Usefulness of oral Indomethacin for Patent Ductus Arteriosus in Full-Term Neonates.

Background   : Indomethacin is an effective treatment to close patent ductus arteriosus(PDA) in preterm neonates, and has been used for many years. Management of patent ductus arteriosus (PDA) in full-term neonates remain controversial. Recently, usefulness of indomethacin for patent ductus arteriosus in full-term neonates was reports. Objective  :    To evaluated the effectiveness of oral indomethacin for patent ductus arteriosus (PDA) in full-term neonates.Setting :    Surin hospitalStudy design  :   Descriptive retrospective studyMethod  :Review of pediatric patient data admitted during 1st January to 31th December 2009.Result   :The patient were 43 full-term neonates with PDA . All neonates were \> 2  days-old and has a gestation age  \> 37 weeks. Patient with ductus-dependent congenital heart disease, severe pulmonary hypertension(gradient \> 40 mmHg), respiratory failure or sepsis were excluded. The echocardiography evaluation was done confirm the diagnosis. The patient received indomethacin suspension (o.2mg/kg/dose. 3 dose12 hours apart). Of the 43 neonates, 33 (76.7%) showed complete closure, and 10 (233%) showed no closure. Statistical analysis revealed no difference between the two groups regarding GA, Birth weight, Apgar score at 1 minute, minimum diameter of the DA before treatment, the average age at the initiation of treatment. There was no significant difference in blood urea nitrogen, creatinine levels or thrombocyte counts in either group before and after treatment with indomethacin (p \> 0.05). No serious adverse reaction was observed in all neonates. Conclusion   : This study showed the efficacy medical treatment of oral indomethacin for earlier closure of PDA in full-term neonates. Keywords  : Patent ductus arteriosus, oral indomethacin, Gestational age. Echocardiography, Full-term neonates

Pediatric cardiac beriberi: 3 different presentations.

The authors report 3 cases of pediatric cardiac beriberi at Queen Sirikit National Institute of Child Health during the last 10-year-period. The first two cases presented classically while the third case came with an unusual presentation. Cardiac beriberi is an old disease in modern Bangkok which can present in as several different clinical patterns. The diagnosis needs a high index of suspicion. Echocardiographic findings of right heart dysfunction and dramatic response to intravenous thiamine are diagnostic.