Hysteroscopic and Pathologic Evaluation of Chronic Endometritis in Patients with Unexplained Recurrent Spontaneous Abortion

BACKGROUND AND OBJECTIVE: Chronic endometritis is one of the most specific, but not the most common causes of infertility, which reduces the amount of pregnancy and poor results of pregnancy, such as preterm labor and abortion. The aim of this study was to evaluate the role of chronic endometritis in recurrent spontaneous abortions (RSA) and to determine the bilateral relationship between the histological and pathological findings of this inflammation. METHODS: A case controlled-prospective observational study was performed on one hundred women 20-35 years in the Fatemeh Zahra infertility center and Rohani hospital. Patient group include forty patients with unexplained RSA and control group include 60 women that underwent hysteroscopy due to vaginal bleeding or other causes except RSA. All of the women underwent endometrial biopsy and examined by pathologist for presence plasma cells in stroma. FINDINGS: In all patients endometritis rate was 8%. Patients with RSA had a significantly higher incidence of CE both hysteroscopically (30% vs. 6.7%; p<0.005) and pathologically (27.5% vs. 6.7%; p < 0.005). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of hysteroscopy in the diagnosis of CE were 93.3%, 97.6%, 87.5% and 98.8% respectively. Also the PPV and NPV of hysteroscopy, sensitivity, specificity in the diagnosis of endometrial polyp were 100%, 87.3%, 76.3% and 100% respectively. CONCLUSION: Based on the results, there was a significant association between CE and unexplained RSA. Due to high sensitivity and acceptable specificity of hysteroscopy in diagnosis of CE and endometrial polyp, we recommended hysteroscopic evaluation of patients with unexplained RSA

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Comparing the effects of prednisolone and promethazine in the treatment of hyperemesis gravidarum: a double-blind, randomized clinical trial

Background: Nausea and vomiting during pregnancy is one of the most frequent obstetric problems of unknown etiology and there is no definitive treatment for it. The purpose of this study was to compare the effects of prednisolone and promethazine in the treatment of hyperemesis gravidarum. Materials and Methods: This double-blind clinical trial study was conducted on 70 pregnant women, with a singleton pregnancy at less than 16 weeks of gestation, with hyperemesis gravidarum. Women were randomly divided into two groups to receive either prednisolone (5mg) or promethazine (25mg) three times daily they received capsules with similar shapes but different codes. The dose of medication was tapered down after the first week and it was discontinued after two weeks. Finally, women were studied for relapse symptoms during the treatment and two weeks post-treatment. Results: There was a significant difference in the improvement of symptoms between the two groups during the course of treatment and also two weeks post-treatment (P=0.001). Moreover, there was no significant difference between the two groups in the frequency of nausea and vomiting during the first 4 days, in the 14th day of the treatment and 2 weeks post-treatment (P=0.07). Conclusion: Results show that both prednisolone and promethazine are effective to control hyperemesis gravidarum

Relationship between the serum B-HCG and preeclempsia and itsseverity

Background and purpose: 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 .Materials and Methods: 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.Results: 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).Conclusion: 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

Managing the sick child in the era of declining malaria transmission : development of ALMANACH, an electronic algorithm for appropriate use of antimicrobials

To review the available knowledge on epidemiology and diagnoses of acute infections in children aged 2 to 59 months in primary care setting and develop an electronic algorithm for the Integrated Management of Childhood Illness to reach optimal clinical outcome and rational use of medicines.; A structured literature review in Medline, Embase and the Cochrane Database of Systematic Review (CDRS) looked for available estimations of diseases prevalence in outpatients aged 2-59 months, and for available evidence on i) accuracy of clinical predictors, and ii) performance of point-of-care tests for targeted diseases. A new algorithm for the management of childhood illness (ALMANACH) was designed based on evidence retrieved and results of a study on etiologies of fever in Tanzanian children outpatients.; The major changes in ALMANACH compared to IMCI (2008 version) are the following: i) assessment of 10 danger signs, ii) classification of non-severe children into febrile and non-febrile illness, the latter receiving no antibiotics, iii) classification of pneumonia based on a respiratory rate threshold of 50 assessed twice for febrile children 12-59 months; iv) malaria rapid diagnostic test performed for all febrile children. In the absence of identified source of fever at the end of the assessment, v) urine dipstick performed for febrile children >2years to consider urinary tract infection, vi) classification of 'possible typhoid' for febrile children 5 year children and lead to more rational use of antimicrobials