Comparision of the efficacy of nebulized l-epinephrine, salbutamol and normal saline in acute bronchiolitis: a randomized clinical trial

Acute bronchiolitis is the most common form of lower respiratory tract infection in infancy. There are numerous contradictory reports regarding the efficacy of nebulized bronchodilators in the management of infants with acute bronchiolitis. This study was designed to compare the efficacy of nebulized epinephrine with salbutamol for treatment of the disease.In a randomized clinical trial, 72 infants with moderately severe bronchiolitis were enrolled in three equal groups. Three doses of epinephrine, salbutamol, and normal saline as a placebo nebulized with oxygen were given at 20 minute intervals. Oxygen saturation, respiratory rate and distress were recorded before intervention and 10 minutes after each dose of the drugs.At the end of the study, pre- and post-treatment mean oxygen saturation values, clinical scores and respiratory rates showed significant differences between the epinephrine and salbutamol groups in comparison with the placebo group. The results were more significant in the epinephrine group than other groups. After the treatment course 66%, 50%, and 25% of patients in epinephrine, salbutamol, and placebo groups respectively showed significant improvement at a degree that they could be sent home. No serious side effects were observed.Both nebulized epinephrine and salbutamol improved oxygenation and decreased respiratory distress better than normal saline. L-epinephrint was more effective in relieving respiratory distress and improving oxygen saturation as well as the need for hospitalization than nebulized salbutamol

review of circumcision complications in newborns and infants by the plastibell device

This study was earned out to review the main complications of newborn and early infancy circumcision by the plastibell device in a nursery and an outpatient clinic. 5725 infants under 12 months old [including 871 newborns] were circumcised by the plastibell device during eleven years from 1991. The operations were done in a private hospital nursery and in an outpatient clinic. Serious and non-serious complications of the plastibell technique were evaluated retrospectively. Results revealed that infection and hemorrhage were the most serious complications of circumcision by the plastibell device and the incidence was 0.47% [27 cases] in this study. Non-serious complications i.e. meatitis, penile adhesions, incomplete separation of the ring and a tight plastibell device were observed in 89 cases [1.55%]. The overall complication rate was 2% [116 cases]. In conclusion, circumcision with the plastibell device in the newborn and early infancy period can be done in nurseries and outpatient clinics and the procedure is simple, safe and complications are low