Effects of metronidazole therapy on preterm labor in women with bacterial vaginosis

Regarding to prevalence of preterm labor and its consequences, there are different reports on relationship between bacterial vaginosis and preterm labor. This study was performed to evaluate the effect of metronidazole therapy on preterm labor in women with bacterial vaginosis. This randomized clinical trial was performed on 120 women suffering from bacterial vaginosis at 20-34 weeks of pregnancy, to evaluate the therapeutic effect of metronidazole to delay preterm labor in Shabih Khani maternity hospital in Kashan, Iran in 2002. Bacterial vaginosis was diagnosed based on clinical and laboratory findings. The patients were randomly divided into two groups. The patients in the case group received 500 mg metronidazole BID for 7 consecutive days, but the control group did not receive it. The demographic characteristics of the patients such as, pregnancy age, educational level and job of the spouse were similar at both case and control groups. Double-blind follow up of the patients at the whole stages of parturition and after delivery with respect to the delivery method, infection, and fever was done by other practitioner besides the main researcher. The results were analyzed statistically by chi-square, and Fischer's exact tests. 420 patients entered the study, of whom 120 (28.6) had bacterial vaginosis. The antibiotic and control groups were not significantly different for maternal age, job of the spouse, and education. No difference was observed in spontaneous preterm birth before 37 weeks of gestation in antibiotic-treated compared with control group. Treatment with metronidazole in symptomatic women with a bacterial vaginosis in the late second trimester does not decrease the incidence of preterm delivery. © 2009 Tehran University of Medical Sciences. All rights reserved

Comparison of the diagnostic value of the visual inspection with acetic acid (VIA)and Pap smear in cervical cancer screening

Objective: This study aimed to compare the diagnostic value of VIA with Pap smear in screening for cervical cancer. Materials and methods: In this cross-sectional study, 440 women who had eligibility criteria, in Kashan city were assessed. All women underwent Pap smear test and then a visual inspection with acetic acid and colposcopy-biopsy (Gold Standard). Then, the diagnostic value indices including the specificity, sensitivity, positive and negative predictive values for the results of VIA and Pap smear were analyzed by SPSS V16 software. Results: Finding showed that 29.9 of women had abnormal Pap smear. The false positive rate of Pap smear was 40.2, and its false negative rate was 37.4. For VIA, the false positive and false negative rates were 21.2 and 4.6. The sensitivity, specificity, NPV and PPV of Pap smear was 29.7, 85.5, 59.8, 62.6, and these values for VIA was 94.6, 81.6, 78.8, 95.4 respectively. Combination of Pap smear and VIA showed the sensitivity of 97.3 and 100 in low grade and high grade cervical lesions. Conclusion: VIA has a higher sensitivity than Pap smear in detection of low and high grade cervical lesions, however, its specificity is less than Pap smears. Therefore it is recommended to use of VIA along with Pap smear to reach a higher sensitivity. © 201

Involuntary urination in pregnancy among patients referred to the Shabi-Khani Hospital

History and Objectives: Due to high rate of involuntary urination in pregnancy and hygienic and social stigma associated with it and due to various reports on its prevalence, the present study was carried out in order to determine the rate of involuntary urination in Shabihkhani hospital in the last 3 months of 1997. Materials and Methods: A descriptive study with probable 50 rate of prevalence was carried on 400 women with first and second pregnancy. Personal records and situation of involuntary urination, start time, severity of the urination and treatment was recorded. Prevalence and confidence of interval was determined. Results: Mean age was 23±4.3 years and 40 of the patients were first time pregnant and 60 were second time pregnant. Prevalence of involuntary urination was 33.5 and most patients were involved in the 3rd trimester of their pregnancy. Conclusion: Due to the high rate of involuntary urination and social and economic side effects, it is suggested that analytical study ought to be conducted in order to determine the causes of the disease and find the way to reduce the rate. Educational programs for pregnant mothers ought to be carried out

Efficacy of Vaginal Misoprostol For Terminating Missed Abortion

Background: Given the prevalence rate of missed abortion and the complications of its surgery and also the propounded controversies about medical treatments and in order to determine the efficacy of vaginal misoprostol in terminating missed abortion cases till 12th weeks of pregnancy, this study has been conducted between Dec. 2004 and Sep. 2004 in Kashan Shabihkhani Hospital. Materials and Methods: The study was a clinical trial in 80 pregnant women with missed abortion. The patients were categorized randomly in two groups (medical group, surgical group). The women in medical group were given an initial dose of 800 m gr. of vaginal misoprostol and if it was necessary more dose of 400 m gr would be repeated every four hours for maximum of three vaginal or oral dose in proportion of amount of bleeding. After 15 days if the ultrasound findings showed residual tissue, curettage would be performed. In the surgical group dilatation and sharp curettage was performed. Patient's data such as age, gravidity, gestational age based on LMP and sonography, previous cesarean and previous abortion was recorded in a data chart. Statistical analysis was performed using X2 analysis, McNemar, Fisher exact test and T-Test. Results: In medical group 87.5 had complete abortion without any need of curettage. In 92.5 of cases in surgical group, gestation products were evacuated completely by curettage. Bleeding period in medical group was significantly more than surgical group but there was no significant difference in hemoglobin concentration level before and after abortion. The most common side effect in medical group was lower abdominal pain and fever.Conclusion: Misoprostol is an effective method with tolerable side effect for terminating missed abortion until 12 weeks, in the other words, it is recommended to use misoprostol as a medical method for terminating first trimester pregnancies in Iran

Trichomoniasis in parturients referring to Shabihkhani hospital in Kashan, 2001-02

