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Volume 56, Issue 5 (7-1998)
Intraventricular hemorrhage (IVH) is one of the major cause of neonatal mortality and morbidity in premature babies. The etiology of intraventricular hemorrhage is multifactorial. The role of normal vaginal delivery as a cause is controversial in literature. During recent years the incidence of cesarian section has been increasing in Iran and many other countries. In a prospective study we compared the incidence of IVH in premature babies who were born by cesarian section (C.S.) or vaginal delivery. In this study we investigated 84 premature babies at or before 34 weeks gestation who were admitted during 2 years period in NICU of Ali Asghar children hospital for IVH. 10 out of 31 neonates who were born by vaginal delivery had IVH (33%) and 18 out of 53 newborns were born by C.S. had IVH (34%). There was no statistically significant difference between 2 groups. Our study showed delivery by C.S. is no associate with lower incidence of IVH and should not be a reason for doing delivery by C.S.
Volume 60, Issue 1 (4-2002)
This study is carried out to determine effective risk factors for early death and their causes in those who died due to intra cerebral hemorrhage within 30 days.
Materials and Methods: From patients who have been admitted in Neurologic ward of Imam Khomeini hospital in Tabriz, We enrolled 100 patients with intra cerebral hemorrhage and the causes and risk factors effective in early death were evaluated among these patients by age, sex, blood pressure, level of consciousness, location of hematoma, CT findings and other risk factors.
Results: We enrolled 100 patients who died due to intra cerebral Hemorrhage among 358 patients with I.C.H, 62 male and 38 female, with mean age of 60.8. The time course of hospitalization was 4.5 days. The most important risk factor was hypertension on 90 percent of patients, previous C.V.A on 28 percent other risk time of admission in 66 percent of patients with G.C.S under 8.
Conclusion: Hypertension was the most common and important risk factors and male gender and age were the second risk factors for early death with intra cerebral hemorrhage.
Volume 61, Issue 1 (4-2003)
Spontaneous intra-cerebral haemorrhage (SICH) is a relatively common neurological emergency, that is associated with significant morbidity and mortality. The goal of the present study was to estimate the neuro-imaging findings (initial CT scans), clinical presentation and possible risk factors in intra-cerebral haemorrhages.
Methods and Materials: The clinical and radiographic findings of 380 patients with intra-cerebral haemorrhage were analysed retrospectively. Patients with haemorrhage secondary to traumatism, brain tumour, or hemorrhagic infarction were excluded. 300 patients considered eligible for final analysis. All CT scans were evaluated to define the location and extension of bleeding.
Results: There were 160 men and 140 women, and the average age was 62 years, (range 26 to 87 years). The most common presenting symptom was consciousness (51 percent), headaches were present in 41.6 percent of patients, only 8.3 percent of patients were comatose at presentation. Location were lobar 36 percent, lenticular and thalamic 47 percent, possible risk factors included hypertension 60.3 percent anticoagulant treatment 9 percent and none 30.6 percent.
Conclusion: Hypertension causes most cases, in which the SICH was located in the basal ganglia. Headaches were more commonly found in patients with cerebellar haemorrhage (70.3 percent). Intra-ventricular extension most frequently occurred in the thalamic haemorrhage and subarachnoid bleeding in lobar haemorrhage location. The majority of patients with SICH that resulted from hypertension were aged >45 years. The control of risk factors, particularly hypertension is crucial to prevention.
Volume 64, Issue 11 (10-2006)
Background: Wagener's granulomatosis (WG) is a systemic necrotizing vasculitis characterized by upper and lower respiratory tract involvement and glomerulonephritis in most instances.
Case Report: We report a 36 years old man with DAH secondary to WG, as the presenting feature. He successfully treated with standard immune suppressive agents including pulse methylprednisolone and cyclophospha-mide, along with tranexamic acid as adjunctive therapy for control of active bleeding. Laboratory results showed mild to moderate anemia, increased serum lactate dehydrogenase and very high c-ANCA titer. Chest radiograph showed bilateral alveolar infilterates.
Conclusion: Diffuse Alveolar hemorrhage (DAH) is a dread complication of Wagener’s granulomatosis. Control of acute phase of hemorrhage with tranexamic acid can improve out come of patients.
