No abstract

Objectives. To compare the analgesic efficacy of intrathecal clonidine and fentanyl added to bupivacaine after cesarean section. Methods. Ninety patients scheduled for cesarean section under spinal anesthesia were randomly allocated to one of the three following groups to receive bupivacaine 10 mg combined with 75 µg clonidine (group C), bupivacaine 10 mg combined with 0.5 mL fentanyl (group F), and bupivacaine 10 mg combined with 0.5 mL distilled water (group P), intrathecally. The time to first analgesic request, analgesic requirement in the first 24 hours after surgery, sensory and motor blockade onset time, duration of sensory and motor blockade, the incidence of hypotension, ephedrine requirements, bradycardia, and hypoxemia were recorded. Results. The duration of anesthesia in clonidine group (275.10 ± 96.09) was longer compared to the placebo (211.73 ± 74.80) and fentanyl (192.33 ± 30.36) groups. This difference between group C versus F (P = 0.006) and P groups (P < 0.001) was significant. Similarly, the mean time to first analgesic request was also longer in group C (519.44 ± 86.25) than in groups F (277.88 ± 94.25) and P (235.43 ± 22.35 min). This difference between group C versus F (P < 0.001) and P groups (P < 0.001) was significant. Conclusion. Intrathecal clonidine 75 µg with bupivacaine prolonged the time to first analgesic request compared to fentanyl; however, the total analgesic consumption within the first 24 h postoperative was similar in fentanyl and clonidine groups following cesarean section. This trial is registered with ACTRN12611000909921 and ClinicalTrials.gov NCT01425658.

Objective. Comparing the effectiveness of vitamin B6 (40 mg twice daily) and ginger (250 mg four times daily) in treatment of pregnancy nausea. Methods. In a clinical trial in health centers of Qazvin University of Medical Sciences from November 2010 to February 2011 on pregnant mothers, the effects of vitamin B6 (40 mg twice daily) and ginger (250 mg four times daily) were evaluated in treatment of pregnancy nausea. Results. In both groups, treatments with vitamin B6 or ginger led to significant reduction in MPUQE score. Scores of symptoms at the day before treatment in vitamin B6 and ginger groups were 9.35 ± 1.97 and 9.80 ± 2.03, respectively, and reduced to 5.98 ± 1.45 and 6.28 ± 1.63, respectively, in the fourth day of treatment; however, mean changes in the two groups were not significantly different. Mean changes of MPUQE score in ginger and vitamin B6 groups were 8.32 ± 2.19 and 7.77 ± 1.80, respectively, showing no significant difference (P = 0.172). Conclusion. Vomiting was more reduced in vitamin B6 group; however, this reduction was not statistically significant. There was no significant difference between the two groups in nausea occurrences and their duration. No side effect was observed in either group.

Background: Management of abortion is an important issue in gynecology. Several millions of spontaneous abortions occur yearly and more than a million induced abortions are performed in the USA. Objectives: The aim of this study was to compare the effect of misoprostol alone and misoprostol with letrozole in the induction of abortion in the first trimester of pregnancy in the Qazvin city of Iran. Patients and Methods: Seventy female candidates for legal abortion within the first trimester of pregnancy were divided to two groups: misoprostol alone and misoprostol with letrozole. The complete abortion, time to open the internal os of the cervix, time to complete the abortion, and drug-induced side effects of misoprostol and letrozole were recorded and analyzed. Results: The complete abortion rate was 69.7% in the misoprostol and letrozole group and 30.3% in the misoprostol group. Incomplete abortion was 32.4% in the misoprostol and letrozole group, and 67.6% in the misoprostol group (P = 0.004). Bleeding, cervix os opening time, and time to complete abortion from induction of drugs were similar in both groups (P > 0.05). There were no medical complications in both groups. Conclusions: Misoprostol plus letrozole was more effective for inducing abortion in the first trimester of pregnancy compared to misoprostol alone.

Induced abortion is the termination of pregnancy by medical or surgical methods before the fetus' viability. Available evidences show that due to spasmolytic effects, use of Hyoscine with Misoprostol may reduce the pain during abortion induction. The aim of this study is to evaluate the effect of Misoprostol in combination with Hyoscine compared with Misoprostol alone in reducing the duration of abortion induction. In a clinical trial at the Department of Obstetrics and Gynecology, Qazvin University of Medical Sciences on 126 pregnant women with gestational age below 20 weeks elected for abortion, the effect of Misoprostol in combination with Hyoscine compared with Misoprostol alone was evaluated in reducing the duration of abortion induction. The mean duration of abortion induction in Misoprostol with Hyoscine represented statistically significant decrease compared with Misoprostol (653.38 ± 80.386 min, with 726.29 ± 64.56 min) (P ≤ 0.001). There was no significant difference in demographic characteristics, including maternal age, gestational age, gravidity, parity and history of abortion between the two study groups, and the two groups were homogeneous. Duration of abortion induction (p < 0.001), the rate of vaginal bleeding (p < 0.001), and the rate of hemoglobin deficiency (p = 0.002) in the group receiving Misoprostol suppositories and Hyoscine was significantly lower than in the group receiving Misoprostol suppositories alone. The need for analgesics in the group receiving Misoprostol suppositories and Hyoscine was significantly less than in the group receiving Misoprostol suppositories alone (p < 0.001). Finally, results of this study showed that adding 20 mg Hyoscine intra venous to vaginal Misoprostol is effective in significantly reducing the duration of the abortion induction, getting less pain killers, less vaginal bleeding and less decrease in hemoglobin changes.