Background : Trichomoniasis was reported to have great influence on pregnancy and fetus health. Since the true epidemiological profile of trichomoniasis profile is not obvious in Kashan, the present study was performed on parturients referring to Shabihkhani hospital, between 2001 and 2002. Materials and methods : For this descriptive study, initial data were gathered via history, clinical examination, laboratory studies, and culturing. Results: Of 450 parturients, 2 (0.44) were revealed to be infected by trichomoniasis. These two had preterm delivery with low birth weight neonates. They both have watery discharge with vaginitis. Conclusion : Trichomoniasis is not a common infection in Kashan. It is associated with preterm delivery, PROM, and LBW neonate. Meanwhile, clinical picture and laboratory findings can not provide adequate clues for definite diagnosis

Vaginal Versus Oral Misoprostol for Second-Trimester Pregnancy Termination: A Randomized Trial

Introduction: The purpose of this study was to compare the efficacy and side effects of two different misoprostol regimens for second-trimester pregnancy termination. Methods: 60 consenting women who were at 14 to 28 weeks of gestation with indications for pregnancy termination were randomly assigned to two equal groups to receive either vaginal or oral misoprostol. The dosing regimen was 400µg as the initial dose followed by 400µg and up to 3 doses (1200µg) if needed in each group. Efficacy and side effects were compared. Results: 30 patients randomly assigned to vaginal and 30 to oral misoprostol group. Demographic characteristics were similar in both the groups. The percentage of women who delivered was significantly higher in vaginal group than the oral group (86.7 vs.43.3, P=0.0006).The average induction to delivery interval was shorter in vaginal group, but this difference was not significant (9.7±4.2 vs. 12.7±7.3 P=0.083). No significant differences in complication rates or side effects were noted between the two groups. Conclusion: Vaginal administration of misoprostol resulted in a higher success rate for second trimester pregnancy termination, whereas, no significant differences in induction to delivery time and complication rates were noted between vaginal and oral groups

Prevalence and causes of hysterectomy among women referring to Dr. Shabikhani Maternity Hospital in Kashan, 1374-75

History and Objectives: Hysterectomy (Removal of uterus) is one of the common surgical operations in females. Due to the importance of determination of its prevalence and causes in health care and therapeutic programs and lack of corresponding data in Kashan, this study was conducted to establish the prevalence and causes of hysterectomy among patients referring to Dr. Shabihkhani maternity hospital in Kashan in 1374-1375. Materials and Methods: A descriptive study was performed on 150 women referring Dr. Shabihkhani maternity hospital for hysterectomy. Data including age, job, marital status, educational level, parity, menopausal status, technique of operation, preoperative diagnosis on the basis of physical examination, laboratory examinations and pathologic reports were recorded in corresponding questionnaires. Finally, after extraction and classification of the information, they were statistically described. Results: This study showed that hysterectomy accounts for 5.9 of all surgical operations in women in this center. 44.7 of patients were 45-55 years old. 56.6 of women had history of one of 5 childbirths, which comprised the largest group among patients. Abdominal hysterectomy was performed in 90.6 of patients and the remainder undergone vaginal hysterectomy. The most common causes of hysterectomy were leiomyoma (49.3) abnormal uterine bleeding (28.6) and pelvic laxation (12.6). Abnormal pelvic examination was reported in 117 patients (78) and in 33 women (22) pelvic examination failed to detect the involved site. 71.3 of patients had laboratory examination and the remaining 28.7 did not have. Pathologic report was abnormal in 60 and normal in 40 of patients. Conclusion: Leiomyoma, abnormal uterine bleeding and pelvic laxity constitute the common causes of hysterectomy. Analytical studies are recommended to determine the contribution of different factors in order to prevent unnecessary hysterectomies

Furosemide versus Hydralazine for Managing Post Partum Hypertension in Severe Preeclampsia: A Comparative Study

Introduction: Gestational hypertension and preeclampsia are important maternal and fetal– infant complications and they can be regarded as the second cause of maternal death as well. The present study aimed to assess the effects of hydralazine and furosemide on blood pressure in sever preeclampsia. Methods: One hundred patients with severe preeclampsia were enrolled. After spontaneous onset of postpartum diuresis and discontinuation of intravenous magnesium sulfate, patients were randomly assigned to receive either Hydralazine10mg QID or furosemide10mg BID for 5 days. Patients’ blood pressure was recorded every 6h and the collected data were compared. Results: Postpartum patients with severe preeclampsia who received furosemide had significantly lower systolic blood pressure by postpartum fifth day(66% compared with 42%, P=0.016;OR=2.6) compared to those who had hydralazine. On the other hand, the time duration of response to treatment was lower in patients who received hydralazine compared with furosemide (24.3h compared with 31.4h; P=0.034). Conclusion: Furosemide proved to be more effective on blood pressure mean reduction compared with Hydralazine in women with sever preeclampsia

Human Serum Protein Adsorption onto Synthesis Nano-Hydroxyapatite

Adsorption of human serum proteins (Albumin and total protein) onto high purity synthesis nano-hydroxyapatite (HA), Ca_(10)(PO_4)_6(OH)_2, has been studied in a wide temperature range by UV–visible spectrophotometer. Adsorption isotherm is basically important to describe how solutes interactwith adsorbent, and is critical in optimizing the use of adsorbent. In the present study, the experimental results were fitted to the Langmuir, Freundlich, Temkin and Dubinin-Radushkevich (DR) models to obtain the characteristic parameters of each model and square of the correlation coefficients (R^2). According to the results, the DR isotherm model had the best agreement with the experimental data. The effect of temperature on adsorption of human serum proteins (HSP) onto the synthesized nano-HA was studied. The experimental results indicated that temperature increase generally causes an increase in the adsorption of HSP onto the nano-HA. This is basically due to the effect of temperature on the HSP activity and its diffusion rate on HA surfaces