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Coagulopathy is known as one of the most challenging effects of COVID-19, and the effects of acute airway diseases resulting from the coronavirus on pregnant mothers and their fetuses can be dangerous. Two women who were pregnant suffering from coagulopathy (one of them with disseminated intravascular coagulation (DIC) and the other one with hypercoagulation) and COVID-19 infection are reported in this study. During hospitalization due to severe vaginal bleeding and placental detachment, cesarean section was performed on the first case and because of acute severe DIC, she received a massive transfusion. The second patient presented with epigastric pain and tachycardia and positive D-dimer, which was eventually treated with a diagnosis of bilateral lower extremities DVT. COVID-19 might have a variety of effects on pregnancy outcome, from vascular and placental involvement to respiratory involvement; there is an association between the coronavirus and hypercoagulopathy state and coagulopathy like DIC.

Introduction: Clindamycin is the preferred antimicrobial agent in the treatment of septic abortions. However, the administration of this medication may be associated with side effects. We describe the uncommon case of a patient who developed chest pain and sinus bradycardia following the administration of clindamycin. Case Presentation: A 19-year-old primigravid woman presented herself to Shahid Motaharri Hospital (Urmia, Iran) with high grade fever and severe pain in the hypogastrium. A physical examination established pyrexia, tachycardia. Vaginal examination revealed active bleeding accompanied by foul-smelling vaginal discharge. Ultrasonography revealed the presence of retained products of conception. Our main diagnosis was septic abortion. The patient was treated by volume replacement and administrating intravenous clindamycin and gentamicin. Following the intravenous infusion of clindamycin, an episode of chest pain and bradycardia occurred. Conclusions: Based on the clinical course of the current case, we conclude that the episode of bradycardia was induced by clindamycin administration. Therefore we advise physicians to exercise caution when administrating clindamycin due to its possible potential to induce bradycardia.

Background: endometrial cancer is the most frequent genital cancer in women  in the developing nation. The purpose of this study was to investigate on  the demographic and clinical aspects of endometrial cancer, or to explain its epidemiology in patients admitted to Urmia's Kosar Hospital. Methods: From 2006 to 2016, the medical records of 179 hospitalized women with an initial diagnosis of endometrial cancer were analyzed in this cross-sectional research. The patients’ clinical and demographic information, including age, menstrual age, first visit reason, number of deliveries, menstrual pattern, history of previous disease in patients and their relatives, disease stage, clinical parameters (including WBC, Hb, and MCV), pathology type, and the presence or absence of metastasis was extracted from their medical records and analyzed. Results: The patients in our research had a mean age of more than 50 years. Nearly 80% of the patients were menopausal, and approximately 90% of the patients presented with bleeding complaints. Patients with endometrioid type adenocarcinoma had the highest frequency of pathology. Conclusion: Our findings show a high proportion of bleeding complaints among the patients evaluated, which might reflect the importance of this finding and help to guide the disease’s diagnosis and therapy. However, further research is needed to establish the epidemiology of this condition in the country.

Background: Choriocarcinoma is the most aggressive kind of gestational trophoblastic neoplasia (GTN). Although the risk of brain metastasis in GTN is rare, in patients with choriocarcinoma, the incidence of brain metastasis is 11%. In this paper, we reported a case of choriocarcinoma with brain metastasis, which was successfully treated with an etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMACO) regimen. Case presentation: A 34-year-old woman was presented with vaginal bleeding, dyspnea, and moderate abdominal pain. She had a menstrual delay of about two weeks. She had a primary β-human chorionic gonadotropin (β-hCG) of 132600 mIU/mL. On lung computed tomography (CT) scan images, a metastatic lesion with a size of 68×50 mm was observed in the lower lobe of the left lung. The patient underwent dilation and curettage (D&C) that revealed choriocarcinoma. Brain magnetic resonance imaging (MRI) also showed a small metastatic mass with a size of 7 mm at the right occipital lobe. The patient was started on chemotherapy with an EMACO regimen. The patient's β-hCG decreased continuously, and it was negative after the fourth cycle and six sessions of radiotherapy. It also remained negative six months after chemotherapy. The final examinations of the patient had no abnormal findings. Conclusion: Brain metastasis may be relatively asymptomatic in patients with choriocarcinoma, and it should be considered by physicians, even when there are no neurological symptoms. Also, the EMACO regimen seems to be an appropriate regimen for the treatment of metastatic choriocarcinoma.

Background & Aims: Endotracheal intubation is commonly performed in the intensive care unit. Many international guidelines for