Normal 0 false false false EN-US X-NONE FA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Times New Roman; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Abortion is one of the prevalent problems of obstetrics throughout the world. Standard and usual method for pregnancy termination at first trimester is surgery (curettage). Another effective pregnancy termination method at first trimester is the use of medical treatments. The aim of this study is to compare the efficacy of misoprostol alone or in combination with methotrexate for termination of pregnancy at first trimester. Methods: This study is a Randomized Clinical Trial. A total of 200 pregnant women at first trimester of pregnancy were randomly divided into two groups for termination of pregnancy. First group received misoprostol alone (800 m g , vaginal, one or two dose) and second group received misoprostol in combination with methotrexate (50 mg/m 2 /IM and 800 m g vaginal misoprostol in one or two dose was administered 72 hours later). Sonography was administered at seventh day for both groups and curettage was done if pregnancy was continued or if fetus residual was existed. Findings: Successful abortion rate was 83% at first group and 81% at second group. There was a significant relation between dose of misoprostol and need for curettage and a significant relation between kind of pregnancy and need for curettage in both groups (P = 0.001 and P (P = 0.934). No adverse events or side effects were reported side-effects were reported with the use of misoprostol and methotrexate. Conclusion: Pregnancy termination with medical method along with misoprostol alone or in combination with methotrexate is safe and cost effective. Key words: Missed abortion, misoprostol, methotrexate, premature medical abortion
Background and Aim: Cervical pregnancy is a rare form of ectopic pregnancy. Treatment approach depends on hemodynamic status; so, it could be medical therapy or more aggressive treatment like emergent hysterectomy. Case report: We present an interesting case of cervical ectopic pregnancy with high level of βhCG which was successfully treated with multidose methotrexate. Conclusion: In cases of early diagnosis of cervical pregnancy in patients with stable hemodynamic status, medical therapy could successfully treat cervical ectopic pregnancy even with high level of βhCG. Keywords: Cervical ectopic pregnancy, methotrexate, treatment.
Introduction: Gestational diabetes mellitus (GDM) refers to diagnosing of carbohydrate intolerance during pregnancy which may cause some serious fetal and maternal complications. GCT (fifty-gram glucose tolerance test) is the first test for GDM screening which is done without regarding of fasting condition. While prevalence of GDM is 2-5, the result of this test is positive in 14-18 of pregnant women. Thus, those with positive results are screened by a three-hour hundred-gram glucose tolerance test (GTT). Execution of this test requires 8-14 hours fasting and four-times blood sampling in which the patient incurs a lot of time, cost and stresses. If GDM cases are reduced by execution of GTT after ten-hour fasting, a hundred-gram GTT is prevented in many patients. The aim of this survey is evaluation effects of fasting on results of fifty-gram oral glucose challenge test in GDM screening Methods: A total of 130 pregnant women who met the inclusion criteria with gestational age of 24 to 32 weeks and were hospitalized in Imam Reza hospital from 2008 to 2009 participated in this study. They were randomly entered into fasting group (80 cases) or non-fasting group (50 cases). After one hour receiving fifty-gram oral glucose, blood sampling was taken from all of them. Then, the level of blood glucose was measured and compared between two groups by T test, Mann Whitney, Chi Square tests and SPSS software version 13. P<0.05 was determined significant. Results: T-test evaluation shows no statistical significant relation between fasting status and the result of screening (P=0.89). But, based on Chi Square test, fasting and non-fasting group were statistically different in terms of mean blood glucose (P=0.03). Conclusion: In GDM screening test, the mean level of blood glucose reduces in fasting status.
Clomiphene citrate is one of the effective drugs for infertility treatment due to oligo-ovulation or anovulation. Intrauterine insemination (IUI) is one of more adherent methods for treatment of infertile cases which is followed by controlled ovarian hyperstimulation (COH).the aim of this study was to evaluate Clomiphene citrate versus letrozole with gonadotropins in IUI cycles.In this prospective randomized trial, 180 infertile women who were referred to Milad Hospital were selected. The first group received 5 mg/day letrozole on day 3-7 of menstrual cycle. The second group received 100 mg/day Clomiphene in the same way as letrozole. In both groups, human menopausal gonadotropin was administered every day starting on day between 6-8 of cycle. Ovulation was triggered with urinary Human Chorionic Gonadotropin (5000 IU) when have two follicles of ≥16 mm. IUI was performed 36 hr later.The number of matured follicles, cycle cancellation, and abortion were the same in both groups. Endometrial thickness was higher at the time of human menopausal gonadotropin administration in letrozole group. Chemical and clinical pregnancy rates were much higher in letrozole group. Ovarian hyperstimulation was significantly higher in clomiphene group.Letrozole appears to be a good alternative to clomiphene citrate with fewer side effects.