Volume 65, Issue 11 (2-2008)
Background: Post-menopausal hemorrhage is one of the most common complains in gynecologic clinics. More than 60% of these cases have abnormal findings in diagnostic work ups. There is contraversy about the best diagnostic method for evaluating post-menopausal hemorrhage. The aim of this study was to evaluate the results of Trans-Vaginal Ultrasonography and compare its result to ones derived from direct endometrial biopsy and Hysteroscopy findings.
Methods: In a cross-sectional study, menopausal women who attended the outpatient clinic of Arash Hospital, Tehran University of medical Sciences, from April 2005 to March 2006 with the complain of hemorrhage were evaluated. In all of these patients, after getting informed consent, Trans-Vaginal Ultrasonography, Dilatation and Curettage and Hysteroscopy were performed.
Results: The total number of 90 women was recruited to the study with the age range of 41-80 years. The mean age of participants was 53.84 ± 6 years and 4.3 ± 5.1 years had passed from their menopause. The mean thickness of endometrium, measured by Trans Vaginal ultrasonography was 6.25 ± 3.7 millimeter. In the biopsy derived specimens, the most finding pathological presentation was atrophy (48.9%) and the Proliferative endometrium had the second prevalence (36.7%). Atrophy (44.4%) and Proliferative endometrium (33.3%) were the most prevalent finding in Hysteroscopy. There was a significant difference in endometrial thickness between groups of different pathological findings. A significant difference in endometrial thickness was also seen between groups with different Hysteroscopic finding. By grouping the data according to endometrial thickness, it became evident that endometrial thickness can predict the outcome of endometrial biopsy and Hysteroscopic finding efficiently. We used ROC curves to find the best grouping threshold for endometrial thickness to achieve the best sensitivity and specificity.
Conclusion: Measuring the endometrial thickness by Trans-Vaginal Ultrasonography is an appropriate non-invasive test for screening post-menopausal hemorrhage.
Volume 68, Issue 1 (4-2010)
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Background: Cerebrovascular accidents are the
most common complications in premature neonates (gestational age <37 weeks). Intraventricular
hemorrhage (IVH) and hydrocephaly are the most
common presentations of these accidents. Premature neonates less than 28 week age or 1000 gr have maximum risk of cerebrovascular accidents with prevalence of 30 percent. Early screening in high risk pregnancies
with real-time ultrasonography can detect these lesions and affect on final
prognosis. The purpose of this study is evaluation of brain ultrasonongraphic
findings of 60 premature neonates born in Yazd University
Hospitals, Yazd, Iran and relationship between these findings and delivery
types.
Methods: In this descriptive cross
sectional study 60 cases of premature neonates
(less than 37 week) who were born from January
to July 2007 in Yazd hospitals were evaluated
ultrasonographically to detect cerebrovascular accidents.
Results: Among 60 premature neonates, 52(86.67%) were low birth weight and 8(13.33%) neonates weighted more than 2500gr. IVH was seen in five (9.6%) LBW neonates and hydrocephaly was seen in five (9.6%) LBW neonates. One LBW neonate (1.9%) had haloprocencephaly. Eight normal weight neonates had no abnormal ultrasonographic
findings.
Conclusion: All factors that induce preterm delivery and high risk
pregnancies can increase cerebrovascular accidents in premature infants. Neonatal
weight had most powerful relationship with neonatal ultrasonograohic findings.
Volume 68, Issue 9 (12-2010)
Background: Topically applied tranexamic acid has been shown to decrease the amount of blood loss associated with major spinal surgical procedures. The aim of this study was to evaluate the effects of locally applied tranexamic acid in epidural space on post-laminectomy blood loss. Methods: One hundred patients who were scheduled to undergo laminectomy in Imam Khomeini Hospital in Tehran, Iran were enrolled in a clinical trial. Patients were divided into two groups of unilateral one level (n=50) and bilateral two level (n=50) laminectomy according to the extent of surgery. Each group was randomly allocated into two groups of tranexamic acid (n=25) and control (n=25). At the end of the operation, 250mg tranexamic acid, with volume of 5ml or 5ml of normal saline were poured on the site of surgery. The blood volume drained during first and second 24hr, and overall hemorrhage, plus the duration of post operative hospitalization were compared between the two groups. Results: The bleeding volume in the 1st 24hr was significantly less in tranexamic acid than control group (p=0.001). The bleeding volume in the 2nd 24hr was significantly less in tranexamic acid than control group (p=0.001). The hospital stay was less in tranexamic acid compared to control group (2.16±0.37 Vs. 2.96±0.89 days, p=0.001) respectively. Conclusion: Locally applied tranexamic acid in epidural space significantly reduces the amount of the 1st day, 2nd day and overall post-laminectomy blood loss, and duration of hospital stay. MicrosoftInternetExplorer4 Vs. 2.96±0.89 days, p=0.001) respectively.
