Tehran University Medical Journal

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Sixty pregnant women with the gestational age of 6-14 weeks who met the following criteria were selected: 1) Presence of nausea and vomiting. 2) Absence of other medical conditions that cause nausea and vomiting. 3) Negative history of medical treatment for at last three days prior to admission. 4) Negative for threatened abortion, molar and twin pregnancy. Cases were randomly divided into two groups. Mean age of the cases was 25.16 y (range: 16-37 y) and not significantly different in the two groups. The two groups were also similar in gestational age, severity of nausea and vomiting, number of previous pregnancies and abortions, profession, working inside or outside the house, family income and education of patients and their spouses. In one group, Pe6 point of acupuncture was stimulated by TENS (once every 2 hours, 10 minutes each time, from the time of awakening). The other group received placebo. Both groups were hospitalized for 48 hours, and were evaluated for severity of nausea and vomiting, apetite, frequency of vomiting and VAS at their worst day, 24 hours prior to admission and 24 and 48 hours after admission. The two groups were similar in frequency of vomiting, VAS, appetite, and severity of nausea 24 hours prior to admission, and the worst degree of nausea and vomiting. However, a significant difference was observed in the severity of nausea and vomiting 24 and 48 hours after the adminission between TENS and placebo (P=0.000). In the group who received TENS, 24 cases (86.7%) reported improvement (compared to 23.3% in the control group). Of all the cases, 81.6% had received prior medication, only 18.3% of the latter reported improvement with medication. Level of VAS in the groups with severe and mild to moderate nausea and vomiting was not significantly different in the first and second days of admission. Fifteen percent of the cases reported a transient cutaneous rash. Five cases were hospitalized more than once. Of the cases who reported improvement with TENS, 5% had improved after two stimulations, and 47% reported a relapse of symptoms in less than 24 hours after cessation of TENS. In one of the cases who were re-admitted, TENS did not result in alleviation of nausea and vomiting, and 56.6% of all the cases suggested to use TENS at home, 45% were attracted to TENS by commercial advertisements. Disscusion: Stimulation of Pe6 (Neiguan) point alleviates the nausea and vomiting of pregnancy.

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Postoperative nausea and vomiting is a common complication that all anesthesiologist are familiar with the problems of its consequences. Although continued research on the recognition of factors affecting the incidence of PONV is being done but they are not sufficient and the need for research along with advances in anesthesiology and newer drugs are considered. In this prospective cohort study 400 children of 3 to 12 age who has been operated for general surgery (other than eye, thorax and upper abdomen) and orthopedic surgery in the Imam Khomeini and Children Medical Center Hospital has been evaluated. Of these, 200 children who had smoking parent and according to definition were passive smokers and the other 200 children had no smoking parents. Both the groups were matched for sex, age, and type of operation. With the analysis of data we noted that the incidence of PONV in both groups was 19.5 and there was no significant difference between the two groups. (Passive smoker 19 percent and non-passive smoker 20 percent). We also noted a relation between the duration and the incidence of PONV. So operation with more than 2 hours had higher incidence of PONV. There was also positive relation between PONV and controlled ventilation. However, there was no significant difference as the sex and type of operation was concerned. In conclusion, children of smoker parents suffer more PONV than children of non-smoker parents if operation takes longer than two hours or the patient is mechanically ventilated during operation.

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Background: Hyperemesis gravidarum (HG) starts between four and seven weeks after the first day of the last period, and ends at twenty weeks of pregnancy. The etiology of HG, is unknown. Recent studies worldwide show the Helicobacter pylori (H. pylori) infection as a possible cause of the severe nausea and vomiting in pregnancy, recent studies showed H. pylori to have a role in occurrence of it during pregnancy. The current study assessed the immunoglobulin G (IgG) and immunoglobulin M (IgM) titer to H. pylori in pregnant women with HG. Methods: This is a case-control study of the pregnant patients of a gynecologist's office in the Marvdasht city from April to September 2013. One hundred and twenty three patients were randomly chosen based on their conditions and were divided into two groups (case n1= sixty three and control n0= sixty). The IgG and IgM titers against H. pylori were measured by ELISA method. Data analysis was performed using Chi-square test, Mann-Whitney U-test, and T-test in SPSS software, version 20 (SPSS, Inc., Chicago, IL, USA). The significant level of the test was considered (P= 0.05). Results: Totally, 123 pregnant women were evaluated 63 women with hypermesis gravidarum and 60 without HG. Forty nine women out of 63 in HG group and 48 women in the control group were IgG positive for H. pylori. Also, mean serum level of IgG was 51.6 in the HG group (P= 0.685). Twelve women out of 63 in HG group and 20 women in the control group were IgM positive for HP. Also, mean serum level of IgM was 27.7 in the HG group (P= 0.675) Except for the mother's blood type, there were no other statistically significant differences found between the two types of antibodies against H. pylori. Conclusion: There is no relationship between helicobacter pylori and hyperemesis gravidarum in pregnant woman. Considering the high prevalence of H. pylori infection in our country, there is a need for studies with more samples and more diagnostic methods.

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