infection [UTI] is a common problem in pregnant women. Since, UTI is caused by bacteria in the stool, hygienic behavior may affect the risk of contracting UTI. The purpose of this study was to determine the relationship between hygienic behavior and incidence of UTI in pregnant women. This case-control study was performed on 250 pregnant women from 2002-2004. One hundred pregnant women from five health centers of Babol University of Medical Sciences for prenatal care, with a diagnosis of UTI by means of positive urine culture [as case group] were compared with one hundred fifty pregnant women [as control group]. Both groups were matched according to age and social, economic, educational status and parity. Patients with recurrent UTI, chronic diseases like diabetis and sickle cell anemia and consumption of immuno suppressive and antibiotic drugs were excluded from this study. Data was analyzed by SPSS. P<0.05 was considered significant. Escherichia coli was the etiologic agent in 83% of cases. Odd ratio for any of the above variables were determined and risk factor for UTI were as follows: for sexual intercourse >/= 3 times per week [OR=5.62], recent urinary tract infection [OR= 3.27], washing of genital pre coitus [OR= 2.16], washing of genital post coitus [OR= 3.89], voiding post coitus [OR= 8.62], washing of genital from back to front [OR= 2.69]. Mean scoring hygienic behaviors in case and control group were 19.9 +/- 3.65 and 23.44 +/- 3.43, respectively. Hygienic habits and sexual behavior may play a significant role in the pregnant women with UTIs, with a positive bacterial urine culture, but evacuating of bladder after coitus was the most strongly associated variable

Effect of heat on the staphylococci and E. coli resistance to antibiotics

One of the most important problems in treatment of infectious diseases is antibiotic resistance in bacteria. The bacteria can be resistant to antibiotics in different ways which the most common one is the plasmid-origin resistance. Since some plasmids have a kind of replication system which is sensitive to heat and eliminated by growing in unauthorized heat, the objective of this study was to survey the possibility of changing in antibiotic resistant bacteria by heat. In this experimental and interventional study after collecting clinical samples, different tests were done to recognize bacteria completely. For every sample, at first an antibiogram test was done by disk diffusion method. Then bacteria incubated in the BHI broth during 24 hours at 43.5°C, in the next step, bacteria were captured in BHI agar during 24 hours at 35°C and finally the second antibiogram was carried out by disk diffusion, P<0.05 was considered significant. Among the staphylococcus, the most changes belonged to oxacillin [11%] which p<0.0001 was considered significant while no changes were seen in rifampicin. Among the E, coli, the most changes belonged to ampicillin [7%] which p<0.0001 was considered significant while no changes were seen in ceftriaxone and ciprofloxacin antibiotics. Heat can cause bacteria to change from antibiotic resistant bacteria to antibiotic semi-sensitive and sensitive bacteria

[ comparision of insulin level and some cardiovascular risk factors in patients with polycystic ovary syndrome and healthy subjects women]

Polycystic ovary syndrome [PCOS] seems to be the most common endocrine disease in women of reproductive age. This study has shown that PCOS is associated with hyperlipidaemia and hypertension. The aim of this study was to compare the cardiovascular risk factor in PCOS and normal women. It is a case - control study that was done on 60 barren and non-affected women and 60 barren women affected to PCOS that had clinical examples and sonographic PCOS. All of women were studied from the characteristics point of view such as age, BMI, the size of around waist and buttocks, time and kind of infertility and Blood pressure. Necessary tests were done such as total cholesterol, LDL, HDL triglyceride, insulin level and fasting blood sugar. Data were analyzed with SPSS. Triglyceride, cholesterol, LDL and BMI of the patients affected to PCOS were significantly higher than normal women [P<0.05]. HDL level reduction was significant in patients affected PCOS [P<0.05], also systolic and diastolic blood pressure in affected women was higher than control group [P<0.05]. PCOS women have higher cardiovascular risk compared to normal women