Conclusion: Locally applied tranexamic acid in epidural space significantly reduces the amount of the 1st day, 2nd day and overall post-laminectomy blood loss, and duration of hospital stay.
Volume 69, Issue 7 (10-2011)
Background: Vascular complications, as the most common complications of diagnostic catheterization and percutaneous coronary intervention (PCI), are important factors in the morbidity of patients undergoing such procedures thus, this study was done to evaluate the prevalence of these complications and their related factors.
Methods: This is a descriptive study composed of 2097 consecutive patients who underwent percutaneous coronary intervention in Shahid Rajaei Cardiovascular Center in Tehran, Iran from January 2008 to January 2009. Occurrence of vascular complications in course of hospitalization and the related factors leading to the complications were investigated.
Results: Out of 2097 patients, 1544 (73.6%) were male and 553 (26.4%) were female, and the mean age of the participants was 57±10 years. Vascular complications from the time of PCI to the time discharge were observed in 19 (0.9%) patients. The other complications included: hematoma in 10 cases (52.6%), pseudoaneurysm in five cases (26.3%), retroperitoneal hemorrhage and arteriovenous fistula in 2 (10.5%) patients each. The complications were significantly more common in female patients (P=0.003), in patients with a history of hypertension (P=0.02), people of shorter stature (P=0.004), and being on gp IIIa/IIb inhibitors (P=0.003).
Conclusion: The rate of vascular complications post-percutaneous coronary interventions is low and it is considered to be a good treatment option for patients with coronary stenosis provided that sufficient compression is applied on the vascular access point in the right time after removal of the arterial sheath. PCI is of fewer vascular complications, especially in female patients, history of hypertension, and higher anticoagulant concentrations.
Volume 70, Issue 3 (6-2012)
Background: Perioperative administration of tranexamic acid (TA), decreases bleeding and the need for transfusion after cardiac procedures. Hence, the results may vary in different clinical settings and the most appropriate timing to get the best results is unclear. The primary objectives of the present study were to determine the efficacy of TA in decreasing chest tube drainage, the need for perioperative allogeneic transfusions and the best timing for TA administration following primary, elective, coronary artery bypass grafting (CABG) in patients with a low baseline risk of postoperative bleeding.
Methods: In this double-blind, prospective, placebo-controlled clinical trial in Seiedoshohada Hospital during 2011-2012, we evaluated 150 patients scheduled for elective, primary coronary revascularization. They were randomly divided into three groups. Group B received tranexamic 10 mg/kg prior to, Group A received tranexamic acid 10 mg/kg after cardiopulmonary bypass and group C received an equivalent volume of saline solution. Blood requirement and postoperative chest tube drainage were recorded.
Results: The placebo group (group C) had a greater postoperative blood loss 12 h after surgery (501±288 vs. 395±184 in group B and 353±181 mL in group A, P=0.004). The placebo group also had greater postoperative total blood loss (800±347 vs. 614±276 in group B and 577±228 mL in group A, P=0.001). There was a significant increase in allogeneic blood requirement in the placebo group (P=0.001).
Conclusion: For elective, first time coronary artery bypass surgery, a single dose of tranexamic acid before or after cardiopulmonary bypass is equally effective.
Volume 70, Issue 4 (7-2012)
Background: Postpartum hemorrhage is a leading cause of maternal morbidity and mortality that is preventive by appropriate estimation of blood loss and its treatment. This study was undertaken to evaluate the accuracy of visual estimation of postpartum hemorrhage by clinicians and co worker who work in the obstetrics department.
