Medical abortion at first trimester of pregnancy with misoprostol.

OBJECTIVE: To evaluate the efficacy of medical abortion at first trimester of pregnancy with vaginal misoprostol. METHODS: This is a descriptive analytic study. It was performed on 100 women at first trimester of pregnancy referred to teaching hospitals related to the Medical Sciences of Mashhad University, Mashhad, Iran for termination of pregnancy in 2006. Each patient received first dose of misoprostol (800 microg/vaginal), the second dose (800 microg/vaginal) was administered 24 hours after the first dose if expulsion of conceptus was not successful and curettage was performed if product of conception remained. RESULTS: From 100 patients, 83 women (83%) had successful complete abortion, and 17 cases required curettage. Among them, pregnancy was terminated in 55 (62%) with first dose of misoprostol and 28 (34%) of them required second dose. No important side-effects were noted due to vaginal misoprostol treatment. CONCLUSION: Termination of pregnancy by medical methods at first trimester of pregnancy with vaginal misoprostol is safe, cost effective, and without side-effects.

Anticonvulsant treatments of dysphoric mania: a trial of gabapentin, lamotrigine and carbamazepine in Iran.

The treatment of dysphoric mania is challenging given the need to treat symptoms of both depression and mania simultaneously without provoking any clinical exacerbation. The newer antiepileptic drugs such as gabapentin, lamotrogine, and carbamazepine are often used as adjuncts to either lithium or valproic acid in the treatment of bipolar disorder. We decided to undertake a monotherapy trial because previous evidence suggested mixed states may be more responsive to anticonvulsants than more traditional antimanic agents. 51 patients with a DSM IV diagnosis of dysphoric mania were randomized to three groups comprising gapbapentin, lamotrogine or carbamazepine and followed for 8 weeks. Psychiatric diagnosis was verified by the structural clinical interview for the DSM-IV (SCID). The MMPI-2 in full was used to assess symptoms at baseline and 8 weeks. All three groups showed significant changes in MMPI-2 scores for depression and mania subscales. Gabapentin showed the greatest change in depression symptom improvement relative to lamotrogine and carbamazepine, respectively. Although manic symptoms improved overall, here were no differences between groups in the degree of manic symptom improvement.