[Relationship between the serum B-HCG and preeclampsia and its severity]

Preeclampsia as the most common complication of pregnancies has unknown physiopathology. Because the role of serum Beta-human Chorionic Gonadotropin [B-hCG] in pathophysiology of preeclampsia is not well known, we decided to determine the correlation between serum concentration of B-HCG and preeclampsia. This case-control study performed on two groups of 40 preeclamptic nulliparous and 40 healthy term pregnant women at obstetrics and gynecology ward of Sh. Yahyanejhad Hospital in Babol during 2003-4. Serum B- hCG concentration was measured in all patients. Patients with chronic hyprtension, diabetes, multiple pregnancies or medial diseases were excluded. The data were analyzed using Chi-square, T-Test and ANOVA, Mann-Whitney and Kruskall-Wallis tests. The maternal serum Beta hCG levels in patients with preeclampsia were [39840 +/- 24630] IU/L which is higher in comparison with healthy ones [27460 +/- 25862] IU/L [P=0.031]. The mean of serum beta hCG levels were 31991 +/- 16758 and 84312 +/- 9257 in mild and severe preeclampsia [P<0/0001]. Serum Beta hCG level is higher in preeclamptic women than normal pregnancies. It is also noticed that the higher the levels of serum Beta hCG the more severe the preeclampsia. This finding, in turn, reinforces the association between elevated HCG concentrations and placental damage

[Comparison of clinical presentations, wet smear, Papanicolaou smear with Dorset's culture for diagnosis of Trichomonas Vaginalis in doubtful women to Trichomoniasis]

Trichomoniasis is an infection of women urogenital tract that is transferred almost in all cases by sexual contact. This study was done to compare clinical presentations of trichomoniasis and several different paraclinical methods to determine simplest and most efficient method in doubtful patients to trichomonas infection in order to treat infected women and prevent from immethodical use of antibiotics and creation resistant strains. One hundred and fifty fertile women [15-50 years aged] that attended in gynecological clinics and had clinical pictures of trichomoniasis were studied to assess for the presence of trichomonas vaginalis by history, wet mount, papanicolaou smear and dorset's culture. Then data were analyzed. In 150 doubtful patients to trichomoniasis, average of age was 30.56 years. The most common symptoms were frequent pain with sexual intercourse and itching in genital area after persistent, malodor, frothy and yellow vaginal discharge. The most common sign in pelvic examination were frothy, yellowish discharge accompanied by cervical erosion. In 28 patients [18.67%] wet smear, Pap smear and culture were positive simultaneously, papanicolaou smear was positive only in 38 patients. Wet smear is most sensitive and specified for diagnosis of trichomonas vaginalis in doubtful female patients to trichomoniasis, and because of over diagnosing according to clinical manifestation, a confirmatory test should be performed before initiating therapy

[Assessment of referral system in health care delivery center of Paeengatab [Babol, 2003]]

Since equal distribution of health services is impossible in different levels of health network, small centers should refer patients to upper level for special services and if it doesn't be according to referral system, causes crowding and insufficiency of health services in upper levels and leads to uselessness of medical services in small centers. This study was done to assess the function of referral system in Babol health care delivery network. This cross-sectional study was performed in Paeengatab health center during autumn 2003. All referred patients to upper levels were included in this study. Data was collected by interviewing with patients and referral forms and then were analyzed. From 445 forms, 200 had complete data. Most referred patients were female [73%] and were at the age of 20-29 [42%]. Most people [58.2%] were referred for paraclinical services [Sonography and laboratory] and the most referred cases were the patients with gynecological and obstetric disorders [18.6%]. Shahid Beheshti, Yahyanejad and Amirkola hospitals accepted the most referred patients, respectively. The feedback rate from hospital to health centers was zero. Referral system is only being performed as one way from health centers to hospitals and there is no feedback, since, gynecological and obstetric disorders make the largest number of referred patients, it is necessary to increase health and treatment services in rural health centers in order to decrease the number of patients who referred to hospitals

