ABSTRACT
<p><b>BACKGROUND</b>Rheum ribes L. is a plant native to China, Iran, Turkey, India, and a few other countries. Antidiarrheal activity is considered to be one of its important properties according to various systems of traditional medicine. An increasing rate of bacterial resistance to antibiotics has led to treatment failure in some cases of shigellosis in children, and underlines a need for safe, efficient and valid options.</p><p><b>OBJECTIVE</b>The purpose of this study is to evaluate the efficacy of R. ribes syrup as a complementary medicine for treatment of shigellosis in children.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>This randomized, double-blind, placebo-controlled trial started with a group of 150 children aged between 12-72 months with suspected Shigella dysentery. R. ribes syrup or placebo syrup was administered to the intervention and control groups, respectively for 5 days. In addition, the standard antibiotic treatment (ceftriaxone for the first 3 days and cefixime syrup for 2 further days) was administered to both groups.</p><p><b>MAIN OUTCOME MEASURES</b>Body temperature, abdominal pain, need for antipyretics, defecation frequency, stool volume and consistency and microscopic stool examination were recorded as outcome measures. Any observed adverse effects were also recorded.</p><p><b>RESULTS</b>Mean duration of fever and diarrhea in the R. ribes group was significantly lower than that in the placebo group (P = 0.016 and 0.001, respectively). In addition, patients in the R. ribes group showed shorter duration of need for antipyretics and shorter duration of abdominal pain (P = 0.012 and 0.001, respectively). However, there were no significant differences between the two groups regarding the microscopic stool analyses. Furthermore, no adverse effect was reported.</p><p><b>CONCLUSION</b>R. ribes syrup can be recommended as a complementary treatment for children with Shigella dysentery.</p><p><b>TRIAL REGISTRATION</b>Iranian Registry of Clinical Trial: IRCT2014070518356N1.</p>
ABSTRACT
Asphyxia is a medical condition in which placental or pulmonary gas exchange is impaired or they cease all together, typically producing a combination of progressive hypoxemia and hypercapnea. In addition to regional differences in its etiology; it is important to know its risk factors. This is a case-control study, all neonates born from May 2002 to September 2005 in Vali-e-Asr Hospital were studied. 9488 newborns were born of which 6091 of the live patients were hospitalized in NICU. 546 newborns were studied as case and control group. 260 neonates [48%] were female and 286 neonates [52%] were male. Among the neonates who were admitted, 182 of them were diagnosed with asphyxia and twice of them [364 newborns] were selected as a control group. The variables consist of; gestational age, type of delivery, birth weight, prenatal care, pregnancy and peripartum complications and neonatal disorders. Our studies showed that 35 [19.2%] patients had mild asphyxia, 107 [58.8%] had moderate asphyxia and 40 [22%] were diagnosed as severe asphyxia. Mean maternal age was 34.23 +/- 4.29yr; [range: 23-38 yr]; and mean of parity was 2 +/- 1.2; [range: 1-8]. Risk factors in our study included emergent Caesarian Section, preterm labor [<37w], low birth weight [<2500g], 5 minute Apgar [less than 6], need for resuscitation, nuchal cord, impaired Biophysical Profile, neonatal anemia, and maternal infertility. All risk factors listed above play a role in asphyxia. The majority of these factors are avoidable by means of good perinatal care