Methods: In this descriptive observational study, 199 educational/clinical personnel participated who worked in the obstetrics department of 3 training hospital in Mashhad in 2010. First characteristic of their occupation, educational and period of work experience recorded. Then scenes similar of postpartum hemorrhage were rebuilt by using of expired whole blood in five different volume (500, 1000, 1500, 2000, 2500, 3000 cc). Participants looked each scenes and estimated volume and necessary treatment and record in forms. Data were analyzed by SPSS software version 12 and fisher and student tests and relation between accurate volume of hemorrhage and estimated volume and treatment, occupation and experience of participants were determined.
Results: Accuracy visual estimation of blood loss in different volume of postpartum hemorrhage was between 14.3% to 52%. There was no significant association between the position of the participants and accuracy of their estimation and proposed treatments. There was no association between the staffs' work experience and accuracy of their estimation.
Conclusion: Visual estimation of blood loss was not accurate in the majority of participants. For prevention of maternal morbidity and mortality education is necessary that to be skilled for accurate estimation of blood loss.
Volume 71, Issue 10 (1-2014)
Background: Stress Ulcer Prophylaxis (SUP) is important in patients in Intensive Care Units (ICU). In this study, we evaluated the efficacy of the American Society of Health System Pharmacists (ASHP) guidelines, for stress ulcer prophylaxis. Methods: In this Quasi experimental study, data of patients that admitted to the ICU of Imam Khomeini Hospital of Urmia was recorded for three months. Then our guideline that was selected on the basis of ASHP guidelines were presented to physicians for one month and then patients’ data were collected again. The patients that hospitalized due to acute gastrointestinal bleeding and died in the early hours of admission were excluded. The data were analyzed. Results: This study involved 234 patients, of them 112 patients (91.1%) in the pre- intervention period and 99 patients (89.2%) in the post-intervention period had received acid-suppressive therapy (AST) (P=0.632). Of 77 patients (62.8%) in the pre- intervention period and 88 (79.3%) in the post-intervention period had an indication for SUP according to our ASHP-based guideline (P=0.005). Of the patients without an indication for SUP, 39 of 123 (31.7%) received AST in the pre-intervention period versus 18 of 111 (16.2%) in the post-intervention period (P=0.006). of 112 (91.1%) cases in the pre-intervention period compared with 93 (83.8%) cases of the prescription drug order was incorrect (P=0.092). Gastrointestinal bleeding were in five patients (4.1%) found during the pre-intervention period and 8 (7.2%) cases in the post-intervention period (P=0.295). Conclusion: In this study the majority of cases not been in accordance with the ASHP-based guideline and our education did not affect the quality of stress ulcer prophylaxis. It seems that more attention to the training of physician in the prophylaxis of stress ulcer can be effective in improving the health status of patients and additional costs may be reduced.
Volume 72, Issue 5 (8-2014)
cBackground: Choriocarcinoma is a highly malignant form of gestational trophoblastic disease. It is characterized by metastatic potential, rapid growth and deeply invasion into blood vessel and then widespread dissemination metastasis. However, the most common sites of metastatic choriocarcinoma are lung, vagina, liver, and brain. But, metastatic choriocarcinomas rarely is extended to gastrointestinal system. It is im-portant to keep in mind that despite extensive metastasis, choriocarcinoma is very curable disease. Due to high responsibility of this disease, early diagnosis of choriocarcinoma and treatment with chemotherapy can prevent mortality and morbidity of these patients. In this case report, we present a rare case of metastatic choriocarcinoma in the small bowel after normal term pregnancy. Case Presentation: A 34-years-old woman G4, P4, L4 presented with abnormal postpar-tum vaginal bleeding (45 days) and unresponsive to usual medical and surgical therapy (oxytocine, metergene, antibiotic, and double curettage). The patient was admitted in the Ghaem Hospital, Mashhad University of Medical Sciences in April 2013. She suf-fered from rectal hemorrhage and severe weakness. Because of unsuitable condition (shock), laparotomy was performed and small bowel involvement was observed. Seg-mental resection of small bowel detected metastatic choriocarcinoma of the lesion. We couldn’t rescue our patient due to unresponsive to combination chemotherapy (actino-mycine, methotrexate, cyclophosfamide, vincrystine, etopuside). Conclusion: In abnormal postpartum hemorrhage, we should consider the possibility of choriocarcinoma. Although, it is important to note rare manifestations of metastatic choriocarcinoma of small bowel in massive gastrointestinal hemorrhage.
