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

Correlation between the reported transcutaneous bilirubin and serum bilirubin in icteric term neonates before and during photothetrapy

Background: Neonatal jaundice is a very common condition in neonates. Serum bilirubin measurement in neonates is invasive and increases the risk of infection. Therefore, recognizing the highly accurate noninvasive methods has been considered by the researchers. This study aimed to evaluate the correlation between the transcutaneous and serum bilirubin before and during phototherapy in icteric neonates. Materials and Methods: This descriptive correlational study was conducted on 200 icteric term neonates (age 1-7 days) referred to Kashan Shahid-Beheshti hospital from July 2010 to January 2011. Blood and transcutaneous bilirubin samples were taken from the forehead and sternum of the neonates on admission and 8 hours after phototherapy. Data were analyzed using the Pearson correlation coefficient. Results: Among 200 neonates, 102 were female and 98 male (mean age, 4.5±1.7 days). There was a significant correlation between the serum bilirubin before phototherapy and forehead transcutaneous bilirubin (r=0.83) and with sternum transcutaneous bilirubin (r=0.71, P0.001). Moreover, there was a significant correlation between the serum bilirubin after phototherapy and forehead transcutaneous bilirubin (r=0.76) and sternum transcutaneous bilirubin (r=0.49, P0.001). Conclusion: Transcutaneous bilirubinometery is a suitable alternative in measuring serum bilirubin in term icteric neonates who need treatment. Transcutaneous bilirubinometery especially through forehead can be used for screening of icteric neonates and their follow-up during phototherapy

An innovative drinking water nutritional quality index (DWNQI) for assessing drinking water contribution to intakes of dietary elements: A national and sub-national study in Iran

Drinking water contribution to intakes of dietary elements in urban communities of Iran in 2014 was determined and an innovative drinking water nutritional quality index (DWNQI) was introduced to assess the overall situation. The investigated nutrients were calcium (Ca), chloride (Cl), copper (Cu), fluoride (F), iron (Fe), magnesium (Mg), manganese (Mn), potassium (K), sodium (Na) and zinc (Zn). The DWNQI was developed in five steps as follows: (1) selecting input minerals, (2) assigning weight factor for input minerals, (3) converting the mineral levels to the sub-index values (from 0 to 100), (4) introducing an aggregation function to calculate the DWNQI and (5) Describing the DWNQI scores (from 0 to 100) in five categories as poor (0-44.9), marginal (45.0-59.9), fair (60.0-69.9), good (70.0-79.9) and excellent (80.0-100). The percentages of drinking water in the recommended dietary allowances (RDAs) of Ca, Cl, F, Mg and Na at the nationwide level were 9.9, 7.1, 20.5, 18.5 and 8.8, respectively which were significantly higher than those of the other minerals. At the provincial level, the highest and lowest average scores of the DWNQI (±standard deviation) were observed in North Khorasan and Kermanshah to be 83.7 ± 1.6 and 59.6 ± 5.2 described as excellent and marginal, respectively. The national average score of the DWNQI was 71.5 ± 8.2 (good description). This study indicated that the DWNQI could reliably characterize the drinking water contribution to the mineral intakes without strong sensitivity to any individual element. Based on the observed role of drinking water in intakes of dietary elements, it is recommended that the DWNQI be used in judgment about drinking source water quality. © 2015 Elsevier Ltd. All rights reserved