Comparing Perinatal Outcome in Twin and Singleton Pregnancies Regarding Doppler Evaluation of Uterine Artery Indices in the Second Trimester

Background: Prediction of adverse perinatal and postnatal outcomes could be possible by using ultrasound Doppler evaluation, however there are some controversies regarding this issue in the literature. The goal of present study was to evaluate predictive value of Doppler indices in single and twin pregnancies during second trimester. Materials and Methods: This prospective study was conducted in Yas Hospital, Tehran, between February 2015 and January 2016. The number of 71 singleton pregnancies and 59 twin pregnancies enrolled in this study. A single expert perinatalogist / sonographer did all Doppler ultrasound exams and followed up cases until the end of pregnancy. To compare Doppler indices and pre-postnatal outcomes between singleton and twin groups, the Student’s t-test, Pearson χ2 test and Fisher’s exact test were used for continue and categorical variables, respectively. Results: Rates of preterm delivery and SGA were significantly higher in twin pregnancies compared with singletons (

Managment of Organophosphate Poisoning Without Pralidoxim- Is It Possible .................IJMTFM (2011) 1(2):75-77

Introduction: Organophosphate compounds are used as insecticides, nerve gases, ophthalmic agents, and antihelmintics.The primary mechanism of action of organophosphate pesticides is inhibition of acetylcholinesterase (AChE). However  Pralidoxim has been introduced as organophosphate `s antidote but recent studies establish that pralidoxim has unclear benefit in treatment of organophosphate poisoning.We explain two cases of organophosphate poisoning that they treaeted well without pralidoxim. The first case was a 36-years old man with history of organophosphates poisoning. He was under mechanical ventilation. Atropine was initiated due to muscarinic signs such as salivation, bronchorrhea and auscultation of  alveolar rhales. On admission day, the pseudocholine esterase level was 235 unit per liter. Pralidoxime was not available, so we did not use it for management of this patient.The  patient was discharged when he was in free symptom completely on the 22th day. The second case was a 23 years old woman with the history of deliberate self poisoning with organophosphate compounds. Atropine was started and she was under mechanical. However, pralidoxim was not available. The pseudocholine esterase level was 1690 unit per liter on the first day which dropped to 952 unit per liter on the 2nd day. After 9 days the discharged from the hospital. Discussion: Pralidoxim has been introduced as organophosphate`s antidote, on the other hand, it has benefit in organophosphate poisoning theoretically, but patients can be treated without it. Key words: Organophosphate, Poisoning, Pralidoxi

Predicting preterm labour by means of uterine artery doppler velocimetry during peak uterine contraction in patients with normal cervical length

Background: This study was conducted to evaluate the uterine artery Doppler velocimetry (UADV) during peak uterine contraction in order to predict preterm labour in Iranian women with a normal cervical length. Materials and Methods: This cohort study was conducted at Shariati Hospital within an interval of 1 year between January 2016 and January 2017. One hundred women within gestational age <24 weeks and preterm uterus contraction were enrolled. UADV during peak uterine contraction was evaluated by a perinatologist. Their flow velocity waveforms were recorded (during three consecutive uterine contractions), and the mean for uterine artery doppler pulsatility index (PI) was documented. Results: One hundred cases with the mean age of 31 ± 4.8 years were enrolled in this study. From this selection, eight (8%) cases delivered during the first 48 h of admission and 13 (13%) during the first 7 days. The mean gestational age and the PI were significantly different between cases who delivered during the first 48 h and those who failed to do so. The correlation coefficient between PI and gestational age was r = 0.2, P = 0.02. For women who delivered within the first 7 days, the mean velocity and the PI were considered as significant variables for predicting preterm birth. At last, similar to the first group, for those women who delivered within the first 14 days, the PI was the only predicting factor for preterm birth. Conclusion: This study concludes that the mean PI of uterine artery during peak contractions can be considered as a strong predictor of delivery in preterm labour in women with normal cervical length