Introduction: Hormone therapy is the standard treatment for menopause symptoms. But trials have shown serious risks even in short-term use. Recently, tendencies toward use of botanic sources have been increased to meet this goal. The objective of this study was to evaluate the efficacy of fluoxetine and black cohosh in treatment of women with postmenopausal symptoms. Methods: This randomized clinical trial was conducted on 82 women with menopausal symptoms who referred to Qaem Hospital of Mashhad city, from January 2010 to February 2011. Participants were randomly divided into two groups and were treated with fluoxetine or black cohosh. After entry into the study, patients were examined at first, second and third month of treatment period. At the beginning and the end of the third month, they completed questionnaires consisting of menopausal rating scale. Data were analyzed by SPSS statistical software version 11.5, chi-square, Mann Whitney, t-student and paired t-test. P value less than 0.05 was considered statistically significant. Result: A reduction in menopausal rating scale rates was seen at the end of third month in both groups compared with baseline values. But no significant difference was observed between two groups. Adverse effects were significantly lower in black cohosh group than fluoxetine group (p<0.001). Conclusion: Both black cohosh and fluoxetine improve hot flashes, night sweats and depression in menopause women. Additional clinical studies that include placebo and estrogen groups are warranted to confirm the effects of black cohosh on postmenopausal symptoms.
To evaluate the efficacy of medical abortion at first trimester of pregnancy with vaginal misoprostol.This is a descriptive analytic study. It was performed on 100 women at first trimester of pregnancy referred to teaching hospitals related to the Medical Sciences of Mashhad University, Mashhad, Iran for termination of pregnancy in 2006. Each patient received first dose of misoprostol (800 microg/vaginal), the second dose (800 microg/vaginal) was administered 24 hours after the first dose if expulsion of conceptus was not successful and curettage was performed if product of conception remained.From 100 patients, 83 women (83%) had successful complete abortion, and 17 cases required curettage. Among them, pregnancy was terminated in 55 (62%) with first dose of misoprostol and 28 (34%) of them required second dose. No important side-effects were noted due to vaginal misoprostol treatment.Termination of pregnancy by medical methods at first trimester of pregnancy with vaginal misoprostol is safe, cost effective, and without side-effects.
A 25-year-old woman (gravida 2, abortion 1) was admitted to Ghaem Hospital affiliated to Mashhad University of Medical Sciences at 24 th week of gestation. Her chief complaint was bloody show. She had a history of incompetent cervix, with premature labor at 22 nd week of gestation. She was hospitalized with 4 cm dilatation and 50% effacement of cervix at 24 th week of gestation. Following bed rest and prescribing heparin for prophylaxis against thromboembolism, she delivered at 39 th week of gestation with good maternal and neonatal out
We want to compare the efficacy and safety of vaginal versus sublingual misoprostol for cervical ripening and induction of labor. This randomized clinical trial was performed on 140 women with medical or obstetric indications for labor induction. The patients were randomly divided into two groups: vaginal and sublingual administration of misoprostol. In first group, 25 µg misoprostol was placed in the posterior fornix of the vagina and second group received 25 µg misoprostol sublingually, every 6 hours for 24 h. Maternal and neonatal outcomes were analyzed. There was no significant difference in the demographic characteristics between two groups. The main indication for cesarean section in both groups was fetal distress, followed by absence of active labor progress. Evaluation of cesarean indication was not significantly different in two groups; including fetal distress, absence of active labor, uterine over activity and failure to progress. The maternal complication in sublingual group included residual placenta (2%), tachysystole (2%), vomiting (12%), atoni (3.3%) and abdominal pain (5.5%), although there was no significant difference between two groups. Sublingual misoprostol is as effective as vaginal misoprostol for induction of labor at term. However, sublingual misoprostol has the advantage of easy administration and may be more suitable than vaginal misoprostol.
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