Efficacy of Topical Coriandrum sativum Extract on Treatment of Infants with Diaper Dermatitis: A Single Blinded Non- Randomised Controlled Trial

Diaper dermatitis is a common disorder. Coriandrum sativum is a herbal remedy with anti-inflammatory, analgesic, anti-microbial and anti-oxidant activities effects. In this nonrandomised clinical trial which was performed on 58 infants with diaper dermatitis referred to Faghihi Hospital, Shiraz University of Medical Sciences, the efficacy and safety of topical Coriandrum extract cream is compared with hydrocortisone ointment. Coriandrum sativum extract cream was administered for 37 (intervention group) and hydrocortisone 1% ointment for 21 (control group) patients. Patients were examined on days 3 and 10. Chi-square test was applied for statistical analysis. The results demonstrated a statistically significant difference in the cure rate (20 (54.1%) for the intervention group versus 19 (90.5%) for the control group) (P-value = 0.005) and side effects (10 (27%) for the intervention group versus 0 (0%) for control group) (P-value = 0.009) both in favor of hydrocortisone. This trial failed to confirm the efficacy of Coriandrum sativum in the treatment of diaper dermatitis; however, it seems that if soothing compounds are used in combination with Coriandrum sativum to reduce the mild irritation, Coriandrum extract can be an alternative treatment for diaper dermatitis.

Assessment of breastfeeding education by face to face and small-group education methods in mothers' self-efficacy in Kazeroun health centers in 2015

Background: Education is a process beginning with informing, followed by attitude-making and finally leading to appropriate behavior and performance in trainees. Breastfeeding self-efficacy, as a term, is originated from the social cognitive theory structures of Bandura. This theory refers to one's beliefs and confidence in her/his ability to perform health behaviors like exclusive and successful breastfeeding

Methods: In this study, 270 pregnant women with gestational age over 30 weeks were selected among those referring to health centers by cluster sampling method. The subjects were randomly divided into 3 groups. One group was considered as the control group and the two other groups were educated through either face to face or small-group methods. Data were collected using a demographic questionnaire, performance assessment check list, and breastfeeding self-efficacy questionnaire. The collected data were analyzed using appropriate statistical tests in SPSS

Results: Data analysis on breastfeeding self-efficacy showed that there was no significant difference between 3 groups before training. The mean scores of women attending face to face and small-group education were 2.89 and 2.88, which increased to 4.73 and 4.18, respectively. There was a significant difference between the intervention groups after education [P < 0.001]. Self-efficacy mean scores after delivery showed that face to face education is more efficient. The results showed that there was a significant association between self-efficacy and performance in mothers [P < 0.001]

Conclusions: Face to face education method has positive effects on infant feeding pattern, mother performance, breastfeeding satisfaction and beliefs as well as self-efficacy

Effect of head covering on phototherapy-induced hypocalcaemia in icterus newborns; a randomized controlled trial

Although phototherapy has been used for more than 60 years it has some complications. The light waves produced from phototherapy reduce melatonin concentration in newborns with subsequent hypocalcemia. We aimed to assess the effect of head covering on calcium and magnesium levels in full term newborns during phototherapy. In this randomized controlled trial, 72 full-term icterus newborns weighing >2500 gr with indirect hyperbillirubinemia who received phototherapy at the phototherapy ward of Moslemin Hospital, Shiraz, southwest Iran, during March to September 2010 were recruited and divided randomly into two groups. The neonates in the case group received phototherapy while wearing a hat, while phototherapy was performed without hats for the control group. The newborns were in perfect health during the tests. The calcium and magnesium levels of each newborn were tested at baseline, and 24 hours after phototherapy and 48 after treatment. The variables were compared using Student's t, Chi-square and repeat measurement tests. 14 [38.8%] newborns in the control group and 5 [13.8%] in the case group had hypocalcemia after phototherapy. A significant difference was found between the incidence of hypocalcemia in these two groups [P=0.03]. However, magnesium levels did not change significantly [P>0.05]. Phototherapy caused hypocalcemia but it had no effect on magnesium levels. This can be prevented by covering the head during phototherapy with no need for prophylactic administration of calcium

effects of low and high dose oral calcium and phosphor supplementation on nephrocalcinosis diagnosed by sonography in premature and low birth weight neonates

Nephrocalcinosis is defined as calcium deposition in the renal interstitium. One of the major causes of neonatal nephrocalcinosis is the use of calcium and phosphor supplements for premature neonates. This study aims at assessing the effects of calcium and phosphor supplementation in neonatal nephrocalcinosis by renal ultrasonography. In this randomized controlled trial, 37 premature neonates with birth weights <1500 g or a gestational age of <34 weeks were considered. Two different doses of calcium 75 vs. 230 mg/kg/day and phosphor 50 vs. 110 mg/kg/day were prescribed and laboratory and sonographic data were then documented and evaluated. The incidence of nephrocalcinosis was 47.8% in group 1 and 28.6% in group 2. There was a significant association between NC and positive family history of renal stones, shorter duration of TPN and NICU stay. The amount of calcium dosage, gestational age, birth weight, sex, use of surfactants, and mechanical ventilation did not have any significant association with NC. In this study, the neonates with NC were mostly the white flake type [8 cases] and the majority of the lesions were 1-2 mm. All the lesions were located in the pyramid and papilla areas, acoustic shadows were not prevalent and stones were not observed in any of the patients

