Rahimi Sharbaf F, Mirzaei F, Kaveh M,
Volume 66, Issue 6 (9-2008)
Abstract
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Background: The
prevalence of Rh alloimmunization has decreased following the use of anti-D
immunoglobulin. With serial amniocentesis, Doppler sonography of the middle
cerebral artery and treatment of anemia with intrauterine blood transfusion, perinatal
mortality has declined. However, Rh alloimmunization in twin pregnancies poses
a diagnostic and therapeutic challenge.
Case report: We are reporting,
for the first time in Iran, the successful treatment of severe Rh
alloimmunization in a dichorionic- diamnionic twin pregnancy leading to the
live births of both neonates. Before treatment, the fetal hemoglobin levels
were 3.1g/dL and 3.9g/dL, with ascites in both fetuses. The fetuses were
treated with several IUTs.
Results: After treatment, the neonates were
delivered, weighing 2200 and 2300g, with good Apgar scores, at a gestational
age of 34 weeks.
Conclusion: 10%
of population in Iran is Rh-negative, although Prophylaxis for Rh
alloimmunization is universal, as other part of the world it cannot irrigated.
For the best management of these cases, we need a well-equipped referral
center.
Gholamreza Rezamand , Mojdeh Ghabaee , Naser Ebrahimi Daryani , Hoda Ghadami ,
Volume 72, Issue 1 (4-2014)
Abstract
Background: Nonalcoholic Fatty Liver Disease (NAFLD) is one of the most wide-spread human diseases that can impair liver function and sometimes progresses to cir-rhosis. Recently NAFLD has been identified as an independent risk factor for cardio-vascular disease. The aim of this study was to investigate the correlation of fatty liver disease and its sonographic severity on the resistance of the intracranial arteries.
Methods: This study was a cross-sectional study of 55 patients referred from Gastroen-trology clinic with diagnosis of NAFLD to Sonodoppler department of Iranian Center of Neurological Research. Pulsaltile index as a Hemodynamic parameter of Middle Cerebral (MCA) and basilar Arteries of NAFLD Patients was measured by Trans Cra-nial Doppler (TCD) sonography and the measurements were compared with normal values. Also the association of these indices with serum liver enzymes and sonographic grading of liver involvement was assessed. The analysis was done by SPSS 16. Fre-quency distribution, mean and standard deviation were used in descriptive analysis and statistical test 2 to compare qualitative variables.
Results: Pulsatile Index (PI) were normal (MCA, P= 0.166, Basilar, P= 0.053) and there was no significant difference with relation to severity of fatty liver based on so-nography findings (P= 0.789), but serum liver enzyme levels were inversely correlated with basilar artery PI (P= 0.014).
Conclusion: Considering the increase of cerebral arteries PI in advanced liver disease, absence of increase in vascular PI of patients in the present study could be attributed to the short duration of disease from diagnosis to perform TCD, lack of advanced liver involvement (absence of liver dysfunction) and the response effect to treatment before the TCD. Therefore, to assess vascular changes over time, repeating the TCD with assess other parameters such as Fibroscan and K18 factor that has more compatibility of liver function, could help to understand the pathophysiology of liver diseases and its effect on vascular resistance.
