Amniotic Membrane for Pain Control After Cesarean Section

Objectives: Pain is one of the major problems for patients after cesarean section. The aim of this study was to assess the effect of amniotic membrane as cesarean wound dressing on pain after cesarean section. Materials and Methods: This study was conducted on 90 pregnant women who underwent cesarean section in Amir-alMomenin hospital, Gerash, Iran. The participants were divided into 2 groups each of 45. The wound was dressed with amniotic membrane in one group and with simple gauze in the other group. Pain was measured and recorded in the 2 groups by visual analogue scale (VAS). The need for receiving analgesics 24 hours after the cesarean section was also assessed and compared between the 2 groups. Results: The results showed no signifcant difference between the 2 groups regarding the mean pain, 4 and 12 hours after the cesarean section (P=0.308 and P=0.628, respectively). However, a signifcant difference was observed between the 2 groups, in this regard, 24, 36, and 48 hours after the operation (P=0.026, P=0.026, and P=0.004, respectively). Moreover, the patients in the amniotic membrane group needed less analgesics compared to those in the control group 24 hours after cesarean section (P=0.041) Conclusions: Use of amniotic membrane dressing can be effective in reducing pain after cesarean section and can eliminate the patients’ need for analgesics. Hence, it can be used as an effective complementary method along with usual analgesics for pain relief

Early Predictive Factors of Hypofibrinogenemia in Acute Trauma Patients

Background: Uncontrolled hemorrhage still remains a major cause of trauma-associated mortality. The events resulting in acute traumatic coagulopathy, particularly hypofibrinogenemia, make control of bleeding difficult. It is essential to timely predict, diagnose, and manage trauma-induced coagulopathy. Aims: The aim of this study is to determine clinical and easily available laboratory variables that are predictive of hypofibrinogenemia in acute trauma patients. Settings and Design: This 2-year retrospective work examined the data of major trauma patients that were referred to Shahid Rajaee Hospital's emergency room in hemorrhagic shock condition. Materials and Methods: Fibrinogen level was assessed for these patients on their arrival at our facility. Along with clinical and routine paraclinical variables, we evaluated the predictive value of these variables for a fibrinogen level below 100 mg/ml. Results: A total of 855 cases were included (females: 16.4%; and males: 83.6%) in the study. The mean ± SD age was 36 ± 17.9 years, and the mean ± SD injury severity score was 12.2 ± 9. Motor vehicle accident was the most common cause of injury. Three factors, including arterial pH (cut off point = 7.34; area under the curve [AUC]: 0.59), base excess (cutoff point = −4.3; AUC: 0.60), and patients' gender had a significant association with the fibrinogen level under 100 mg/ml. When three factors of pH, BE, and patients' gender are being assessed simultaneously, the AUC became 0.62 (the predictive ability improved). Conclusions: Variables, including arterial pH, BE level, and patients' gender have predictive value for fibrinogen transfusion in trauma