[Effect of topical Mitomycin-C [0.01%] in treatment of severe vernal refractory keratoconjunctivitis]

Severe cases of vernal keratoconjunctivitis can reduce visual acuity due to corneal involvement. This study was performed to evaluate the efficacy and safety of low- dose topical mitomycin- c in patients with severe vernal keratoconjunctivitis refractory [SVKC] to conventional treatment. This clinical trial was performed on 36 refractory cases of SVKC. All of the patients were using corticosteroid and mast cell stabilizer before they entered this study but their symptoms and signs were persistent. Topical mitomycin - c 0.01% was used in both eyes of 18 patients for 14 days. The other patients [18 cases] was used saline normal drop. The symptoms and signs were checked on the day of enrollment and were compared at the end of first and second weeks. All of the patients were following up 4 week post treatment for required additional medication. There was a significant decrease in all the symptoms and signs after 2 weeks of treatment. Only papillary reaction was persistent despite treatment in 14 cases. Drug toxicity was observed in two eyes manifesting as punctate keratitis. None of the patients required any other medication during the 4 weeks post treatment. Short-term, low-dose mitomycin-c may be considered in the acute exacerbation periods of patients with SVKC refractory to conventional treatment

[Prevalence of G6PD deficiency among primary school students in Amol]

G6PD [glucose-6-phosphate dehydrogenase] deficiency is the most common enzyme deficiency in human beings. Using fava beans, some drugs and oxidant agents cause life-threatening hemolysis in children and other ages. The aim of this study was to determine the prevalence of G6PD deficiency and its relation to age and family history. This cross sectional, descriptive and analytical study was performed on 732 persons. Students aged between 7-11 years old were randomly chosen by cluster sampling method. Data were analyzed by SPSS. For comparing enzyme deficiency between two sexes and the effect of family history, chi square test was used. From 732 students, 295 were male and 437 were female. 11.2% of males and 1.4% of females were G6PD deficient that this difference was considered significant [p<0.0001]. Children who have G6PD deficiency, history of G6PD deficiency among their family members was significantly more [p<0.0001]. Due to high prevalence of G6PD deficiency as a threatening factor for public health in north of Iran, it is suggested cord blood G6PD screening be considered at birth especially in male neonates and the quality of primary health care and public information be increased by teaching

Microbiological evaluation of dental unit water at dental offices and dental school in the city of Babol

The quality of dental unit water is of considerable importance since patients and dental staff are regularly exposed to water and aerosols generated from the dental unit. Following ADA instruction, this study was performed to control the contamination of Dental Unit Water Line [DUWL] to less than 200 CFU/ml. The purpose of this study was to evaluate the microbiology of DUWL at dental offices and dental faculty of Babol. In this laboratory study, DUWL of dental offices from different areas as well as that of the dental faculty of Babol was microbiologically evaluated. An amount of five ml water from the syringes and high speed hand pieces before and 2 minutes after flushing and drinking water of units and tap water were gathered in three different sterile polyethylene dishes. Then the samples were cultured on the specific media and the number of the bacterial colonies were counted after keeping at 37 for 48 hours. The data were analysed by SPSS software and chi-square, Fisher's exact and Paired t-tests as well as ANOVA were used. 33.3% of all species samples were positive for presence of bacteria. Microorganisms isolated were as follow: Staphilococcus aureus, coliform, E.coli, Pseudomonas aeroginosa, Streptococcus [except beta hemolytic group A], Klebsiella, coagulase negative staphylococcus and proteus. The number of the colonies were more than the standard limit. Contamination of the water of hand pieces was reduced after flushing. Contamination of tap water compared to the water of handpieces was less and mean contamination of the samples gathered from the dental offices was higher than those gathered from the dental faculty. Flushing decreases the contamination of DUWL, but in surgeries and in persons with immunodeficiency, the use of other methods of DUWL control and decontamination is recommended