ABSTRACT
BACKGROUND: The oral suspension form of ibuprofen has been shown to have the same efficacy and safety as indomethacin in the treatment of symptomatic PDA, however its role is still questionable in the prophylaxis of symptomatic PDA. OBJECTIVES: 1. To assess the efficacy and safety of the drug in the prevention of symptomatic PDA in premature infants. 2. To study its pharmacokinetics-pharmacodynamics relationship. MATERIAL AND METHOD: A randomized, single-blinded, controlled study was performed on premature neonates with a gestational age between 28-32 weeks, birthweight < or = 1500 grams at the neonatal unit, Queen Sirikit National Institute of Child Health from July 2003 to April 2004. Three doses of ibuprofen suspension or placebo were given 24 hours apart. Clinical evaluation was performed daily until the 28th day of life. Echocardiogram was performed prior to the drug administration, on the 3rd and 7th day of life. RESULTS: There were 22 and 20 cases in the ibuprofen and control group respectively. The epidemiologic data between the groups before enrollment showed no significant differences. Prevalence of symptomatic PDA was lower in the ibuprofen than in the control group without any significant side effects (0/22 vs 5/20, p = 0.015 on day 3 and 0/22 vs 6/20, p = 0.006 on day 7). Comparing with the pharmacokinetic study in older children and adult, the present study revealed nearly the same Cmax but longer Tmax and T1/2 in premature neonates. CONCLUSION: Oral ibuprofen suspension could reduce the prevalence of symptomatic PDA without any significant side effects.
Subject(s)
Cyclooxygenase Inhibitors/therapeutic use , Ductus Arteriosus, Patent/drug therapy , Echocardiography , Female , Humans , Ibuprofen/administration & dosage , Infant , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature , Male , Single-Blind MethodABSTRACT
Proteus syndrome is a rare genetic disorder, characterized by partial gigantism of the hands and/or feet, asymmetry of the limbs, plantar hyperplasia, multiple hamartomatous subcutaneous tumors, hyperostoses, and long bone overgrowth. A one day old Thai male infant is reported with macrosomia, hemihypertrophy of the left side of the face and left leg, large feet, macrodactyly of toes, plantar hyperplasia, large subcutaneous mass with a violet-red surface over the left side of the chest wall and a large port-wine stain involving the lateral aspect of the right chest wall. The clinical findings, diagnostic criteria, differential diagnosis, and management of the Proteus syndrome are reviewed.
Subject(s)
Diagnosis, Differential , Humans , Infant, Newborn , Male , Proteus Syndrome/diagnosisABSTRACT
A pilot study was conducted in order to identify the cases and determine the incidence of congenital hypothyroidism, phenylketonuria (PKU) and glucose-6 phosphate dehydrogenase (G6PD) deficiency in the newborn infants born at Rajavithi Hospital. During May 1995 - July 1998, 32,407 out of 49,092 (66%) infants were screened for congenital hypothyroidism by measuring thyroid stimulating hormone (TSH) by radioimmunometric assay method. Seven cases of congenital hypothyroidism were identified (incidence of 1 : 4,629 live births). The recall rate was 0.66%. The screening for PKU was done on 17,421 out of 29,443 (59.14%) infants by measuring phenylalanine level by Guthrie method during June 1996 to July 1998. There was no PKU found. From January 1996 to July 1998. 24,714 newborn infants were screened for G6PD deficiency by fluorescent screening technique. The total incidence of 5.13% was found. The incidence in males and females was 9.13% and 1.66% respectively. This study confirms the benefit of the screening program in early detection and treatment of the disorders.
Subject(s)
Congenital Hypothyroidism , Glucosephosphate Dehydrogenase Deficiency/diagnosis , Humans , Hypothyroidism/diagnosis , Incidence , Infant, Newborn , Neonatal Screening , Phenylketonurias/diagnosis , Thailand/epidemiologyABSTRACT
The study on perinatal mortality, neonatal mortality and weight specific death rate of neonatal infants born at Rajavithi Hospital in 1996 was carried out and compared with the rates of 1976 and 1986. It was found that in 1996 the total number of births was 15613 with 106 stillbirths. The perinatal mortality rate was 9.09 per 1000 births and neonatal mortality rate was 2.90 per 1000 live births. Reduction in perinatal and neonatal mortality rates from 1976 and 1986 to 1996 was observed. The neonatal mortality rate was close to the rate of developed countries but not the perinatal mortality rate. The weight specific neonatal mortality in 1996 was reduced from 1986 and 1976 in all weight groups. It is concluded that the neonatal mortality rate in 1996 was improved because of effective neonatal care. To reduce the low birth weight infant rate by means of an effective family planning program and antenatal care may improve the perinatal mortality rate at Rajavithi Hospital.
Subject(s)
Age Distribution , Birth Weight , Fetal Death/epidemiology , Health Care Surveys , Hospital Mortality/trends , Humans , Infant Mortality/trends , Infant, Low Birth Weight , Infant, Newborn , Retrospective Studies , Thailand/epidemiologyABSTRACT
Harlequin fetus is a rare and the most severe form of congenital ichthyosis. Most of the infants die within a few weeks after birth due to sepsis and respiratory difficulties. The case of a female harlequin baby is reported. The baby survived because of good neonatal intensive care, topical emollients and oral etretinate. Now she is over three years old and the skin developed into congenital non-bullous ichthyosiform erythroderma. Unfortunately she had delayed growth and development. This is the first case report of a harlequin fetus in Thailand that had prolonged survival.