Journal of Clinical and Basic Research
Volume:3 Issue: 3, Summer 2019

Delayed postpartum hemorrhage is a midwifery emergency that occurs following vaginal or cesarean delivery. It is one of the leading causes of postpartum hysterectomy and maternal death. The condition may be caused by dehiscence of uterus incision after cesarean section, which can lead to severe and fatal bleeding. We herein report a case of secondary postpartum hemorrhage after cesarean section.

 A 34-year-old G3p3 woman with severe bleeding was admitted to the maternity hospital of Yazd (Iran) in preshock state. The patient had previously had three cesarean sections and underwent elective cesarean section at 38 weeks ten days age. The patient was immediately transferred to the operating room and underwent hysterectomy. Blood transfusion and serum therapy were performed. After the surgery, the patient was kept in the intensive care unit for four days and then was transferred to gynecology ward. Finally, she was discharged on the sixth day of hospitalization after partial recovery.

Secondary postpartum hemorrhage is a deadly complication of postpartum period. However, it is often diagnosed at critical stages due to its low incidence, which may endanger the mother's life if left unattended. Therefore, it is recommended to discharge all mothers after fully explaining the complications of genital infections, so that they may seek medical attention upon appearance of alarm symptoms. Gynecologists and health professionals should follow up this group of women more carefully to prevent irreversible consequences.

Esophageal squamous cell carcinoma (ESCC) is a prevalent subtype of esophageal cancer in certain areas of the world. Molecular evaluations can provide a better understanding of the disease that could contribute to earlier diagnosis and treatment. Amplification or absence of microRNA (miRNA) genes has been described in many types of cancer, indicating that altered patterns of miRNA expression may affect cell cycle and its features. In this study, we investigated alteration of miR-196a expression in ESCC tissues and its association with tumor status.

The study was done on 30 specimens including matched tumor and normal tumor margin tissues. RNA extraction and complementary DNA synthesis were performed using specific primers. Quantitative PCR was done to assess the relative expression of miR-196a in tumor tissues of patients with ESCC. Data were normalized by expression level of SNORD gene as an internal control. The GraphPad Prism and SPSS software were used for analysis of data.

MiR-196a expression was higher in cancer tissues compared to normal tissues (P>0.05). The miRNA upregulation had no significant correlation with clinicopathological features such as age, gender and survival rate.

The results of the present study indicate a nonsignificant increased expression of miR-196a in ESCC tumor specimen. Future studies with a larger sample size could confirm our findings.

HELLP syndrome is a multisystemic disorder characterized by elevated liver enzymes, hemolysis and low platelet count. If left untreated, it is associated with high risk of maternal and fetal mortality. It usually occurs in the third trimester of pregnancy but may sometimes occur after pregnancy. Herein, we report a patient with postpartum HELLP syndrome.

A 32-year-old woman (G2Ab1) with gestational age of 36 weeks and a history of hypothyroidism, multiple sclerosis, favism, gestational diabetes and pregnancy-induced hypertension was admitted to hospital due to labor pain. The patient underwent cesarean section and showed triad of postpartum HELLP syndrome. Fortunately, with timely diagnosis and appropriate intervention, the patient was discharged with good general condition after four days of hospitalization in intensive care unit.

Pregnancy-induced hypertension is a life-threatening condition for mothers. HELLP syndrome is often related to preeclampsia but can also occur as a stand-alone disorder. Absence of symptoms should not rule out this syndrome, and it is recommended to consider risk of postpartum HELLP syndrome during follow ups.

One of the adverse effects of prone positioning in spine surgery is the occurrence of skin damage. Due to the high rate of spine surgeries and the frequent use of prone positioning during these procedures, we aimed to investigate postoperative skin complications after spine surgery in the prone position.

This descriptive cross-sectional study was performed in 2016-2017 on 160 patients undergoing spine surgery in the prone position at a teaching hospital in Tehran, Iran. The patients' body parts were examined for presence any redness, ecchymosis and pressure ulcers before discharge from the hospital. Collected data were analyzed in SPSS software (version 19) using descriptive statistics, Chi-square test, Mann–Whitney U test and Kendall's correlation coefficient.

Almost all patients had skin damage, especially redness, in the postoperative stage. Age, gender, duration of surgery, height, weight and body mass index were significantly associated with incidence of skin damage (P<0.05).

Our results indicated that the incidence of postoperative skin damage is relatively high in patients undergoing spine surgery in the prone position. Therefore, it is recommended to take appropriate precautions in order to prevent these complications.

Aging and its consequences are one of the major demographic issues in the world. The aim of this study was to determine quality of life and some related factors in elderly people living in Turkmen County (Iran) in 2017.
This cross-sectional, descriptive-analytic study was conducted on 300 elderly people aged 60 years and older who were living in the Turkmen County, Iran. The subjects were selected via stratified random sampling. Data were collected using the World Health Organization Quality of Life-BREF Questionnaire. Data analysis was performed in SPSS software (version 16) using independent t-test, one-way ANOVA and nonparametric tests, such as Mann-Whitney U test and Kruskal-Wallis test. P-values less than 0.05 were considered statistically significant.

Of 300 subjects, 152 cases (50.7%) were women and 148 (49.3%) were men. The mean total score of quality of life was 54.4 ± 12.7. The mean standardized score of quality of life differed significantly depending on marital status, income level and number of children (P<0.05). There was a significant relationship between the mean standardized score of quality of life in terms of physical health and occupation status, age, income level and number of children. In addition, the mean standardized score of quality of life in the social relationship domain differed significantly based on gender, marital status, income level and number of children. Moreover, the mean standardized score of quality of life in the environmental health domain differed significantly based on occupational status and income level (P<0.05).

Considering the impact of various factors on quality of life of the elderly, it is crucial to take measures for promoting quality of life in elderly women, unemployed elderly, people aged 80 years or older and those with a low income level.

Systemic lupus erythematosus (SLE) is a multi-systemic inflammatory disease that mainly affects women of childbearing age. Development of SLE during pregnancy increases the risk of some maternal and fetal complications. We herein present a pregnant woman with new-onset SLE during pregnancy.

 A 30-year-old pregnant woman with a gestational age of 30 weeks and twin pregnancy was referred to a hospital because of bradycardia and arrhythmia of fetuses during routine pregnancy checkups. The patient was later diagnosed with SLE and received hydroxychloroquine and dexamethasone. During the course of treatment, the patient developed erythematosus skin lesions and was hospitalized for further evaluations. Various consultations were made. Given the overall conditions of the mother and fetuses, caesarean section was performed at week 34 of pregnancy. Finally, the patient was discharged with good general condition after one month of hospitalization.

Active SLE during pregnancy is associated with an increased risk of maternal and fetal complications. It is essential to consider the impact of pregnancy on the disease, the impact of the disease on fetal health and the safety of medications used during pregnancy and lactation. For improved fetal and maternal outcomes, a multidisciplinary approach comprising of gynecology, neonatology and internal medicine should be taken when treating pregnant women with SLE.