سونیا صادق پور

Considering the importance of complications caused by cesarean sections performed during the second stage of labor for both the mother and the newborn, as well as its impact on future pregnancies, the purpose of this study is to investigate the complications associated with cesarean sections during the second stage of labor.

Materials & Methods :

In this case-control study, the case group includes patients who underwent cesarean section in the second stage of labor, and the control group includes patients who underwent elective cesarean section. Finally, the clinical findings obtained between the two groups of cases and controls were analyzed.

Out of 60 mothers in this study, 30 were in the control group and 30 were in the intervention group. The duration of hospitalization for the control and intervention groups was 2.94 ± 1.14 days and 4.03 ± 1.35 days, respectively. Statistically, the difference between the two groups was significant (P = 0.002). Additionally, the average volume of bleeding, as indicated by the number of sterile gauzes used, was 7.9 ± 1.3 gauzes in the control group and 13.9 ± 2.8 gauzes in the intervention group. The difference in the volume of bleeding between the two groups was statistically significant (P < 0.001).

Cesarean section in the second stage of labor is associated with higher maternal complications compared to elective cesarean sections. These complications include a higher rate of hemodynamic instability and blood pressure disorders, more bleeding, a higher blood transfusion rate, extension of unintentional uterine incision, uterine atony, sepsis, fever, more antibiotic treatment, more admissions to the ICU, longer hospitalization days after cesarean section, need for hysterectomy, longer operation time, re-laparotomy, postoperative pyrexia, and wound infection.

The prescribing pattern of non-steroidal anti-inflammatory drugs (NSAIDs) has scarcely been studied in Iran. This study aims to evaluate the prescribing pattern of NSAIDs in the prescriptions of the patients who referred to Taleghani and Imam Khomeini educational pharmacies from March 21st to September 22nd, 2019 in order to find a way to reduce their irrational and excessive prescription as well as their serious side effects.

In this retrospective, cross-sectional study all the prescriptions containing NSAIDs from March 21st to September 22nd, 2019 in Taleghani and Imam Khomeini educational pharmacies were analyzed using the Tebyan software and the drug interactions were determined using the Lexicomp application and the data was collected.

Among the overall 47652 prescriptions analyzed in both pharmacies, the most and the least prescribed drug in both pharmacies were the 30 mg/mL ketorolac ampoule and the 250 ml mephenamic acid, respectively. The greatest number of major and moderate interactions between drugs in Imam Khomeini pharmacy were both seen in prescriptions containing the 30mg/mL ketorolac ampoule with the percentages of 41.9% and 32.1%, respectively; and in Taleghani pharmacy the greatest number of both interactions were seen in prescriptions containing the 30mg/1mL ketorolac ampoule with the percentages of 75.2% and 76.6%, respectively.

NSAIDs are widely prescribed and a high number of drug interactions are observed in prescriptions containing these drugs. We can conclude from this study that physicians need more attention and education concerning NSAID drug interactions with each other and with other drugs.

Heterotopic mesenteric ossification is a rare bone-like lesion located inside the abdominal cavity. Its etiology is unclear but most of the patients had a history of abdominal trauma or surgical operation.In this study, we present the case of a 29-year old woman admitted with acute abdominal pain and fever that underwent emergency laparotomy. She had a history of recurrent pelvic inflammatory disease and surgical appendectomy. During a laparotomy, a massive left tubo-ovarian abscess was seen and drained out. There was also a hard mass-like lesion measuring 2×1cm attached to the mesentery that was excised and sent for pathologic evaluation. The patient was discharged in good general condition.Microscopic evaluation of the mass in hematoxylin and eosin stained section revealed a structure consisting of bony trabeculae and fibroblastic proliferation.This case represents a rare simultaneous occurrence of mesenteric ossification with a ruptured tubo-ovarian abscess that due to a history of recurrent inflammatory disease introduce inflammatory prosess as a possible cause of heterotopic mesenteric ossification.

More than half of all infertility cases are contributed by males. One of the important causes of infertility is free radicals in seminal fluid which causes sperm DNA oxidation and alteration in organic bases in DNA structure that finally leads to sperm destruction and reduction of its movement and fertility ability Therefore, in addition to semen analysis, sperm function tests are recommended. One of these performance tests is the evaluation of sperm double-stranded DNA. So the effect of vitamins E, C, omega-3W supplementation)) and zinc (Zn) as a treatment of anti-oxidative stress on the level of DNA fragmentation of sperm as well as the outcome of pregnancy in IUI candidates couples will be examined. The aim of this study was the evaluation of effects of ant oxidative treatment on sperm DNA fragmentation and IUI pregnancy tests. In a randomized clinical trial study, 150 infertile IUI candidates who met our inclusion criteria were enrolled in the study. A simple non-probability sampling was performed and 150 infertile couples (aged 25-40 years) attending were classified into five groups of 30 as follows: control group, the group receiving vitamin C, the group receiving vitamin E, the group receiving omega- 3, and the group receiving zinc (Zn); all groups were treated for 2 months. Statistical analysis was performed by SPSS, and DNA fragmentation index results were compared between the groups. The mean DFI in group receiving Zn before and after the treatment was 33.6±2.14 and 21±2.9 respectively. The mean DFI in group receiving Vitamin C before and after the treatment was 38±5.36 and 26.9±5.4 respectively, and in the control group it was 34.7±3.66 in the first sampling and 35.3±5.4 in the second sampling. In the group receiving omega 3, it decreased from 37.2±4.72 before treatment to 22.6±3.5 after the treatment. In the group receiving vitamin E, it was 37.1±3.54 before the treatment that decreased to 21±3.09 after the treatment. The comparison of the changes in 5 groups shows that vit. E was effective in reducing the fragmentation rate significantly (P<0.001). The pregnancy rate was not significantly different in study groups based on the chi-square analysis. Accordingly, this study and better response to treatment in groups receiving antioxidants comparing to the control group, we can conclude that the antioxidant therapy can decrease the sperm DNA fragmentation. The difference between the control and case groups was significant; the most considerable decrease in defragmentation was in group receiving vit. E. There were no cases of pregnancy in groups receiving the antioxidants and no cases of pregnancy were seen.