Does full enteral feed from day one of life influence weight gain in hemodynamically stable VLBW babies weighing between 1000-1500 grams as against standard feeding? an open label randomized controlled trial

Background: Preterm neonates post-natal growth should be similar to the intrauterine growth of the fetus of the same gestational age. This study aims to' evaluate the effects of full enteral feed (60 ml/kg/day of human milk on day one, 20ml/kg/day during feeding advancement) started from day one of life (intervention) in enhancing'' the regain of birth weight compared to that of standard feed (both human milk feeds and intravenous fluid) in a group.Methods: Babies were started on enteral feeds with human milk at the rate of 60ml/kg/day from day one and progressed by increments of 20 ml/kg/day up to maximum enteral feed of 180 ml/kg/day. The primary outcomes like Number of days taken to regain the birth weight, Duration of hospital stay, Incidence of Necrotising Enterocolitis (NEC), Incidence of sepsis, need for intravenous fluid therapy was assessed and statically analysed.Results: Full enteral feeding group infants had lesser days of intravenous fluids. Full enteral feeding group regained birth weight at a mean age of 17.37'4.9 days and in the standard feeding group, birth weight was regained at a mean age of 19.8'4.3. Full enteral feeding group regained birth weight at a mean age of 13.12'2.17 days and in standard feeding group at a mean age of 15.38'3.57and this was statistically significant (p - 0.009). Full enteral feeding group babies had lesser number of days of intravenous fluids compared to babies in standard feeding group. It was statistically significant (p - 0.003).Conclusions: Full enteral feeding practices from day one of life with human milk is feasible, cost effective and safe in hemodynamically stable VLBW infants and results in earlier regain of birth weight

A randomized controlled pilot on chronic non-specific low back pain treated with the superficial needling therapy combined with mild moxibustion / 中国针灸

OBJECTIVE@#To compare the differences in the clinical therapeutic effects on chronic non-specific low back pain (CNLBP) between the combined treatment of the superficial needling technique and mild moxibustion and the traditional warm acupuncture.@*METHODS@#A total of 60 patients were randomized into a combined treatment group and a warm acupuncture group, 30 cases in each one. In the combined treatment group, the superficial needling technique was used in combination with the mild moxibustion with moxa box at the muscle region of the bladder meridian on the back. In the warm acupuncture group, the traditional warm acupuncture was adopted on the lumbar region and the upper back. Each treatment lasted 30 min, 3 times a week. The treatment was provided continuously for 3 weeks. The follow-up visit lasted 3 months. Separately, before, 3 times after treatment and at the end of treatment, as well as after the follow-up visit, the visual analogue scale (VAS), the range of motion of the lumbar region (ROM) and the Oswestry disability index (ODI) were observed in the patients of the two groups.@*RESULTS@#During and at the end of treatment, as well as at the follow-up visit, VAS score, ROM and ODI were all improved as compared with those before treatment in the two groups (all <0.05). The results in the combined treatment group were better than those in the warm acupuncture (all <0.05). At the end of treatment and the follow-up stage, VAS score, ROM and ODI were better than those during treatment in the two groups (all <0.05). At the follow-up stage, VAS score, ROM of the backward extension and rotation of spine, as well as ODI were better than those at the end of treatment in the two groups (all <0.05).@*CONCLUSION@#The combined treatment of the superficial needling technique and mild moxibustion relieves pain, improves the ROM of the lumbar region and reduces the functional disability in CNLBP. This combined therapy achieves the better effects as compared with the traditional warm acupuncture and is high in the patient's compliance.

Comparison of clinical outcomes, patient, and surgeon satisfaction following topical versus peribulbar anesthesia for phacoemulsification and intraocular lens implantation: A randomized, controlled trial.

Background: Both cataract surgery and anesthesia techniques are rapidly evolving to become more patient friendly. However, comparison of topical anesthesia (TA) and peribulbar anesthesia (PA) for phacoemulsification and cataract surgery is limited. We evaluated the clinical outcomes and patient and surgeon satisfaction between anesthetic techniques. Materials and Methods: This randomized clinical trial was conducted between January and June 2012. Patients were randomly assigned to TA and PA groups for surgery. Visual acuity at 4 weeks postoperatively, status of the cornea and the wound and intraoperative complications were compared between groups at day 1, and 1 and 4 weeks after surgery. Patients and the surgeon completed a close‑ended questionnaire on satisfaction with analgesia and comfort. The relative risk (RR) with 95% confidence intervals (CI) was calculated. Result: There were 500 patients in each group. There were no significant differences between groups preoperatively. Complications at 1‑day postoperatively were significantly greater in the TA group (RR = 1.36, 95% CI: 1.17–1.58). Satisfaction with the mitigation of pain was statistically significantly greater in the PA group compared to the TA group (χ2 = 10.9, df = 3, P = 0.001). Surgeons were more satisfied with PA compared to TA (RR = 1.4, 95% CI: 1.34–1.63). There were more anesthesia‑related complications in the PA group compared to the TA group. Conclusions: Patients who underwent surgery with topical anesthetic experienced lower complications by more pain compared to patients who underwent PA. Topical anesthetic supplemented with analgesic medications could help the patient and surgeon during cataract surgery.