Sleep disturbance in late pregnancy and type and duration of labour.

In this study, the relationship between sleep quality and type and duration of labour has been evaluated. A total of 88 pregnant women completed the Pittsburgh Sleep Questionnaire three times during their last 3 weeks of pregnancy at their prenatal visits and once postpartum. A mean score of >5 was considered as poor-quality sleep. Duration of labour, type of delivery and weight of the newborn at delivery was considered. Of the study population, 56.2% were categorised as the good-quality sleep group and 43.8% as the poor-quality sleep group. The reported sleeping time per day was 8.47±1.86 hours for the good-quality sleep group and 6.45±2.07 hours for the poor-quality sleep group. The poor-quality sleep women were 20% more likely to undergo caesarean section and had a longer labour duration. Gestational age at delivery and mean gravidity was respectively 38.53±1.17 weeks and 1.91±1.03 in the good-quality sleep group and 38.36±1.59 weeks and 1.86±1.07 in the poor-quality sleep group. Thus, it was found that women with sleep problems experience longer labour duration and are more likely to undergo a caesarean section.

The clinical manifestation, evaluation and surgical management of sphenoid sinus mucoceles: a case series and literature review.

OBJECTIVE: This study was designed to describe clinical manifestation, treatment and outcomes in patients with sphenoid sinus mucocele presenting to Amiralam Hospital, Tehran, Iran. METHODS: A review of 43280 medical records covering a period of 10 years included just 12 patients with sphenoid sinus mucocele presenting to our teaching centre. RESULTS: The mean age of the patients was 35 years (ranging from 19 to 52 years). Headache was the most frequent symptom in 9 of the 12 patients. Visual disorders were noted in five patients. Two patients underwent external ethmoidectomy accompanied by intranasal sphenoidotomy while transseptal sphenoidotomy was performed for five patients and five patients underwent endoscopic endonasal sphenoidotomy. Wide spectrum antibiotics were given to all the patients for 3 to 5 days in order to prevent any iatrogenic infection. All patients did well after surgery without postoperative complications. CONCLUSIONS: Sphenoid sinus mucocele should be considered in the differential diagnosis of cystic lesions presenting as visual disturbance. Retro-orbital headache with or without visual symptoms is a leading symptom. CT and MRI are essential in the diagnosis of sphenoid disease.

[Emergency fibrogastroduodenoscopy in the diagnosis and treatment of peptic gastroduodenal hemorrhages in the middle-aged and elderly]. / Ekstrennaia fibrogastroduodenoskopiia v diagnostike i lechenii iazvennykh gastroduodenal'nykh krovotechenii u bol'nykh pozhilogo i starcheskogo vozrasta.

Urgent fibrogastroduodenoscopy was performed in 145 of 178 elderly and senile patients with bleedings from upper portions of the digestive tract, ulcerous bleedings being revealed in 92 of them. Surgery is thought to be the best method in cases with persistent bleedings and in the revealed during examination thrombosed vessels in the ulcer without active bleeding. In 33 patients not subjected to endoscopy the latter could have given better results of treatment.