Volume 72, Issue 9 (12-2014)
Background: Maternal mortality is one of the most important indicators of women health standard in developing countries. This study aimed to determine the prevalence of risk factors and etiology of maternal mortality in a geographic region of Iran. Methods: This descriptive- analytic cross sectional study included all pregnant women who died during pregnancy and six weeks after delivery due to pregnancy related fac-tor. The study was done in Sistan region in the north of Sistan and Baluchestan Prov-ince of Iran from April 2002 to March 2014. The immigrant women were excluded. Data were collected using 3 parts questionnaire. The validity and reliability of ques-tioner were approved by experts in this field. Data were analyzed using the statistical software SPSS version 18, Chi-square test and ANOVA analysis were performed. Results: The total number of deliveries during this time period was 60496. The total number of maternal mortality was 57 patients which means 94.2 out of 100.000 live births. Most of the dead mothers had more than 35 years old (46.9%), gestational age was more than 22 weeks (77.2%), gravidity more than 4 (21.1%), pregnancy interval lower than two years (46.9%) and 75.4% of death was in post-partum. The main cause of mortality was post-partum hemorrhage (19.3%). Conclusion: Based on our findings, some factors including multiparity, pregnancy his-tory more than 4 times, short interval between pregnancies lower than 2 years and ma-ternal age more than 35 years were some risk factors for maternal death. Maternal mortality in the postpartum period was more than pre-delivery period. Bleeding was the main cause of maternal mortality. Therefore monitoring of vital signs in the post-partum period and the proper management of bleeding are very important. It is sug-gested that risk assessment should be done for pregnant women in delivery ward for detecting high risk pregnant women. Suitable management for these women especially for patients with postpartum hemorrhage plays an important role to decrease the ma-ternal mortality.
Volume 74, Issue 12 (3-2017)
Background: Late postpartum hemorrhage (PPH) is defined as uterine bleeding between 24 hours until 12 weeks after delivery. Uterine artery pseudoaneurysm is a rare cause of life-threatening late postpartum hemorrhage (PPH). Emergency uterine artery embolization (UAE) is an appropriate method for control of hemorrhage. The aim of this report was to present a case of uterine artery embolization in late postpartum hemorrhage due to uterine artery pseudoaneurysm.
Case Presentation: A 25-year-old woman with the history of three previous cesarean sections was admitted 35 days after the last cesarean. She had severe vaginal bleeding for 35 days after cesarean section. Because of severe vaginal bleeding 35 days after cesarean section, the patient was at nearly shock state (BP=90.60 mmHg, positive tilt test, tachycardia PR=120/m). In speculum examination, she had severe vaginal bleeding, but there was no lesion in vagina or cervix, also, bimanual examination of the uterus and adnexal area were normal. She reanimated by two liters of normal saline and uterotonic agents (oxytocin and methergine) were administered.
Laboratory data showed severe anemia (Hb=6.5 gr/dl), but coagulation tests were normal. Ultrasonography didn’t show any abnormality. Because of continuation of vaginal bleeding after stabilization of the patient, UAE was planned. During pelvic angiography, a pseudoaneurysm was diagnosed and then it was treated by successful UAE.
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Conclusion: Uterine artery embolization is a conservative management for control of late postpartum hemorrhage. It can be a useful and alternative method for uterine and hypogastric artery ligation and hysterectomy, therefore it has an important role in treatment and fertility preservation for young women. |
Volume 75, Issue 12 (3-2018)
Methods: This is a retrospective study on all patients who underwent non-cardiac surgeries between June 2005 and March 2013 in Ghaem hospital in Mashhad and aspirin continued due to many reasons. Most frequent surgeries included laparoscopic appendectomy and cholecystectomy. Information such as bleeding and its amount both during surgery and post-operative, hematoma after surgery, requiring re-operation due to bleeding and cardiovascular events in hospital were recorded and analyzed. Moreover, all patients were followed within one month after discharge from hospital to check whether any cardiovascular events had been happened. Furthermore, bruising in the skin, and bleeding after discharge were evaluated. Data were analyzed using SPSS Version 16 (SPSS, Chicago, IL, USA).