Olfactory stimulation by vanillin prevents apnea in premature newborn infants

Apnea is one of the most common problems in premature newborns. The present study aimed to determine the effect of olfactory stimulation by vanillin on prevention of apnea in premature newborns. In this randomized controlled trial, 36 premature newborns with the postnatal age of 2 days and weight under 2500 grams referred to the hospitals affiliated to Shiraz University of Medical Sciences, were selected through simple random sampling and allocated into control and experimental groups. The experimental group received olfactory stimulation by saturated vanillin solution, while the control group received no interventions. The newborns of both groups were continuously monitored for presence/absence of apnea and number of episodes of apnea as well as arterial blood oxygen saturation and heart rate for 5 days. The data were analyzed by independent Student t-test and repeat measure ANCOVA. The presence of apnea revealed to be significantly different between the two groups in the first, second, and fourth day of the study [P<0.05]. The number of episodes of apnea during five days was also significantly different between the study groups [t=8.32, P<0.05]. Using olfactory stimulation by vanillin caused a 3.1-fold decrease in apnea and the effect size was 0.72. Moreover, the two groups were significantly different regarding the arterial blood oxygen and heart rate during the study period [P<0.05]. This study indicated the beneficial effect of saturated vanillin solution on apnea; therefore, it may be used for prevention and treatment of apnea in premature infants. Further studies are needed to improve evidence-based practice in this regard

Prevalence and assessment of the appropriate laboratory indices for screening of hemoglobinopathyies in southern Iranian newborns

Newborn screening is a systematic application of tests for early detection, diagnosis, and treatment of certain genetic or metabolic disorders that may lead to mortality and morbidity if untreated. As stated by WHO, each year over 330,000 babies are born worldwide with a severe form of hemoglobinopathy. Newborn screening for hemoglobinopathies could become one of the most important methods of decreasing mortality and morbidity and mitigating rising healthcare costs. The diversity and heterogeneous distribution of hemoglobin disorders make it necessary to develop strategies at the country level. Overall, 499 healthy full term Iranian neonates were screened for hemoglobinopathies who were originated from Fars province in southern part of Iran. The screening was performed on cord blood samples collected on EDTA. Following sample collection, complete blood cell count cell indices, osmotic fragility test and hemoglobin electrophoresis were performed. Total prevalence of significant hematologic abnormal findings was 12.4% in this study, the most prevalent one was Alpha thalassemia [6.4%] followed by hereditary spherocytosis [4.8%], and sickle cell anemia [1.2%]. The total analysis for detection of Alpha thalassemia by mean corpuscular volume [MCV]

Intraventricular hemorrhage in premature infants and its association with pneumothorax

Intraventricular hemorrhage [IVH] is one of the major causes of the cerebral palsy and mental retardation. Prevention and early management of these neurologic developmental problems will require determining the perinatal risk factors associated with this clinical entity. Pneumothorax increase the risk of IVH, and cause of pneumothorax has an important effect in severity of IVH. This is a prospective cross sectional study in 2010. This study includes 150 preterm neonates. Cranial ultrasound was performed in all neonates in age 3, 7, 30, 60, just after pneumothorax and every 2 week until chest tube discontinuation. Then prevalence of IVH and pneumothorax was calculated in preterm infant and severity of IVH was investigated before and after development of pneumothorax, and this comparison was divided by different causes of pneumothorax with SPSS version 11.5. Prevalence of IVH and pneumothorax in preterm infants were 30% and 10% respectively. Pneumothorax was not a risk factor of IVH [P>0.05], but prevalence of pneumothorax caused by RDS was a risk factor of development of IVH [P=0.01]. Also pneumothorax in patients with birth weight less than 1000 g and gestational age less than 28 week was a risk factor of IVH pneumothorax [P=0.008, P=0.01 respectively]. Our study discusses the differences in previous studies about association of pneumothorax and IVH. Also we suggest the hypothesis that lack of cerebral autoregulation in neonates with gestational age less than 28 week can cause IVH development after hypotension induces by pneumothorax.

Incidence and risk factors of retinopathy of prematurity among preterm infants in Shiraz/Iran

Retinopathy of prematurity [ROP] is a serious complication in preterm infants. To avoid this complication the risk factors leading to the disabling This is a descriptive study. All preterm infants with birth weight under 1500 g and preterm infants with birth weight between 1500-2000 g who had unstable clinical condition and admitted in neonatal intensive care unit from February 2006-March 2007 at tertiary hospitals of Shiraz University, Iran, were introduced into the study. All infants are examined by indirect ophthalmoscopy. Risk factors analysis was performed in two groups. Group 1 consisted of infants with no ROP or ROP that regressed spontaneously, and Group 2 of those with severe ROP that needed laser therapy. Of 199 preterms, ROP that needed laser therapy was detected in 19 [9.5%]; 65 [32.6%] had ROP that regressed spontaneously and 115[57.8%] had no ROP. Risk factor analysis showed significant P-values for gestational age, birth weight, Apgar score of first minute, mean duration of mechanical ventilation, mean duration of oxygen therapy, eclampsia-preeclampsia, hypoxia, hyperoxia, Pa CO2 >60 mmHg, pH>7.45 and frequent blood transfusions. Using stepwise logistic forward regression showed the three factors mean duration of oxygen therapy, birth weight and mechanical ventilation to be independently significant variables for increasing the rate of ROP. The main risk factors for development of threshold ROP are low birth weight, mechanical ventilation and duration of oxygen therapy. So it seems that prevention of premature delivery and judicious oxygen therapy is the main step for prophylaxis of ROP