بی بی مریم میرلاشاری

Scorpion bite is an important health issue that in many cases occurs in Sistan and Baluchistan province. Severe complications of scorpion bite include: decreased renal blood flow, renal failure, severe hemolysis, pancreatitis, hepatitis, DIC, miscarriage, and death. In this study, a case of mother's death due to DIC caused by scorpion bite is reported.

A 19-year-old primigravid woman with the gestational age of 33 weeks, 5 days after being bitten by a scorpion, following a decrease in the level of consciousness with GCS: 3/15, intubation,undergoing blood transfusion was transferred from Rusk Hospital and admitted to the ICU ward. After being sent to Iranshahr, the patient was examined by anesthesiologist and gynecologist. In the examinations, severe lung rales were heard and bruises caused by scorpion bite were observed on the left side. In ultrasound, a fetus without heartbeat, biliary edema and hydronephrosis were evident. Induction and antiserum treatment started for scorpion stings. Four hours later, mother suddenly had bradycardia and asystole, CPR was performed and despite 45 minutes of CPR, the patient died.

In this patient, due to delay in transferring her to the medical center caused the doctors to fail to save her in time. If the patient bitten by scorpion does not come to hospital within the first 6 hours, she will lose the chance of treatment, and if the more time passes, she will face the risk of death due to the infiltration of poison into the bloodstream, so a person bitten by scorpion should refer to the hospital at the first opportunity and special tests should be performed.

  The rate of bleeding is associated with impaired synthesis of endometrial prostaglandins, especially PGE2. One of the most common causes of anemia in women is menstrual bleeding. Bromelain, an enzyme found in pineapple, has anti-inflammatory effects and reduces prostaglandin E2 in inflammatory regions. This study was performed with aim to compare the effects of Bromelain and Mefenamic acid on the amount of menstrual bleeding. A double-blind randomized clinical trial was conducted on 90 students with primary dysmenorrhea in dormitories of Velayat University of Iranshahr in 2017. The students were monitored for two cycles with Higham chart in terms of the rate of bleeding. Then, they were randomly assigned to two groups: Bromelain (n=32) and Mefenamic acid (n=34). The Higham chart was completed to measure menstrual bleeding in two cycles of control and two cycles of intervention. The subjects received 250mg capsules of Bromelain or 250mg capsules of Mefenamic acid, if needed, they received two interventional cycles every 6 hours during the first three days. Data was analyzed by SPSS software (version 22) and Mann-Whitney, Paired t-test and independent t-test. P <0.05 was considered significant. The results of Paired t-test showed significant difference in the amount of bleeding after intervention in the Bromelain group (P = 0.036), but this difference was not significant in the Mefenamic acid group (P = 0.088). The difference between the mean of bleeding in two cycles of intervention compared to the two cycles of control was -6.79 ± 17.57 in the bromelain group and was -5.36 ± 17.57 in the Mefenamic acid group that showed no significant difference (P = 0.744). Consumption of Bromelain for reducing menstrual bleeding has no difference with Mefenamic acid in primary dysmenorrhea.