Results: One hundred seventy patients enrolled in the study and all of them underwent general anesthesia. Of all patients 37.06% were male and 62.94% were female. The mean age was 52.78±5.01 years. Majority of operations included laparoscopic cholecystectomy (41.62%). Also in most of the patients (58.38%) surgery were emergency and discontinuation of aspirin were impossible. 91.37% of patients were taking less than 80 mg aspirin per day. Mean bleeding amount during surgery was 100 ml. 13 patients (6.59%) who undergo laparoscopic cholecystectomy and one patients in appendectomy group had bleeding more than 110 ml due to inadequate artery ligation and they underwent conversion to open surgery and bleeding were controlled successfully. Other eight patients (4.06%) treated conservatively without need to conversion to open surgery. In 7.61% of patients, ecchymosis happened which were healed within one month. No patient underwent reoperation due to post-operative hemorrhage. No vascular event and hematoma had been reported during one month follow up after surgery.
Conclusion: Continuing aspirin in perioperative period of non-cardiac surgeries were without additional risk of bleeding and it also helped to reduce risk of vascular evets post-operatively.
Volume 76, Issue 12 (3-2019)
Case presentation: A 30-year-old G2L1 woman with history of a previous cesarean section and possible diagnosis of missed abortion referred to the Gynecology Clinic of Ghaem Hospital, Mashhad University of Medical Sciences, Iran, in 21 May 2017. Cervical pregnancy was diagnosed during curettage. Severe hemorrhage occurred after curettage and the hemodynamic status of the patient was unstable immediately after curettage. Severe threatening vaginal bleeding was controlled with intrauterine Foley catheter containing 60 cc normal saline and then vaginal packing. The patient was discharged with good general condition.
Conclusion: In cervical pregnancy and unstable hemodynamic status and desire to preserve fertility, intrauterine Foley catheter and vaginal packing after curettage is helpful.
Volume 78, Issue 6 (9-2020)
Methods: This randomized clinical trial was performed in Ommolbanin hospital; an academic hospital that is affiliated to Mashhad University of medical sciences from September 2016 to January 2018. The subjects were 90 pregnant women with a term pregnancies who were candidates for emergent cesarean delivery under spinal anesthesia and were at high risk for postpartum hemorrhage. All participants received 40 IU oxytocin in 1 liter of normal saline after delivery, and then they were randomly assigned to the intervention group who received 400 μg sublingual misoprostol in combination with oxytocin infusion, and the control group who received only oxytocin infusion without adding misoprostol.
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Results: Sublingual misoprostol in combination with oxytocin infusion during cesarean section led to a significant decrease in postoperative blood loss for six hours after the surgery (P<0.001). The decline in the hemoglobin and hematocrit levels and the amount of intraoperative hemorrhage were the same in both groups. Less additional uterotonic agents were needed in the misoprostol group. The frequency of fever and other side effects were similar in the two groups.
Conclusion: It seems that adding sublingual misoprostol to oxytocin infusion among high-risk women for postpartum hemorrhage is more effective for reducing blood loss during and after cesarean section. |
Volume 78, Issue 11 (2-2021)
Case Report: The patient was a 24-year-old woman who had referred to the outpatient clinic of Ghaem Hospital in September 2016 due to prolonged post coital bleeding after intercourse. At the time of the pelvic examination, posterior lip of cervix was very vascular and there was black color that had extend to the vagina. The patient underwent colposcopy. Following colposcopy, due to severe cervical bleeding, the vagina packed. The patient's bleeding was controlled with the pack after 24 hours. Cervical pathology revealed a cavernous hemangioma.
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Conclusion: Cervical cavernous hemangioma is extremely rare. This should be considered in the differential diagnosis of patients with abnormal vaginal bleeding, especially those of childbearing age, and no clinical or radiologic findings such as leiomyoma, adenomyosis, or dysfunctional uterine bleeding. Pelvic examination is the first step in the management of the patient with vaginal bleeding. Increased awareness of this unusual cervical lesion can lead to early diagnosis and conservative treatment approaches. In most cases, hysterectomy is performed, but the patient with mild symptoms can be treated with conservative management. Increased awareness of this unusual cervical lesion can lead to early diagnosis and conservative treatment approaches.
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Volume 80, Issue 9 (12-2022)
Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al-Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings.
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Results: Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070).
Conclusion: The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding. |
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