Determination of Clinical Process and Response Rate to Treatment in Patients with Gestational Trophoblastic Neoplasia (GTN) with Low and High Risk and Evaluation of Their First Pregnancy Outcome.

Background: The present study was conducted to determine the response to treatment in patients with GTN, the survival rate and to investigate the outcomes of first pregnancy after chemotherapy. Materials and Methods: The treatment protocol was based on the FIGO Staging of GTN and the Modified WHO Prognostic Scoring. Results: Complete remission was achieved with MTX in 100% of the low-risk patients and with combination therapy in 91% of the high-risk cases. Out of 27 low-risk patients, 21 had no metastasis 6 had lung metastasis, 18 preserved their fertility and conceived in the first year following the chemotherapy. Out of 3 patients who had developed invasive moles, 1 got pregnant after chemotherapy. Four of the patients with choriocarcinoma conceived in the first year following the chemotherapy. In the patient with placental site trophoblastic tumors, there was no pregnancy due to hysterectomy. Conclusion: GTN was found to be a chemosensitive condition, but more effective therapeutic protocols are therefore required.

Effect of intraumbilical vein oxytocin injection on third stage of labor.

OBJECTIVE: Manual removal of placenta is performed in 1-3% of cases, and although it is a well-established and relatively safe procedure, it is not without complications. We carried out this study to determine whether intraumbilical vein oxytocin injection reduces the need for manual removal of placenta and shortens the third stage of labor, in comparison with placebo. MATERIALS AND METHODS: In this randomized clinical trial, 178 women with singleton pregnancy and normal delivery were studied in 1 year. Immediately after fetus delivery, oxytocin infusion (20 IU/L) was started in both groups. Moreover, 10 IU oxytocin and 1 mL normal saline were injected into the umbilical vein of women in the experimental and control groups, respectively. The duration of third-stage labor, need for manual delivery of placenta, and drug side effects were evaluated in both groups. With regard to the mean level of hemoglobin before and after delivery, the two groups were compared using the Levene test and independent t test, and other qualitative variables of the two groups were compared using the χ(2) test. RESULTS: The women who received intraumbilical vein oxytocin had a shorter third stage of labor as compared with the placebo group (4.24 ± 3.27 min vs. 10.66 ± 7.41) (p < 0.001) and there was less need for manual delivery of placenta in the experiment group (1.1% vs. 5.1%) (p = 0.024). CONCLUSION: It was concluded that intraumbilical vein administration of 10 IU (1 mL) oxytocin immediately after fetus delivery was clinically effective in shortening the third stage of labor.

Surgical management of the cesarean scar ectopic pregnancy: a case report.

Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. The diagnosis and treatment of cesarean scar pregnancy (CSP) is challenging. The authors reported here a case of cesarean scar pregnancy (CSP) with hypovolemic shock that underwent emergency laparotomy with resection of ectopic mass. The patient was discharged from the hospital without any complications.

Comparison of 25-hydroxy vitamin D, calcium and alkaline phosphatase levels in epileptic and non-epileptic children.

OBJECTIVE: There is evidence for the existence of bone disease in epileptic patients. The goal of this study was the comparison of serum levels calcium, alkaline phosphatase (ALKP) and 25-hydroxyvitamin D in ambulatory epileptic children in order to evaluate the bone metabolism in epileptic patients. METHODS: In this prospective analytical study 48 ambulatory epileptic children who were treated by antiepileptic drugs for atleast 6 months as case group compared with 48 children who were age and gender matched as control group. Patients with any neurological deficits and other systemic diseases were excluded. Data was collected by questionnaire and analyzed by spss software version 18. RESULTS: Mean of calcium level in case and control groups was 9.91 ±0.675 and 10.08 ±0.331 mg/dl respectively, means of ALKP in case were 703 and 607.75 IU/L respectively. Only difference between the ALKP were significant. Calcium levels, ALKP and vitmain D in any of the two groups were not associated with age and a sex but ALKP level in patients was higher and it was statistically siginificant. Calcium levels, ALKP and vitamin D in patients with drug type, dosage and duration of treatment were irrelevant. CONCLUSION: The results of this study showed that calcium and vitamin D levels were in normal ranges in epileptic and control groups but ALKP levels were significantly higher in epileptic group which can be a valuable indicator of bone metabolism in these patients.