Comparison of oral ibuprofen and indomethacin on closure of patent ductus arteriosus in preterm infants

Although intravenous indomethacin and ibuprofen are widely used for closure of patent ductus arteriosus in premature infants, these formulations are unavailable in the Islamic Republic of Iran. In this study of the therapeutic effects of oral treatments, 20 preterm infants were randomized to oral ibuprofen [1x10 mg/kg, then 2x5 mg/kg at 24-hour intervals] or oral indomethacin [3 x 0.2 mg/kg at 24-hour intervals]. Complete ductal closure was seen in 7/10 of the indomethacin and 8/10 of the ibuprofen group. The difference was not significant. There was no reopening after the ductal closure during the hospital stay or in the follow-up visits in either group and no excessive increases in the blood urea nitrogen or serum creatinine levels were observed

Effect of cutaneous application of sunflower-seed oil on serum triglyceride and cholesterol levels in preterm infants

Intravenous lipid solution [intralipid] provides essential substances for optimizing growth in premature infants, but has potential side effects. We investigated the effects of dermal application of sunflower-seed oil [SFSO] as a substitute for intralipid in preterm infants. This study comprised of 20 preterm infants, unable to be fed enterally divided into case and control groups of equal numbers. SFSO was rubbed over the whole skin [1 gr/kg, three times daily] in case group only. Serum triglyceride and cholesterol levels were measured in both groups initially, and on the third and seventh day. The initial mean of serum triglyceride [TG] levels in the case and control groups were 42.6 +/- 15.5mg/dl and 45.2 +/- 14.0 mg/dl respectively. TG level had a steady state increase at three [47%] and seven [80%] days of cutaneous application of SFSO in the case group, whereas, it decreased steadily in the control group. The respective initial mean cholesterol levels in the study and control groups were 94.6 and 102.5 mg/dl which did not significantly change during the course of the study in both groups. This study is indicating that although, deficiency of essential fatty acids or their related clinical complications were not observed in either group, application of SFSO steadily improved the level of triglyceride in preterm infants. Therefore, dermal application of sunflower-seed oil is a noninvasive and economic way, and it appears to be a suitable non-complicated alternative for intralipid

Assessment of anxiety in 12-18 years old overweight and obese students in Isfahan

Childhood obesity has become a health hazard in different communities. In addition to organic disorders, it can also lead to some psychological disturbances such as anxiety. To compare the mean anxiety score between overweight and obese adolescents with controls, and to assess the correlation between the anxiety of adolescents with their school performance and the jobs of their parents. This case-control study was performed in 2003 among 266 students aged between 12-18. They were selected by multi-stage random sampling from among guiding-and high schools of Isfahan. Ninety three overweight and obese students [body mass index or BMI>85th age and gender specific percentile] were considered as the case group and 176 students with a BMI<85th percentile as controls. Two questionnaires, validated in a pilot study on 50 students, were completed by each subject. Data were analyzed by SPSS 11 software using the t-Student Chi-Square, ANOVA and Pearson correlation at p<0.05. The mean anxiety score and the school performance were not significantly different between two groups. A significant correlation was found between the parents' jobs and the mean anxiety score and school performance of their children. The students whose parents were an employee or teacher had a lower anxiety score and a better school performance. In spite of higher anxiety score in obese adolescents found in western countries, the present study was not indicative of any significant difference between two groups which is supposed to be mainly associated with a public opinion in which many people in our society yet believe that the obesity is an indicator of health. Larger longitudinal studies are recommended

[ study on the correlation between brain CT-scan and clinical findings in neonatal asphyxia]

Background: Brain damage resulting from perinatal cerebral hypoxia-ischemia is a major cause of acute mortality and chronic neurological disability in infants and children. Statistics suggest an incidence of systemic asphyxia up to 20 per 1000 full- term neonates. Between 20 to 50 percent of asphyxiated newborns who exhibit hypoxicischemic encephalopathy die during the neonatal period. Among the available neuroimaging modalities, brain CT-scan is superior as a new technique with a low cost. It is a non-invasive technique which can provide information about the nature and extent of cerebral damage

Patients and Methods: This is a cross-sectional analytical study performed for evaluation of neonates with asphyxia who were admitted in the neonatal wards of Nemazee and Hafez Hospitals, Shiraz. Inclusion criteria were a gestational age of more than 37 weeks, appropriate weight for gestational age, severe peripartum asphyxia, abnormal neurological signs and absence of major congenital anomalies. Staging of clinical findings was according to the Sarnat staging of hypoxic-ischemic encephalopathy which divided the cases into three groups. Correlation of clinical findings with brain CT-scan was performed during the first two weeks of life and the data were analysed using chi-square and Fisher's exact tests

Results: Forty-five neonates with asphyxia were enrolled in this study. There was a statistically significant difference between the three stages of clinical findings and brain edema [p=0.02] and possibility of brain edema was more in the higher stages [stage one: 10 percent, stage two: 45 percent, stage three: 66.7 percent]. Intracranial hemorrhage [ICH] was present in 15 cases [33.3 percent]. The incidence of intracranial hemorrhage in stages 1, 2 and 3 were 20, 20 and 60 percent, respectively [p=0.027]. There were 9 cases [20 percent] with normal and 36 cases [80 percent] with abnormal CT -scan findings which correlated directly with higher clinical stages. Abnormal findings in CT-scan were found in 75, 75 and 93.3 percent of the neonates in stages 1, 2 and 3, respectively, with 30 percent specificity and 83 percent sensitivity

Conclusion: According to clinical findings, severity of damage in asphyxiated neonates and its complications such as brain edema, intracranial hemorrhage and convulsion are directly related to brain CT-scan findings. Therefore, in the absence of access to CT-scan, patients may be managed according to clinical findings